Appl.
No: 3158528525 Dt:06-08-2025 FORM 4-A
[See Rule 14(2)]
FORM OF APPLICATION FOR ISSUE OF INTERNATIONAL DRIVING PERMIT
TO DRIVE A MOTOR VEHICLE IN OTHER COUNTRIES
To
The Licensing Authority,
RLA BALLABGARH (NT)
I apply for an International Driving Permit to enable me to drive vehicles of the following categories:-
CATEGORIES OF VEHICLES FOR WHICH THE PERMIT IS APPLIED FOR
(A) Motor Cycles Category L1 and Category L2;
PARTICULARS TO BE FURNISHED BY APPLICANT
1. Name : VIVEK SHARMA
2 Father's Name : V.P SHARMA
3. Place of Birth and Country (Proof : Delhi
to be enclosed)
4. Address :
(a) Present : [Link]. 1134 SEC-7/C BLB FBD, BALLABGARH,FARIDABAD, 121004
(b) Permanent : [Link]. 1134 SEC-7/C BLB FBD, BALLABGARH,FARIDABAD, 121004
(c) Email : vivekpoorav@[Link] (d) Mobile : 9467761134
m
5. Date of Birth (Proof to be enclosed): 13-10-1995
6. Educational Qualification : Graduate in Non Medical Sciences
7. Identification marks :
8. Blood Group/RH factor : B+
9. Have you previously held :
International Driving Permit ? If so
give details
10. Particulars and date of every :
conviction which has been ordered
to be endorsed on any driving
licence held by the applicant.
11. Have you been disqualified for
obtaining driving licence to drive ? If
so, for what reason ?
(a) Have you been disqualified for : No
obtaining a driving licence to
drive?
(b) Have you been barred by the : No
current
country to drive in that country?
12. Have you been subjected to a : .......................................................................................................
driving test as to your fitness or
ability to drive a vehicle in respect of
which a driving licence is applied for
? If so, give the following details
Date of Test Testing Authority Result of Test
1)
2)
3)
4)
13. I enclose three copies of my recent passport size photograph.
14. I enclose the copy of driving licence No. HR-2920140072115
..................................................
dated :01-08-2014 RLA BALLABGARH (NT) 31-07-2034
.......................... issued by ............................................................................valid upto:
[Link] address where I wish to collect my IDP,(applicable only in case if applicant is applying from a
Foreign Country after expiry of IDP issued during his current stay)
16. I have paid the fee of Rs.
I hereby declare that the particulars given above are true to the best of my knowledge and belief.
06-08-2025
Date: .................................. Signature / Thumb Impression of Applicant.
* Strike out whichever is inapplicable.
Booking ID: GOFLISTAFKXA2822795
Flight booked on 12 July
Barcode(s) for your journey Delhi-Abu Dhabi on ETIHAD AIRWAYS
Vivek Sharma
Barcode(s) for your journey Abu Dhabi-SCHWECHAT INTL on ETIHAD AIRWAYS
Vivek Sharma
Your Delhi - SCHWECHAT INTL flight is booked for travel on
Wed, 03 September
Thank you for booking with us. We wish you a pleasant journey!
