3/17/22, 7:47 AM Nigeria Driver's Licence

Application Details ML 15R

Application Id 17032022915684 Application Date (dd/mm/yyyy) 17/03/2022
Application Type Renew DL Application Validity Period 5-Years
Class of Licence Applied for B Do you want to recapture? Yes
You are expected to visit your
selected DLC to complete your
application.
Reason for Renew Expired Comments NONE
D/L Number SAP00959AA01 First State of Issuance Edo
First Issued Date (dd/mm/yyyy) 02/03/2009
Personal Details
Applicant's Name Nkechi Julia Odili Mother's Maiden Name EUNICE ENEBELI
Gender Female Height (In Meters) 1.6
Date of Birth (dd/mm/yyyy) 04/03/1984 Blood Group O+
Tax Identification Number NA State of Origin Delta
(TIN)
LGA of Origin Ndokwa East Nationality Nigeria
Facial Mark No Do you require glasses for No
driving?
NIN Number NA Any Form of Disability No
Contact Details
Mobile Number 08035819313 Next of Kin Phone Number 07037855700
Email Address nkemgirl@yahoo.co.uk
Residential Address
Address Line1 124 Address Line2 SAPELE WARRI ROAD
City SAPELE State Delta
Local Government Area (LGA) Sapele Postal Code NA
Mailing Address
Address Line1 124 Address Line2 SAPELE WARRI ROAD
City SAPELE State Delta
Local Government Area (LGA) Sapele Postal Code NA
Payment Details
Payment Status Payment Confirmed Validation Number 67541574638
Payment Gateway Innovate1Pay (Card) Payment Date (dd/mm/yyyy) 17/03/2022
Processing Details
State Delta Local Government Area (LGA) Sapele
Capture Center Sapele

I declare that the information provided in this document is true and binding on me. I will notify the appropriate authorities of any changes therein.
____________________________
Applicant Signature / Date

For Official Use only: Processing State Board of Internal Revenue Officer's Details
Have you checked payment status? (Fill in 'Yes' or 'No' ): __________
I hereby declare that the applicant has made payment for this transaction and affirm here that this information is true to the best of my knowledge.
_____________________________________________________________________________ ___________________________________________________________
State BIR Officer's Name Signature / Date

For Official Use only: Road Traffic Officer's Details

Vision Test Result: ______________________________________________
Does applicant require glasses to drive? (Fill in 'Yes' or 'No')
Have you checked all the details given by the applicant? (Fill in 'Yes' or 'No') _______________
Do you recommend issuing licence? (Fill in 'Yes' or 'No') ____________________________
Ref: No Road Traffic Officer ___________________________________________________________________________
I hereby declare and affirm that all the information stated on this form are true to the best of my knowledge.
______________________________________________________________________
Test Officer's Name
______________________________________________________________________
Signature / Date
Date of Test: ______________________________________________
If yes, indicate Class(es):_______________________________
________________________________________________________________________
Authorizing Officer's Name
________________________________________________________________________
Signature / Date

[Application is valid for 12 months from the date of payment.]

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