Form 40 [ see rule 63 (2) ] Application Form for grant or renewal of Letter of Authority To The Registering Authority, ............. I/We.................................. address .................................. hereby submit the following information, namely: 1. Name of the applicant : 2. Son/wife/daughter of : 3. Address (Proof to be enclosed) : 4. Qualification of the applicant : 5. Experience in automobile workshop : 6. Whether involved/connected directly or indirectly in transport business : 7. Machinery and equipment : 8. Staff engaged in different cadres: 9. Particulars of a person as required under clause (a) of sub-rule (3) of rule 63 of Central Motor Vehicles Rules, 1989 (a) Name : (b) Age (c) Qualification in Automobile Engineering : (d) Actual experience in Automobile workshop : (e) Name of firm with full address : (f) Driving experience in various types of Transport vehicles : (i) Driving licence number : (ii) Issued by : (iii)Date of Issue : (iv)Type of vehicles (v) Period of validity of Driving licence : (vi) Endorsement of driving Licence, if any : 10. Proof of land owned by or hired by the applicant : 11. Whether garage is equipped with following facilities : (i) Water supply : (ii) Electricity : (iii) Toilet : (iv) Rest Room : 12. Sources of Finance 13. If applicable is for the renewal of letter of authority furnish following particulars namely: (i) Number of existing letter of authority : (ii) Date of issue : (iii) Period of validity : (iv) If applicable is not Submitted within time : (v) Whether letter of authority suspended/cancelled/ /surrendered earlier, Furnish details : 14. I hereby solemnly declare that the information given above is true and correct. Further I hereby that I shall abide by the rules, regulations and conditions attached to the letter of authority and as prescribed in the Motor Vehicles Act, 1988 and the Central Motor Vehicles Rules, 1989. (i) Manager (ii) Foreman (iii) Mechanic (iv) Helpers (v) Other administration staff : Dated ...... (Signature of the Applicant) Please pay the cost of this form at concerned RTO PRICE : RS 10.00 Printed from www.goatransport.com