FORM P. Pu. C. A. [See rule-70 (1) (v)] Application for a Goods Carriage Permit To, The Regional Transport Authority Full name and Region. address of the applicant I hereby apply for a permit in respect of a goods carriage as herein under set out : 1. The area or areas for which the permit is required 2. The type and capacity of the vehicle 3. The nature of goods prepared to be carried 4. The rates to be charged by the applicant for carriage of goods 5. The details of arrangements made/intended to be made for : (i) Housing of the vehicle (ii) Maintenance of the vehicle (iii) Repair of the vehicle (iv) Storage and safe custody of the goods 6. Particulars of any permit in respect of goods carriages, held by the applicant within the State and the registration mark of all the vehicles covered by such permits 7. The details of last three years' record of payment of taxes in respect of vehicles stated in item No. 6 above 8. The details of last three years' record of suspension or cancellation or any permit stated in item No. 6 above 9. Whether the applicant is in possession of the vehicle if yes, the registration mark of such vehicle if no, the details of arrangement made/to be made to acquire the vehicle 10. Particulars of any agreement or arrangement affecting in any material respect the provision (within the region of the Regional Transport Authority) of facilities in the transport of goods for hire or reward entered / or proposed to be entered into by the applicant with any other person by whom such facilities are provided, whether within of without the region 11. Particulars of any agent's license to the applicant for the business of collecting, forwarding or distributing goods carried bu goods carriage 12. Whether the applicant intends be carry goods for or in connection with a trade or business carried on by the applicant if yes, the nature of his trade or business and the nature of goods to be carried 13. I hereby declare that the above statements are true, and that I have supplied all the information and documents necessary to support the statements made in this application. 14. I hereby agree that the above statements are true, and that I have supplied all the information and documents necessary to support the statements made in this application. 15. I herewith tender the fee prescribed in Rule VI. Date : Place : Signature of the applicant Note : Where the space is not sufficient, the applicant should furnish the information, itemwise on separate sheets, must sign each sheet, and must attach them with the application. * Strike out whichever is either not required or not applicable.
