	Government of Karnataka

APPLICATION FOR THE GRANT OF LEARNER'S LICENCE.

Please go through the GUIDELINES before filling up this form

RTO Office *

Available Test Dates

Class of Vehicle *
Motor Cycle Without Gear below 50cc Motor Cycle Without Gear

Motor Cycle With Gear Light Motor Vehicle NonTransport

Light Motor Vehicle NonTransport-Auto Light Motor Vehicle Tractor/Trailer

Invalid Carriage

Full Name *

Son/Wife/Daughter of *

Permanent Address
*

Temporary Address (Optional)

Proof of Address *

Date of Birth (YYYY)*
Proof of Age : *

Educational Qualification *

Identification Marks(Optional)

Blood Group & RH factor (Optional)

I Enclose 3 copies of Passport Size Photos Yes*

Fee Payment By CashDD

DD No. DD Date : (YYYY)

DD Bank Name

Medical Certificate Dated (YYYY)
Doctor Name

I have Enrolled in Driving

School Dated (YYYY)
Driving School Name

Driving School Address