FORM P. Co. P. A.

[ See rule 70(1) (iii) ]

Application for a Contract Carriage Permit
To, Full name and
The Regional Transport Authority, address of the
Region. applicant
I hereby apply for a permit in respect of a motor vehicle to be used as a
contract carriage as herein under set out :
1. The area or areas for which the permit is required
2. The type and seating capacity of the vehicle
3. The details of arrangements made for :
(i) Housing of the vehicle
(ii) Maintenance of the vehicle
(iii) Repair of the vehicle
4. Whether the applicant intends to carry goods in the vehicle, in addition to or to,
the exclusion of, passengers if yes, total weight and description
of the goods to be carried the vehicle
5. Particulars of any contract carriage permit held by the applicant within the State
and registration marks of all the vehicle covered by such permits

6. The details of any other permit held by the applicant within the State at the
registration marks of all the vehicles covered by such permits

7. The details of last three year’s record of payment of taxes in respect of vehicles
stated in item No. 5 above
8. The details of last three years’ record of suspension or cancellation of any permit
stated in item No. 5 above
9. Whether the applicant is in possession of the vehicle if
yes, the registration marks of such vehicle, if no, the details of arrangements
made/to be made to acquire the vehicle
10. Whether the applicant is a co-operative society/ex -serviceman
if yes, the details and the proof of such status
11. I hereby declare that the above statements are true, and that I have supplied all
the information and documents necessary to support the statements made in this
application.
12. I hereby agree that the statements made by me in this application shall be the
conditions of permit issued to me.
13. I herewith tender the fee prescribed in rule 71.
Date :
Place : Signature of the applicant.
Note : Where the space is not sufficient, the applicant should furnish the
information, item -wise on separate sheet must sign each sheet and must attach
them with the application.

* Strike out whichever is either not require or not applicable.