FORM P. Gd. C. A. [See Rule 71 (l) (iii)] Application in respect of Goods Carriers permits To, The Director of Transport/Asst. Director of Transport. In accordance with the provision of Section 69,77,79 and 80 of the Motor Vehicles Act, 1988. I, undersigned hereby apply for a good carrier's permit under section 66 of that Act, as herein under set out. 1. Full Name of the Applicant/Company ______________________________ (Surname) (Name) (Father's/Husband's name) 2. Age _________________ 3. Full address: H. No. ____________Road/lane________________________ Name of the Locality ____________________ City/Town ______________ ________________ Pin _________________ Tel. No., if any ________________ 4. The nature of goods proposed to be carried __________________________ 5. Type nature of goods proposed to be carried _________________________ No. of Vehicle Type Load capacity Laden weight Kegs. Registration Mark Overall length Width 1 2 3 4 5 6 7 Note: -(1) If any of the vehicles are not in the possession of the applicant if will suffice if the figures in columns (3) and (4) are correct within ten percent above/or below, subject to any limitation of weight in force. The certificates of registration must be presented to the Transport Authority so that the registration marks may be entered in the permit before the permit is issued. (2) If the application is in respect of a larger number of vehicles than can be specified above an additional schedule may be appended to the form. 6. Particulars of any goods carrier's permit valid in any State and held by the applicant which has been the subject of any order of suspension or cancellation ___________________________________________________ 7. I forward herewith the certificate of registration of the vehicle or I will produce the certificate of registration on the vehicles before the permit issue to me. 8. I hereby declare that the above statements are true and agree that they shall be conditions of any permit issue to me. Dated: __________________ 20 Place: ___________________ Signature or thumb impression of applicant (To be filled in the office of Transport Authority) 1. Date of receipt ________________________ 2. Amount of rupees __________________ received vide receipt number _______________ dated __________________ 3. Granted/Granted in modified form/rejected on the ____________________ 4. Number of permit issued _________________________________________ Secretary, ________________________ Transport Authority Note: Please pay the cost of this form at concerned RTO Price: Rs. 10.00 Printed from www.goatransport.com
