FORM CCPA. Application for a permit in respect of a Contract Carriage. (See rule 170) To The Regional / State Transport Authority, ................................................................. In accordance with the provisions of sections 69, 73 and 80 of the Motor Vehicles Act, 1988, I / We the undersigned hereby apply for permit under section 66 of the Act in respect of a contract carriage hereunder set out : 1. (a) Name :..................................................................................... (b) Age (in words and figures) :..................................................................................... (c) If the applicant is a minor, full name and address of the guardian. :..................................................................................... ...................................................................................... 2. Father name / Husband name :..................................................................................... 3. Full address :..................................................................................... ...................................................................................... 4. Area / route for which the permit is required. :..................................................................................... 5. Registration number of the vehicle :..................................................................................... 6. Seating capacity :..................................................................................... 7. Number of vehicle proposed to be put in the area Registration Mark. Type. Seating Capacity. (1) (2) (3) 8. Particulars of service to be performed by contract carriages (not necessary in case of motor car) and the manner in which it is claimed that public convenience will be served. Registration Mark. Type. Seating Capacity. (1) (2) (3) 9. Particulars of all contract carriage permits valid in the State held by the applicant at present and whether any permit in any other State is held by the applicant. ................................................................................................................................................. 10. Particulars of previous permit, certificate of registration cancelled or vehicles seized on accordance of the offences committed under any law or any rule or order made thereunder prohibiting or regulating the import, or transfer of passengers or goods. 11. I / We enclose cash / challan / cheque / money order receipt for Rs...............................being the prescribed fee. 12. I / We desire the permit valid for years..................................................................................... I / We hereby declare that the above statements are true. ..................................... Date : Signature of Applicant. Note : 1. Strike out words not applicable. 2. In the case of applicants who are not individual please state whether - (a) Partnership firm. (b) Private or public limited company. (c) Registered co-operative society. 3. In the case of clause (a) above, please attach statement showing the names and address of Managing Partner and Partners. 4. In the case of clause (b) above, please attach statements showing the names and address of Managing Director and Directors. 5. In the case of clause (c) above, please attach copy of the certificate of registration.