FORM XIV
(See rule 125 of the West Bengal Motor Vehicles Rules, 1989)
Special permit No……………………………………….
(Issued under sub-section (8) of Section 88 of the Motor Vehicles Act. 1988)
Office of the State / Regional Transport Authority…………Murshidabad…………… certified that the Vehicle bearing :-
i) Engine No. :- HAHZ423151
ii) Chassis No. :- MB1PREHD4HAXG9247
iii) Registration Mark………………………………WB57.D.1212……………………………………….... registered by the
Registering Authority……………………Murshidabad…………………………………………………………………….....
and Owned by………………Ananya.Banerjee……………………………………………………………………………….
w/o…………………Bivas.Banerjee……………………………………………………………………………………………..
(Permanent Address)……Radhikanagar Purbasha.Cossimbazar.Berhampore.Murshidabad………………………....
…………………………………………………………………………………………………………………………………...
……………………………………………………………………………………………………………………………………
…...
iv) Seating capacity of the vehicle…………………59.ID………………………………………………………………………...
Covered by permit No……………………………………………………………………….dated…………………………….
Issued by the State / Regional Transport Authority, ………Murshidabad….………………………………………………
Has been engaged by the person whose particulars are given below :-
_____________________________________________________________________________________________________
Full name and name of father Age Place of residence
or husband
1 2 3
1. for carrying reserve party
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
PTO
(2)
Berhampore to Deoghar via Kuli, Snaithia, Suri, Massanjor, Dumka, Patabari, Deoghar, Trikut Pahar, Tapaban, Nayalakhya
Mandir, Nandan Park, Baidyanath dham, Tarapith, Rampurhat, Nalhati, Moregram, Back
From 24/02/2023 to 28/02/2023
This special permit is valid up to ………………………………………28/02/2023……………………………………….……
Certified that in respect of the vehicle mentioned above, all taxes and fees payable in this State up to the date of expiry
of this special permit have been paid.
This special permit is valid throughout India without countersignature by any other Regional / State Transport Authority.
It shall be produced on demand by any police officer in uniform.
In addition to the above general conditions, the permit holder shall also comply with any of the special conditions
stipulated by the R.T.A.
The permit holder shall comply with all the relevant provisions of the Motor Vehicles Act, 1988 and of the Central Motor
Vehicles Rules, 1989 and of the West Bengal Motor Vehicles Rules, 1989
Signature of the issuing authority.
The validity of the special Permit is extended up to …28/02/2023…………………… during this period the party may
visit the following place also :-
Signature of the competent authority
Note 1. The period of validity of the special permit shall not exceed one month. Extensions may be granted for a
maximum period of one month.
Note 2. The competent authority shall mean the State / Regional Transport Authority, which issued the special permit
or the State / Regional Transport Authority of the State / Regional in which the party happens to be at the time of applying for
extension, whichever is nearer, while granting extension the competent authority shall satisfy that all taxes and fees payable up
to the period of extension have been paid by the applicant.
Note 3. The holder of the Special permit shall display the “Special Distinguishing Mark”, prominently on the windscreen
of the vehicle during the period of validity of the permit.
Important: This issuing authority may please cross out all the blank columns not utilized.
