FORM ACIRA Application for the renewal of canvasser's licence (See Rule 234 (4)) 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. Nature of licence : .............................................................................. d. Name of licensee (in block letters) : .............................................................................. e. Address : .............................................................................. : .............................................................................. : .............................................................................. If the licence is not attached, reasons why it is not attached. If the application 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 no such change in the circumstances in which the licence was issued to me / us from continuing to hold this Licence. Place : Date : .......................................... Signature of the applicant.