Your trip details
Delhi - SCHWECHAT INTL
Wed, 03 Sep 2025 • 1 stop • 12h 50m duration
ETIHAD Delhi Abu Dhabi
AIRWAYS
EY-217
DEL 21:15 hrs 3h 35m 23:20 hrs AUH
Operated by Wed, 03 Sep Wed, 03 Sep
ETIHAD
AIRWAYS Indira Gandhi International Abu Dhabi Intl Terminal A
Airport Terminal 3
PNR 9O3X7Z
YVALUE Economy Regular Fare
Check-in: 30 Kgs per Adult Cabin: 7 Kgs (1 Piece only) per Adult
TRAVELLER SEAT MEAL E-TICKET NO
MR. VIVEK SHARMA Adult 607-3093994067
3h 10m layover in Abu Dhabi
Change in FLIGHT
ETIHAD Abu Dhabi SCHWECHAT INTL
AIRWAYS
EY-153
AUH 02:30 hrs 6h 5m 06:35 hrs VIE
Operated by Thu, 04 Sep Thu, 04 Sep
ETIHAD
AIRWAYS Abu Dhabi Intl Terminal A Vienna International Terminal
3
PNR 9O3X7Z
YVALUE Economy Regular Fare
Check-in: 30 Kgs per Adult Cabin: 7 Kgs (1 Piece only) per Adult
TRAVELLER SEAT MEAL E-TICKET NO
MR. VIVEK SHARMA Adult 607-3093994067
You have also bought the following add ons
Visa Protection Guarantee Go to MyTrips
You can claim the benefit up to 24 hours before departure.
Booking ID: GOFLINTAFKXE6766563
Flight booked on 12 July
Your SCHWECHAT INTL - Venice flight is booked for travel on
Thu, 04 September
Thank you for booking with us. We wish you a pleasant journey!
Your trip details
SCHWECHAT INTL - Venice
Thu, 04 Sep 2025 • Nonstop • 1h 5m duration
AUSTRIAN SCHWECHAT INTL Venice
OS-523
Operated by
VIE 12:50 hrs 1h 5m 13:55 hrs VCE
AUSTRIAN Thu, 04 Sep Thu, 04 Sep
Vienna International Terminal Marco Polo
PNR FRH5AH
3
Economy Classic Economy Regular Fare
Check-in: 23 Kg(1 PC x 23Kg each) per Adult Cabin: 8 Kg(1 PC x 8Kg each) per Adult
TRAVELLER SEAT MEAL E-TICKET NO
MR. VIVEK SHARMA Adult 7F 257-28188117505
You have also bought the following add ons
Visa Protection Guarantee Go to MyTrips
You can claim the benefit up to 24 hours before departure.
8/6/25, 10:11 PM DL Services Acknowledgement
Application Reference Slip
Application No : 3158528525 Name : VIVEK SHARMA
Application Date : 06-08-2025 Date of Birth : 13-10-1995
Blood Group : B+ Father's Name : V.P SHARMA
Applicant Gender : Male DL NUmber : HR-2920140072115
DL COVs : MCWG,LMV NT Validity : 01-08-2014 to 31-07-2034
Services Requested Documentary Proof Required
• Passport
1. ISSUE INTERNATIONAL DRIVING
• Driving Licence
PERMIT
• Medical Certificate-Form1A
Application Number is generated for the above mentioned services. The application number is:
3158528525 .
An SMS has been sent to your registered mobile Number : ******1134 .
Note 1: Applicant should take print out of the
Application Form (pre filled)
and duly signed with all required Documents to the concerned RTO / RLA office.
2: The online facility of application submission, upload documents, payment of fees, slot booking
etc., does not complete the process of issue of Driving Licence or any other Service requested. The
applicant has to compulsorily visit the concerned Regional Transport Office to finish the process of issue
of Driving Licence and/or any other associated services.
3: Applicants are requested to note that after completion of all stages mentioned under `Applicant
Stages’, the applicant has to visit the concerned Regional Transport Office on the scheduled date of
appointment, along with the necessary documents to complete the remaining process (or) In cases where
online slot booking facility is not available for any particular RTO, the applicant has to go to the
concerned Regional Transport Office at the earliest along with the necessary documents, to complete the
remaining process.
For any reference visit: [Link]
Applicant Address : RTO Location :
[Link]. 1134 SEC-7/C BLB FBD RLA BALLABGARH (NT)
BALLABGARH,FARIDABAD RLA-CUM-SDM PANCHYAT BHAWAN ,
Pincode : 121004 NEAR AGGARWALDHARAMSHALA,
BALLABHAGARH-121004
Phone: 0129-2304500
Application Form (pre filled)
Print Acknowledgement
[Link] 1/1