Transport Department Haryana

Application Form for Heavy Vehicle Driver Training

Application Form No. 0406638 Online Submission date : 19-Feb-2021 13:52

1. Applicant Name SACHIN KUMAR

2. Applicant Father's Name SURENDER PAL

VPO BIHALI TEH ATELI DIST
3. Address MOHINDERGARH HARYANA PIN
CODE NO. 123021
4. Educational Qualification 12TH

5. Date of Birth 15-Aug-2000

6. Category (Gen./SC/BC) BC

7. Aadhaar Card No. (optional) 528536746705

8. Mobile No. 9485561204

9. LMV-NT/LTV Driving Licence Information

Licence Number HR35 20190005011

Licence Issue Date 31-Oct-2019
Licence Issuing Authority RLA NARNAUL

It is certified that above given informations are correct to the best of my knowledge.

Date : ........................
Place : ....................... ( Signature of Applicant )