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ZIMBABWE NATIONAL ROAD ADMINISTRATION

Application for Tollgate Exemption Ticket


(To be accompanied by the vehicle registration book and appropriate fee)

The Registering Officer. .. I (Full name).. being the owner of vehicle registration number . which is, or is to be ordinarily kept at night at Tollgate Area.... apply for an Exemption Ticket in respect of the above vehicle for the period From.. to I certify that to the best of my knowledge and belief, that I reside within the periphery of the tollgate and the documents attached are true and correct. (Signature of Applicant)
NB: Applicant must attach the following documents: a. b. c. d. Confirmation slip of current residential address; either Bank Statement or Water/ZESA or phone bill. A letter of proof of residence from the local / district Vehicle Registry Book with current residential address of the applicant. National identity card, Passport or drivers licence

(Date)

FOR OFFICIAL USE ONLY The Registrar, I certify that this application is in order and that Exemption ticket No. has been issued.

. Registering Officer

DATE STAMP

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