FORM 3
[See Rules 3 (a) and 13]
LEARNER S LICENCE ’
Space for
passport size
photograph
Licence No .................................................. Date .................................
(Name to be written across the photograph)
Specimen signature / thumb impression
of the holder of the licence.
Signature and seal of
the licensing authority
1. Name : .........................................
2. Son/Wife/Daughter of : .........................................
3. Date of birth : ..........................................
4. Optional
Blood group : .........................................
RH factor :
5. Present / Permanent address : .........................................
Temporary / Official (if any) : .........................................
6. Mark (s) of identification (1) :
(2) :
is licensed to drive a motor vehicle of the following description throughout India and , in case of B-
rickshaw or B-cart, as a learner, subject to the provisions of Rule 3 of the Central Motor Vehicles
Rules, 1989.
The holder of the licence has passed the medical test under Rule 5 and the preliminary test referred
to in Rule 11(1) of the Central Motor Vehicles Rules, 1989.
The holder of the licence is exempted from the medical test under Rule 6 and from preliminary
test under Rule 11(2) of the Central Motor Vehicles Rules, 1989.
This licence is valid from ....................................... to
*Strike out whichever is inapplicable.
Signature and designation of the
Licensing Authority
Warning. The attention of the holder of this licence is drawn to Rule 3 of the Central
–
Motor Vehicles Rules, 1989, which prohibits him from driving any motor vehicle unless he has
besides him a person duly licensed to drive the vehicle and in every case, the vehicle carries
L plates both in the front and in the rear of the vehicle.
“ ”