Form - P V A. Application for variation of permit (See rule 216 (1) To The Regional / State Transport Authority, ................................................................. I / We the under signed apply for the variation of the following permit(s) : 1. Full Name and Address of the Permit Holder :....................... 2. Description of permit, Permits in respect of Stage Carriages of goods carriage(s) or contract carriages :......................... 3. Authority by which permit was issued :........................ 4. Authority / Authorities if any by which the permit has been counter signed :........................ 5. Number or counter Signature(s) :........................ 6. Date of Counter Signature(s) :........................ 7. Date of expiry of the permit :........................ 8. Route(s) Area(s) for which the PERMIT IS VALID :........................ 9. Permitted passengers Capacity (in the case of Public Service Vehicle(s) :........................ 10. Permitted laden weight (in the case of goods carriage(s)) :........................ 11. Unladen weight (SP) of vehicle(s) :........................ 12. Registered laden weight(s) of vehicle(s) :........................ 13. a) Nature of Variation(s) desired and the manner in which public interest will be served thereby :........................ b) Total daily mileage permitted with existing and proposed timings (in the case of Stage carriage(s)) :........................ 14. Registration mark(s) of vehicle(s) in respect of which the variation(s) is / are desired :........................ 15. The amount of fees paid and the mode of payments (Cash receipt) treasury challan, Money order, receipts or cheques as the case may be, to be enclosed 16. Is / are the permit attached, if not give full reasons (in case of temporary permits) it is enough to attach that permit 17. Is a rough sketch showing the route(s) / area as existing and as varied enclosed in case of each variation(s). 18. I / We hereby declare that the above statements are true and agree that they shall be the basis of any variation that may be granted to me / us. Place : Date : :. . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Signature of applicant(s).
