FORM P.G.A.
[RULE 53 OF THE DELHI MOTOR VEHICLES RULES, 1993]
APPLICATION FOR A GOODS CARRIER PERMIT
To
The State Transport Authority
5/9, Under Hill Road
G.N.C.T. of Delhi
Delhi-110054
In accordance with the provision of Sections 69 and 77 of the Motor Vehicles Act, 1988, I/We
the undersigned hereby apply for a permit in respect of a contract carriage as hereunder set
out:—
1. Name of Applicant ……………………………………………………………………………………..
2. Name of father (in case of an individual)……………………………………………………………..
3. Address …………………………………………………………………………………………………
…………………………………………………………………………………………………………..
4. Route or area for which permit is desired
…………………………………………………………………………………………………………..
5. Type and Capacity of vehicle (s) for which permit derived:—
Type GVW in kgs. Unladen weight in kgs Registration Mark(s)
(1) (2) (3) (4)
Note:— If any of the vehicles are not in the possession of the applicants it will suffice if the
figures in columns 2 and 3 are correct within 10 per cent above or below, subject to any
limitation of weight in force. The certificate of registration must be presented to the State
Transport Authority, so that the registration marks may be entered in the permit before the
permit is issued.
6. The arrangement intended to be made for the parking, maintenance and repair of the vehicle
And for the storage and safe custody of
goods……………………………………………………………………..
7. Details of any business as a carrier of goods for him on hire or reward carried by the
applicant at any time before making of application and the rates charged by the applicant
…………………………….
…………………………………………………………………………………………………………..
8. Particulars of any agreement or arrangement regarding facilities for the transport of goods for
Hire or reward entered into by the applicant with any person by whom such facilities are
provided……………………………………………………………………………………………………
……….. ……………………………………………………………………………………………………..
9. Particulars of the service to be performed by the vehicle(s) and the manner in which it is
Claimed that the public convenience will be
served……………………………………………………………………………………………
…..
10. Particulars of any goods carrier permit held by the applicant at present:—
Ring Mark of Vehicle
Type of Permit Permit No. Max/Min freight charged
Area where applied
11. (i) Particulars of any goods carrier permit or public motor vehicle licence held by applicant
Which has been subject of any order of suspension or cancellation
…………………………………………………
………………………………………………………………………………………………………………
………..
(ii) Particulars of challan/prosecution/conviction of any goods carrier of the
applicant………………
…………………………………………………………………………………………………………..
12. Particulars, other than particulars furnished under item 8, of any agreement or arrangement
effecting in any material in respect of the provision of facilities of transport of goods for hire or
reward entered into by the applicant with any other person whom such facilities are provided
whether within or outside the N.C.T. of Delhi……………………………
………………………………………………………………………………………………………………
………..
13. (i) Nature of goods proposed to
carry……………………………………………………………………
…………………………………………………………………………………………………………..
(ii) Whether these are dangerous or hazardous goods Yes/No
(iii) Nature of the chemical or explosive to be carried with special reference to their dangerous or
hazardous nature to human
life…………………………………………………………………………………..
…………..…………………………………………………………………………………………………
………..
…………..…………………………………………………………………………………………………
………..
14. I/We desire to use the vehicle(s) as goods carrier(s) for carriage of goods which are my own
property on the carriage of which is incidental to my business (indicate nature of
business)……………..…………..…………………………………………………………………………
………………………………..…………..…………………………………………………………………
…
15. I/We enclose herewith the certificate(s) of registration of the vehicle(s) or will produce the
certificate(s) of registration of the vehicle(s) before the permit is issued.
16. I/We hereby declare that the above statements are true and agree that they shall be
conditions of any permit issued to me/us. I/We also agree that in event of any of the statements
made above or information furnished being found false, the permit granted shall be liable for
cancellation.
Dated:
Signature or thumb impression of
the applicant (s)