Application for the grant of National Permit

To,
The Regional/State Transport Authority,
I/We, the undersigned hereby apply for the grant of National Permit valid throughout the territory of India/in the State of ........................................(here write the name of the States desired)

1. Name of the applicant(s) in full.

2. Status of the applicant, whether individual, company or partnership firm, Co-operative Society, etc.

3. Name of father or husband (in case of individual) and in case of company or firm the particulars of managing partner or managing director as the case may be.

4. Full address : (to be supported by attested copy of ration card, electricity bill, etc. in case of individuals or any other valid documentary proof to the satisfaction of State Transport Authority/Regional Transport Authority and in case of company or firm the certified copy of the Memorandum of Association or copy of the deed of partnership as the case may be).

5. (a) Whether applicant himself intends to drive the vehicle.

(b) (i) If so, whether applicant holds Heavy Goods Vehicle Driving Licence.

(ii) The number, date and validity period of the driving licence.

(iii) Name and address of the Licensing Authority.

6. Registration Certificate along with the date of first registration, Insurance Certificate.

7. Details of any other permits if held in respect of a particular vehicle.

8. Details of number of national permits held by the applicant.

9. Type of vehicle, whether two-axle truck, or articulated vehicle or mutli-axle vehicle or tractor trailer combination.

10. Make of motor vehicle.

11. Particulars of convictions/suspensions/cancellation, if any, during the past three years in respect of the vehicle/permits held by the applicant(s).

12. I/We forward herewith the certificate of registration of the vehicle or I/we will produce the certificate of registration of the vehicle before the permits are issued.

13. I/We hereby declare that the above statements are true and that I/We am/are the resident(s) of the State having principal place of business in this State at ........................

14. I/We have paid the fee of rupees...

Date :........................
Signature or thumb impression of the applicant.