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Form 9 A

This document is an application for a duplicate driving license. It contains information about a lost, destroyed, or damaged original license including the license number and expiration date. The applicant declares that to their knowledge, the original license had not been suspended or cancelled. They are requesting a duplicate license and have included a police report about the lost original license. They also provide their signature, address, and specimen signatures.

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frenz2kiran
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129 views1 page

Form 9 A

This document is an application for a duplicate driving license. It contains information about a lost, destroyed, or damaged original license including the license number and expiration date. The applicant declares that to their knowledge, the original license had not been suspended or cancelled. They are requesting a duplicate license and have included a police report about the lost original license. They also provide their signature, address, and specimen signatures.

Uploaded by

frenz2kiran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FORM 9-A

[See Rule 26(1) (20 (30]



INTIMATION OF LOSS OR DESTRUCTION OF THE DRIVING LICENSE AND
APPLICATION FOR THE ISSUE OF DUPLICATE DRIVING LICNSE.

To
The Licensing Authority,



Sir,
The Driving License No . which is valid up
to .. has been lost / destroyed / completely written off / spoiled / torn / mutilated
in the following circumstances.



I/We hereby declare that to the best of my/our knowledge that the Driving License has not
been suspended or cancelled under the provision of the Act or Rules made thereunder and the
circumstances explained above are true.

I/We do hereby apply for the issue of a duplicate Driving License.

The written off/spoiled/torn/mutilated certificate of Driving License is enclosed.

I/We have reported the lost to the Police Station .(date).




Date. Signature/Thumb impression
of applicant along with
full address.



Specimen Signature of the Holder of Driving License.

1.

2.

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