FORM ALRA APPLICATION FOR RENEWAL OF AGENT'S LICENCE. (See Rule 235) To The Secretary, Regional Transport Authority, ............................................... I/We hereby apply for the renewal of my / our licence which is attached, and particulars of which are as follows: (a) Licence No :........................................... (b) Date of issue :........................................... (c) Name of the licensee (in block letters) :........................................... (d) Address :............................................................................. .............................................................................. If the licence is not attached, reasons why it is not available......... ............................. .................................................................................................................................................................... If the applications for renewal was not made thirty days before the date of expiry of the licence, reasons for the delay........... ......................................................................................................... The prescribed fee of Rs........ . Is tendered hereby by means of ........ .............. I / We hereby declare that there is not such change in the circumstances in which the licence was issued to me / us disqualifies me / us from continuing to hold this licence. Place: ........................................... Signature of the applicant. Date :
