HP FORM 1 L. L .D.
( Rule 10 of Himachal Pradesh Motor Vehicles Rules, 1999)
INTIMATION OF LOSS OR DESTRUCTION OF LICENCE AND
APPLICATION FOR DUPLICATE LICENCE.
To
The Licensing Authority,
__________________________.
I
_______________________________________________________________
(Permanent
address
of
__________________________________________________
(Present Address_ ______________________________________________________
(Father’s name) _____________________________________________ hereby report
that
driving
licence
NO.
________________
issued
by
Licensing
Authority
_________________________________ on or about the _____________ day of
_____________ 19, has been lost/destroyed in the following circumstances:2.
I hereby apply for a duplicate license and tender twenty five rupees as fees
through cash receipt/treasury challan No. and date.
3.
I attach two clear copies of a recent photograph of myself.
(Date)
Signature or thumb-impression of
applicant.
For use in the office of the Licensing Authority
PART-I
(1)
Duplicate of driving Licence No. _______________________________
first granted on ________________________ has beeb issued by me this
__________ ____________________________ day of
__________________________.
(2)
Application refused in letter No. ___________ dated _______________
to the applicant giving reasons.
(Date)
Licensing Authority
(1)
Strike out alternative not required
PART-II
Forwarded to the Licensing Authority _______________________________________
___________________________________________________________, for
verification and completion of part-III
(Date)
Licensing Authority
PART-III
Returned to the Licensing Authority ------------------------------------------------ Signature
The photograph and thumb-impression (1) have been compared with
No such licence appears to have been issued by this office (1)
I am not satisfied that the applicant was the holder of the licence described (1).
I am satisfied that the applicant was the holder of a licence issued by this office as
follows:(1) Number ……………………………………………………………………
(2) Date of issue…………………………………………………………. 19
(3) Last renewed by the Licensing Authority ………………………………….
(4) Date of expiry ………………………………………………………….. 19
(5) Classes of vehicles (2) ……………………………………………………..
(6) The licence—
(a) Entitled the holder to drive as a paid employee (1)
(b) Carried an authorization to drive a public service vehicle, granted
(1)…………………………………………………………………
(c) Carried the following endorsements
(Date)
Licensing Authority
……………………………………………………………………………………………………
(1) Strike out alternative not required.
(2) Here fill in (a), (b), (c) etc. as specified in section 10 of the Act.
Part-IV
Returned to the Licensing Authority ………………………………………………………
A duplicate licence has been issued by me on the …………… day of …………… 200
(1) A copy of the photograph affixed thereto is attached.
I have in my letter No. ……………………………………….., dated the ……………….
declined to issue the duplicate licence applied for, a copy of that letter is attached (1).
(Date)
Licensing Authority
……………………………………………………………………………………………..
(1)
Strike out alternative not required