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Ch) Rae Show AR adore Ce oTeISe @ (8) WTA 6 Crary Bate Bats Ti BAS ARO OB Vora Seats at Vey, aah oTARyorky a ca Stel SHYGASTCA Offre abe CaIBaaIA BtRA-Dd cuba ate Grr BE Beate tera Fea AC MRC AAT AT wat Veet ere wears Faathaw ras GR RAPS Eon AB TROT A FARTS TH STS THA AI! eH Sweater COAT TRTOAE a, OTA GAT HA GIT A TAR yAeTOT ATR etal A SIR otra HRA CRe AcE CHOATE sete Fiat ertetad eters TY R05 AIH | cabs coment RS: TRC RaTIETA BICATANTE ALE a cafe BRC ACT arses ea oP waCH RR ak caferwr onitfece ARC AEBS caer Srrebarits BET at AAS AOS VACay TTT aT ayes SHR eae cafe aia ah tap aI SHS ITeA @ Gera BEG VALS AH) | ores, weet aurea a1 Seer aQe Bias aeons (Di) Application Form Insiucsone 4-16 and 20-28 must be filled up. 9 must be fled by te foreign driving cence holders or foreigners. 43 Passport size Photograph, Maney Recoipt, copy of National ID, Tost Result et. should be attached. 4. Please fil in each bax with one character and leave an empty box afler each word. ‘Only use CAPITAL letters in English, SECTION A 1, whi tftewsia =z_/ National Identification Number: 2. ASIAN / Date of Birth: _asmm X 45mm Bonderines Colour Photo owe ‘ithe phota wit a ‘of us in te box et PAGE 1412, a6ata fee / Present Address: HouseMVillage/Road: Other Citizenship: tyes, country: . ‘ontact Details: ‘Tami (PT) / Phone Number (Res.): Te {Phone Number (Cell): ‘tam Cafe) / Phone Number (Office): 16. weet ecarers tanticamt / Emergency Contact Person's Details: * Please attach copy of work permit / recommendation from Ministry of Foreign Affairs, passport and visa, foreign licence BANGLADESH ROAD TRANSPORT AUTHORITY! tving Lanes Application Form PAGE 21620. 22. 23, 24, 25, 26, 28. 29. 30. 31. 32. SECTION B BRTAOfice Code: 21. Bank Transaction Number: Most Recent DL./ Leamer Licence Number (Not applicable for leamer application): ‘REE AIH / Driving Licence will be printed in mer English “wieenreitta gf / Applicant Type General Defense Personnel Foreigner [| Diplomat “Siem ‘3H / Application Type: a) Leamer Licence [| b) DL tssue ¢) Renewal | ] d) Duplicate ) Addition to DL [_ |) Change of Vehicle Class [| g) Change Type of Licance [| h) PSV 1) Change of Address a) rer / b) Wie wim Ryze / a) Learner Licence /b) DL Issue Instructor's Licence Number {Not Required for Motorcycle): 27. st&-Iet <# / Type of Licence: Professional Non-professional ‘abate CHA / Class of Vehicle: ‘Tera / Professional: ‘Three Wheeler Light Vehicle Medium Vehicie Heavy Vehicle “Serta / Non-professional: Motorcycle Light Vehicle Other, specify: at Fem PRCT TIORRCRS 9 CORT BETTE RETF FF / Please attach medical certfficate form and others ©) =a / Renewal + Rd FT IRV IRR RIT FT TENN FAT / Please attach @ copy of ald driving licence €) 291% / Duplicate Ta SIREA SIA REIT / Select a reason to apply: Lost Damaged | | Other, specify: «+ ate Rice eee Perit srearte Bivrer IaCaTT eT | Were eT Meo war fT | / Hf lost, please attach copy of GD papers. Otherwise please submit your existing licence. ‘©) "exten / Addition to Driving Licence vaitzeraa 70a Gt / Existing Vehicle Class: ‘Three Whesler [| Light Vehicle |__| Medium Vehicle Heavy Vehicle [_ | Motorcycle ‘Cafe aA FCAT / Adit ‘Three Whesler [| Light Vehicle |__| Medium Vehicle Heavy Vehicle [| Motorcycle Other, specity: rat ren tihete errecT a 8 5H Mito FEAT FPF / Please attach a copy of test result and existing Af catterene at oferes (cam othe BEAT) / Change of Vehicle Class (Conthued on the next page) ‘Tabet qaTeT TAA / Old Vehicle Class: ‘Three Wheeler |_| Light Vehicle |__| Medium Vehicle Heavy Vehicle [__| Motorcycle Other, spectty: BANGLADESH ROAD TRANSPORT AUTHORITY! Otving Leanee Application Form83, CHaUTAT ABT ZA / New Vehicle Class: ‘Three Wheeler |_| Light Vehicle [| Medium Vehicle Heavy Vehicle [| Motorcycle Other, specity: FR yan ene ere FM 8 TERT ROT TORN FT / Please attach a copy of test result and existing 8) “RTT 4 afte / Change of Licence Type 34. Change Type to: Non-Professional to Professional |__| Professional to Non-Professional 35. If changing from Non-Professional to Professional, please select any of the fol ‘Three Wheeler Light Vehiole Medium Vehicle Other, specity: If changing from Professional Motorcycle Light Vehicle Other, specity: * Sir hy Pani (PSV ty site ere 9 sa test resuft and RTC approval copy 1) emt afteéy J Change of Address 36. New Address: House/Village/Road: of the witiceis / Postcode/Zip: ‘38. DGTB Serial No ‘89. RTC Approval Date (if Applicable): deciare that the information provided in the application form is accurate and complete, \F any false information is found | will be liable to legal prosecution. a ete eH a CTT HT HAE RT | CHT FRY eS Frm CH eT eS MET | 41, wf / Date: 42, stammetta Wa / Applicant's Signature: Movement Register Scroll Number: REF Date: prosenseony Deaitng Assistant ‘Vertted by Motor Vaicie Inspector “Approved by Lcencing Autotly (LA) BANGLADESH ROAD TRANSPORT AUTHORITY! Otving Leanee Application Form PAGE 414Medical Certificate Form for BRTA Driving Licence Intructone: {Please ll lp each box with one character and leave Applicant Detalls 1, What is the applicant's apparent age? 2. Is there any defect of vision? ‘Yes No '80, has it been corrected by suitable spectacles? []y¥es [| No 4. Can the applicants readily distinguish the pigmentary colors red and green? [Yes [| No 5. Does the applicant suffer from night blindness? LJ ves [] No 6. Does the applicant suffer from a degree of deafness which wound prevent his hearing the ordinary sound signals? Yes No 7. Has the applicant any deformity or loss of members which would interfere with the efficient performance of his duties as a driver? Yes No 8. Does he show eny evidence of being addicted to the excessive use of alcohol or drugs? ‘Yes No 9. Is he, in your opinion, generally fit as regards (a) bodlly health, and (b) eyesight? C [] No ntification 14, Medical Practitioner's Signature: 15. Date PAGE AN