Existing Licence

Form of Application for Services on Existing Licence to Drive a Motor Vehicle

To The Licensing Authority

Application Number

LL DL

Aadhaar No:

2 Name of the applicant

Gender

or 2.2 Age(In Years)

First Name Middle Name Last Name

1. Specify the details of the DL already held by the applicant

Licence Number * Type State Licencing Authority that Issued * Date of Issue (D D -M M -Y Y Y Y)

Part A

State

Name of the RTO/DTO Office

EXISTING

Male Female Others

2.4 Place of Birth

2.4(a) If place of birth is out side India, Month & Year when migrated to India: Month Year

2.4(b).Country by Birth

2.6 Email Address

2.1 Date of Birth (dd-mm-yyyy)

2.5 Citizenship Status By Birth Non IndianNaturalization Registration Descent

*

*

*

*

*

*

*

*

(Read the instructions on page-5 carefully before filling the form)

2.3 Mobile Number*

Part B3.1*Requested Transaction Service (with class of vehicle)(DL Revalidate is renewal of Driving Licence that was expired 5 years back)

S.No. Description of Vehicle Type Duplicate LL

DL Transactions Add a new COV

PSV Badge

Surrender of COV

Re Validate

S.No. Description of Vehicle Type Duplicate LL

DL Transactions Add a new COV

PSV Badge

Surrender of COV

Re Validate

Registeration Certificate Number

If Request is for duplicate LL then specify LL No.

1

2

3

4

LL

LL

LL

LL

3.2.Requested Transactions

S.No. Requested Transactions (Independent of Class of Vehicle)

Licencing Authority Code




Part C

4) List of Enclosures (Applicant should produce the original documents before the Licensing Authority at the office. )

Document Type Licence Number/Certificate No./Badge No., etc Issuing Authority/RTO Code Date of Issue

(DD-MM-YYYY)

5. if Request includes Change of Name

First Name Middle Name Last Name

a)Applicant Name Changed as

Part D

f) Village / Town / City

g) Taluka / Mandal

h) District

i) State Code

j) PIN code

Years Months

k) Phone

l) Mobile

m) Duration of Stay at this address

Present Address is same as Permanent Address

e) Locality

d) Street

6. If Request includes Change of Address: (provide the details)

Permanent Address changed as

a) Flat Number

b) Flat / House Name

c) House Number/Plot No

Present Address changed as

Reasons for Late Renewal / DL Not Attached, etc

Years Months

Application Number

*

*

8. I have been convicted / disqualified / my Licence was cancelled /suspended / my Licence was revoked

Yes No

(If Yes, attach Documents):

If Yes, DL Number Date of Conviction (dd-mm-yyyy)

Reason

I hereby declare that to the best of my knowledge and belief the particulars given above are true and I have enclosed all the necessary documents required as per the rules.

Signature or Thumb impression of the Applicant

7. I have submitted along with my application for Learners Licence,. I enclosed all the Necessary Enclosures / Certificates: -

Yes No

Part E

Date

Application Number

This form can be used for applying for services on Existing Learner's Licence (LL) or Driving Licence (DL). Please fill up the data with CAPITAL letters only. Columns marked as ( *) are mandatory. Enclosures: The Applicant should produce the proof for claims made in the Application where ever necessary. A set of codes defined for each of such type of enclosures to the application is shown in HELP section ( See Code List - A,B,C) The Licensing Authority Code or RTO Code: The RTO/DTO/RLA office under whose jurisdiction the applicant resides or his/her place of business. Name of the Applicant : Fill the Applicant's name in the order of first name, middle name and surname/family name. However, ensure that the name is entered as per the relevant records being produced as proof. Eg. JANGA REDDY CHEBANDI, DEVSINGH NAIK, SULTAN ISMAIL MOHAMMED Class or type of Vehicle(COV): Different class of vehicles are given in column 3.1. If the requested service is Add a new COV, then at least one class / type of vehicle should be selected to fill the unified application form. Part- A : Specify the details of the DL already held by the applicant i.e 1 of Part A Part - B : It is mandatory to select at least one service from column 3.1 or 3.2. If the service is for duplicate LL, then the LL Number has to be mentioned in column labelled as If Request is for duplicate LL then specify LL No. Part - C: It is mandatory to fill column 4 to provide details on the required documents like age proof, qualification proof etc. If you are holding a DL or LL , please mention those details also in these columns. Part - D: Fill column 5 if the requested service is for Change of Name, column 6 if the requested service is for Change of Address Part - E: The applicant shall fill in this part wherever applicable. Part - F: For Office Use only.

