FORM 3 [See Rule 3 (a) & 13] Learner's Licence Space of photograph of the size five centimeter by six centimeter Licence No.............. Dated ..................... Name to be written across the photograph specimen signa ture/thumb impression of the holder of Licence Signature and seal of the Licensing authority 1 Name ................ ................................... 2 Son/wife/daughter of ............. ... ................................... 3 Date of birth ................ ................................... 4 Blood Group & RH factor ................ ................................... 5 Present address-Permanent ................ ................................... Temporary/Official (if any) ................ ................................... 6 Mark of Identification [1] ................ ................................... [2] ................ ................................... is Licence to drive throughout India as learner subject to provision of rule 3 of the Central Motor Vehicle Rules, 1989, a motor vehicle of the following description. The holder of the Licence has passed the medical test under rule 5and preliminary test reffered to in rule 11 (2) of the Central Motor Vehicle Rule, 1989 The holder of the Licence is exempted from the medical test under rule 6 and preliminary test reffered to in rule 11 (2) of the Central Motor Vehicle Rule, 1989 This Licence is valid from .................... to ............... X Strike out which ever is inapplicable. Signature and designation of the Licensing Authority Warning:-The attention of the holder of this drawn to rule 3 of Central Motor Vehicle Rules, 1989 which prohibits him from driving any motor vehicle unless he has beside him a person fully licenced to drive the vehicle and in every case, the vehicle carries "L" plates both in the front & in the back of the vehicle.
