Form 3 [see Rule 3(a),13] is licenced to drive throughout India as a learner subject to the

LEARNER LICENCE provisions of rule 3 of the Central Motor Vehicles Rules 1989, a motor
LL No. : MH12 /0269517/2023 DOI: 28-12-2023 vehicle of the following description
Name : AYAAN IMTIAZ KHAN ....................................................................
MCWG,
Father's Name IMTIAZ AKHTAR KHAN This Licence is valid from 28/12/2023 to 27/06/2024
Address : 311 B C D GURUWAR PETH ROSHNI *The holder of the licence has passed the medical test under rule 5 and
APT FLAT NO-11 Pune (M Corp.) Pune from the preliminary test referred to in rule 11(1) of the CMV Rules
City,Pune,MH,411042 ,1989.
*The holder of the licence has exempted from the medical test under
Temp. Add : 311 B C D GURUWAR PETH ROSHNI rule 6 and from the Preliminary test under rule11(2)of the Central Motor
APT FLAT NO-11 Pune (M Corp.) Pune
City,Pune,MH,411042
Vehicle Rules,1989

D.O.B. : 15-11-2005 B.G. : A+

Identification Marks :
Application No: 4798144623
(Sign/Thumb Of Holder) Licence Authority