Instructions for filling up the Unified Application Form for Existing Services on a Licence

1.2.3.4.

5.6.

7.

8.9.

10.

11.12.13.

form1[0]: #subform[0]: Subform1[0]: DDL_STATE[0]: TXT_APPLNO_0[0]: RD_LICENCE[0]: Off

TXT_UID[0]: DDL_RTO[0]: DT_DOB[0]: TXT_AGE[0]: TXT_APP_FNAME[0]: TXT_APP_MNAME[0]: TXT_APP_LNAME[0]: LicDetailTbl[0]: Row1[0]: TXT_LICENCENO[0]: TXT_LICENCETYPE[0]: DDL_ISS_STATE[0]: TXT_ISSAUTH[0]: DT_ISSUE[0]:

Button2[0]: RD_GENDER[0]: Off

Button3[0]: Button4[0]: TXT_PLACEOFBIRTH[0]: TXT_MONTH[0]: TXT_YEAR[0]: TXT_EMAIL[0]: DDL_COUNTRY[0]: RD_CITIZENSHIP[0]: 0

TXT_APDMOBILE[0]:

#subform[2]: PARTBTEXT[0]: VehicleTypeTbl[0]: Row1[0]: TXT_SLNO[0]: TXT_VEHICLETYPE[0]: CHK_DUPLL[0]: OffCHK_NEWCOV[0]: OffCHK_PSVB[0]: OffCHK_SURRCOV[0]: OffCHK_REVALID[0]: Off

Row1[1]: TXT_SLNO[0]: TXT_VEHICLETYPE[0]: CHK_DUPLL[0]: OffCHK_NEWCOV[0]: OffCHK_PSVB[0]: OffCHK_SURRCOV[0]: OffCHK_REVALID[0]: Off


















#subform[5]: TXT_RCNUMBER[0]: TXT_LLNO1[0]: TXT_LLNO2[0]: TXT_LLNO3[0]: TXT_LLNO4[0]: Req_TransTbl[0]: Row1[0]: TXT_SLNO[0]: TXT_REQTRANS[0]: CHK_TRANS[0]: Off

Row1[1]: TXT_SLNO[0]: TXT_REQTRANS[0]: CHK_TRANS[0]: Off











TXT_OLACD1[0]: TXT_OLACD2[0]: TXT_OLACD3[0]: TXT_OLACD4[0]:

#subform[7]: EncTypeTbl[0]: Row1[0]: DDL_ENCTYPE[0]: TXT_CERTNO[0]: TXT_ISSAUTH[0]: DT_ISSUE[0]:

Row1[1]: DDL_ENCTYPE[0]: TXT_CERTNO[0]: TXT_ISSAUTH[0]: DT_ISSUE[0]:




TXT_FNAME[0]: TXT_MNAME[0]: TXT_LNAME[0]: TXT_DIST[0]: TXT_MANDAL[0]: DDL_STATE1[0]: TXT_PIN[0]: TXT_PHONE[0]: TXT_MOBILE[0]: TXT_APPLICANTDUYRS[0]: TXT_APPLICANTDUMNTHS[0]: CHK_TEMP[0]: OffTXT_LOCALITY[0]: TXT_CITY[0]: TXT_STREET[0]: TXT_FLATNO[0]: TXT_FLATNAME[0]: TXT_HOUSENO[0]: TXT_PST_FLATNO[0]: TXT_PST_FLATNAME[0]: ImageField1[0]: TXT_REASON1[0]: TXT_PST_PIN[0]: TXT_PST_DISTRICT[0]: TXT_PST_PHONE[0]: TXT_PST_MOBILE[0]: TXT_PST_DURYRS[0]: TXT_PST_MONTH[0]: TXT_PST_MANDAL[0]: DDL_PST_STATE[0]: TXT_PST_STREET[0]: TXT_PST_LOCALITY[0]: TXT_PST_CITY[0]: TXT_PST_HOUSENO[0]: TXT_APPLNO_1[0]:

#subform[9]: RD_CONVICTED[0]: 1

TXT_DLNO[0]: DT_CONVICTION[0]: TXT_REASON[0]: Button1[0]: PrintButton1[0]: TXT_FORMSTATUS[0]: RD_CERTIFICATE[0]: 1

DT_SUBMIT[0]: TXT_NAME[0]: TXT_APPLNO_2[0]: Button5[0]: nextStepBtn[0]: