FORM L.L.D. [Rule 29(1) of Punjab Motor Vehicle Act. 1943] Intimation of Loss of Destruction of License and APPLICATION FOR DUPLICATE To The Licensing Authority _____________________________ I, ______________________________________________________________________ of (Permanent Address) __________________________________________________________ and (Present Address) ___________________________________________________________________ Father's Name ________________________________________________ day of ______________, 200 has been lost / destroyed in the following circumstances:- 2. I hereby apply for a duplicate license and tender ten rupees n the form of Judicial stamps 3. I attach two clear copies of a record photograph of myself. The ________________________200 Signature or thumb Impression Of the applicant For use in office of the Licensing Authority Part I 1. Duplicate of driving License No ______________________ first day of ________________200 ____________________________ to the applicant giving reason 2. Application refused in Letter No _______________________ dated the ____________________ to applicant giving reason. Licensing Authority ________________ Part-II Forwarded to the Licensing Authority ____________________________________________ for verification and completion of the Part III Licensing Authority RECEIPT Received from Shri / Smt / Miss ___________________________________________ S/o D/o W/o ___________________________ for issue of Duplicate License / RC _____________________ License clerk for ______________________ PART-III Returned to the Licensing Authority _____________________________________________________ The Photograph and Signature / Thumb Impression have been completed with my records. No such license to have been issued by the office. (i) I am not satisfied that the applicant was the holder of license described (1) I am satisfied that the applicant was holder of the license issued by the office as follows. 1. Number _____________________________________ 2. Date of Issue _____________________________________ 3. Has renewed by the Licensing Authority _____________________________________ 4. Date of Expiry _________________200 5. Class of Vehicles _____________________________________ The license _____________________________________ (a) Entered the holder to drive as a paid employee (b) carried an authorized license to drive a public service vehicle granted by I __________________________________ Carried the following endorsement. Dated _________________ Licensing Authority PART-IV Returned to the Licensing Authority ____________________________________________________ ____________________________________________________ for record A duplicate license has been issued by me on the __________ date _____________________ of _____________200. A copy of photograph fixed is attached. Licensing Authority
