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    Kamran Altamash Khan
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    This document is a registration form showing the enrollment of a trainee in a driving school establishment. It provides details about the trainee such as name, address, date of birth, date of enrollment, learner's license number and date of issue. It also shows the course of training, period of training and signature of the license holder/instructor.

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    This document is a registration form showing the enrollment of a trainee in a driving school establishment. It provides details about the trainee such as name, address, date of birth, date of enrollment, learner's license number and date of issue. It also shows the course of training, period of training and signature of the license holder/instructor.

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    © All Rights Reserved
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    14 views1 page

    1058form14ReportPrint Do

    Uploaded by

    Kamran Altamash Khan
    This document is a registration form showing the enrollment of a trainee in a driving school establishment. It provides details about the trainee such as name, address, date of birth, date of enrollment, learner's license number and date of issue. It also shows the course of training, period of training and signature of the license holder/instructor.

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    of 1

    FORM 14

    [See rule 27(a)]


    REGISTER SHOWING THE ENROLLMENT OF TRAINEE(S)
    IN THE DRIVING SCHOOL ESTABLISHMENTS

    Register for the year 2022

    1. Enrollment number 25284/1058

    2. Name of the trainee PRADIP GOPINATH GAJBHAR


    3. son/wife/daughter of GOPINATH GAJBHAR
    4. Address
    (a) Permanent Address , at.aregaon(tanda) post.moha (ijara) tq.pusad ,Aregaon Khurd
    Yavatmal Maharashtra,445204

    (b) Temporary Address/official address(if , at.aregaon(tanda) post.moha (ijara) tq.pusad ,Aregaon


    Khurd Yavatmal Maharashtra,445204

    28-10-1997
    5. Date of birth

    6. Date of enrollment 14-09-2022

    7. Learners's licence number and date of it's MH29 /0037205/2022 08-03-2023

    8. Date of passing the test of competence to drive


    9. Driving licence number and date of issue and the 03/MH27/2018 15-02-2018
    licence authority which issued the
    MH29

    Course of Training in Driving Period Remarks

    From To

    LMV-TR null null null

    13. Signature of the licence holder/instructor

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