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FORM 3

[See Rule 3(a) and 13]


LEARNER'S LICENCE

Fee Details Rs.150.0/- /GJV/1958334 /13-11-2022 ApplNo: 4409901722

1. Licence No. GJ06 /0050380/2022

2. Name VARUN KETAN JAJAL

3. Father's Name KETAN P JAJAL

4. Date of Birth 31-08-2002

5. Optional/Blood A+
Group-RH Factor

6. Present Address B-12 VISWAMITRY DHAM SOC


Vadodara (M Corp. + OG) BESIDES
SARVAM HEIGHTS,390011 Holder's Signature

7. Permanent B-12 VISWAMITRY DHAM SOC Vadodara


(M Corp. + OG) BESIDES SARVAM
HEIGHTS,390011
(1)
8. Marks of Identification
(2)

is licenced to drive throughout India as a learner subject to the provisions of rule 3 of


the Central Motor Vehicles Rules 1989, a motor vehicle of the following description

MCWG,
.......................................................................................................................................

This Licence is valid 18/11/2022 To 17/05/2023

Licensing Authority
Warning: RTO,VADODARA

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.

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