International Driving Permit (Page 3 of 3) in pdf

International Driving Permit Page 3

for ? If so, give the following

details.

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Date of Test

Testing Authority

Result of Test

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13. I enclose three copies of my recent passport size photograph.

14. I enclose the copy of driving licence No. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

dated : - - - - - - - - - - - - - - - - - - - issued by - - - - - - - - - - - - - - - - - - - - - - - - - - - -

valid upto: - - - - - - - - - - - - - - - - - - - -.

15. I enclose a medical certificate in Form 1A.

16. I have paid the fee of Rs. - - - - - - - - - - - - - - - - - - - - -

I hereby declare that the particulars given above are true to the best of my

knowledge and belief.

Date: - - - - - - - - - - - - - -

Signature / Thumb Impression

of Applicant.

* Strike out whichever is inapplicable.

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International Driving Permit Page 3