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FORM 3

[See Rule 3(a) and 13]

LEARNER'S LICENCE

Fee Details Rs.0.0/- / / ApplNo: 2209607724

1. Licence No. MP17 /0018919/2024

2. Name ROSHANI KHAN

3. Husband Name SANJAY KHAN

4. Date of Birth 12-01-1996

5. Optional/Blood Unknown
Group-RH Factor

6. Present Address ward no 39 binda kuan bichhiya Rewa


Huzur Huzur Rewa Madhya
Pradesh,486001 Holder's Signature

7. Permanent Address ward no 39 binda kuan bichhiya Rewa


Huzur Huzur Rewa Madhya
Pradesh,486001
(1)
8. Marks of Identification
(2)

is licenced to drive throughout India as a learner subject to the provisions of rule 3 of


the Central Motor Vehicles Rules 1989, a motor vehicle of the following description

LIGHT MOTOR VEHICLE, Motor Cycle with Gear(Non Transport),


.......................................................................................................................................

*The holder of the licence has passed the preliminary test referred to in rule 11(1) of
the CMV Rules ,1989.

*The holder of the licence is exempted from the medical test under rule 6 and from
the Preliminary test under rule11(2)of the Central Motor Vehicle Rules,1989

*Strikeoff which ever is inapplicable

This Licence is valid from 18/06/2024 To 17/12/2024

Licensing Authority
Warning: RTO,REWA RTO
The attention of the holder of this licence is drawn to rule 3 of CMV Rules, 1989 which
prohibits him from driving any motor vehicle unless he has besides him a person duly
licenced to drive the vehicle and in every case , the vehicle carries "L" plates both in
front and in the rear of the vehicle.
Note:
a. This is a computer generated Document. No signature is required.
b. This Learners Licence is issued based on the Information and declaration
submitted by the applicant with regards to his/her physical fitness to drive a Motor
Vehicle and liable for cancelation if found incorrect/ unfit to drive.

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