FORM LICENCE CONDUCTOR (Rule 4.47(4) of the Punjab Motor Vehicle Rule 1940) FORM IF APPLICATION OF HARYANA CONDUCTOR'S LICENCE 1. Name : . . . . . . . ............................. . . . . .. 2. Father's Name : . . . . . . . ............................. . . . . .. 3. Permanent Home Aggress : ........................... . . . . . . . . . . . . . . . . .............................. . . . . . . . . .............................. 4. Present Address : . . . . . . . . . . . . .............................. . . . . . . . . . . . . .............................. 5. I have not previously held a Conductor Licence permanently held a Conductor Licence issued by. 6. I am not/disqualified for holding Conductor's Licence. 7. I hereby declare that I am not less that eighteen years of age that the above statement are true and correct to the my best of knowledge. I attach two copies of recent photograph of my self. Dated : . . . .............. Signature or thumb impression of applicant Duplicate signature or Impression of Applicant Licence No. ................... Badge No. .................... The ............. 200......... Licensing Authority POLICE REPORT Verification of Application for a Conductor Licence Application . ............................... Age. ............S/o Sh. . .........................................................R/O Vill.......................... Post Office. ................Police Station ......................Tehsil .................... Distt. ........................ has been identified from the photograph attached and vouched for by the following respectable persons of the locality. He is living at the above Address for the last ........... Yr. He is living at the present Address with his wife and children/ relatives/parents. He bears a good/her character or has the following convocation. Signature of the S.H.O. Police Station : Tehsil : Distt. : Signature or Thumb Impression of the applicant FORM C. OF CONDUCTOR (Rule 4.47(5) of the Punjab Motor Vehicle Rules 1940) FORM OF MEDICAL CERTIFICATE FOR CONDUCTOR 1. Name of the person examined : ........................ . . . . . . . . . . . . 2. Father's Name : . . . . . . . . . . . . . . . . . . ......................... 3. Age : . . . ......................... 4. Is the person examined, to the best of your judgment fit physically and mentally to perform the duties of a stage carriage ? 5. Does the show any evidence of being dedicated to the excessive of alcohol or drugs ? 6. Marks of Identification 1 ........................ . . . . . . ... 2 ........................ . . . . . . ... I certify that person examined has affixed his signature of the thumb impression here to in my presence and that to the my best of my knowledge and belief and above statement are true and that the attached photograph is a responsible correct likeness of the person described. Signature or Thumb Impression of the person Name .......................... . . . (In Block Letter) Signature ..................... . . Designation .................. . .
