FORM. L. Ag. A [See rules 147 (1), 148(1)] Form of application for fresh licence or renewal to work as Agent for collecting, forwarding or distributing goods carried by goods vehicles or for opening additional branch office To, The Regional Transport Officer In accordance with the provisions of sub-section (1) of section 93 of the Motor Vehicles Act, 1988, I the undersigned hereby apply for a licence to work as an Agent for *Collecting/*Forwarding/*Collecting, *Forwarding or distributing goods carried by goods vehicles/*for opening additional branch office in the State of Goa. 1. Full Name _____________________________________________________________________ (Surname) (Name) (Father's/Husband's Name) 2. Age _________________________________________________________________________ 3. Full Address ________________________________ H. No. ____________________________ Road/Lane ____________________________ Name of Locality _________________________ City/Town ________________________________________ Pin _________________________ 4. (a) Experience in the management of Transport business. (b) Particulars of licence if already held. (c) Place where the applicant proposes to be engaged as an Agent, Name of the town. (d) Place where the applicant proposes to establish his branch office with detailed addressName(s) of Town(s). 5. Nature and extent of financial resources of the applicant. Particulars of goods vehicle, if any, (Registration Mark) (i) Owned (ii) Under Control. Note: please pay the cost of this form at the concerned RTO Price: Rs. 10. 00 Printed from www.goatransport.com
