TRANSPORT DEPARTMENT

TRANS GOMTI OFFICE, LUCKNOW

FORM 3
[See Rule 3(a) and 13]
LEARNER'S LICENCE

Fee Details Rs.300.0/- /UPV/2420410 /18-06-2022 ApplNo: 2390730222 Issue Dt. 18-06-2022

1. Licence No. UP32A/0009096/2022

2. Name ANANT VERMA

3. Father's Name VINAY KUMAR VERMA

4. Date of Birth 23-10-2000

5. Optional/Blood Group- AB+

RH Factor

6. Present Address 495/19 MAYA NAGAR NIRALA NAGAR

Lucknow,UP,226020
Holder's Signature

7. Permanent 495/19 MAYA NAGAR NIRALA NAGAR

Lucknow,UP,226020

(1) INJURY MARK ON HEAD

8. Marks of Identification
(2)
is licenced to drive a Motor Vehicles of the following description through out India and in case of E-
rickshaw or E-cart, in specified areas or routes, as a learner,subject to the provisions of Rule 3 of
the Centeral Motor Vehicle Rules 1989:
Motor Cycle with Gear(Non Transport), LIGHT MOTOR VEHICLE,
.......................................................................................................................................

*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

*Strike off which ever is inapplicable

This Licence is valid 18/06/2022 To 17/12/2022

Signature and Designation of

the Licensing Authority
Warning: TRANS GOMTI OFFICE,
LUCKNOW
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.