[See Rule 10]
Applicant's Name :       Mobile No :  
Email Id :     Id Proof * :
  Enter the Id Proof Number * :  
To the Office of the
I here by apply for a licence authorising me to drive as a learner,  the following motor vehicle(s):

Motor vehicle of the following description:
01. Full Name of Applicant
02. Son/Wife/Daughter of
03. Permanent Address (House No./Bldg Name)
04. Temporary address (House No./Bldg Name)
05. Duration of stay at the present address Years
06. Date of Birth [2] (dd/mm/yyyy) / /        
07. Place of Birth
08. If Place of birth outside India, when migrated to india
09. Educational Qualification
10. Identification Marks:                                                             (1)
11. Declaration of citizenship status  
      (i)  If deemed Citizen or Citizen by birth (Birth Certificate/School 
           certificate in support of citizenship as Indian  to be enclosed)

      (ii) If Citizenship is acqured by Descent, birth Certificate, land / 
           property  document  of parent to be enclosed
      (iii) If Citizenship By Naturalization (Certificate of naturalization and
            certificate of registration to be enclosed)
      (iv) If non-indian Citizen (Valid passport or other travel documents
            and such other  document or authority as may be prescribed)
12. Blood Group RH(Rhesus) Factor
13. I hold an effective driving licence to drive Motor cycle/light motor
      vehicle/transport with  effect  from
14. Particulars of any driving licence previously held by applicant.
     Whether it was cancelled and if so, for what reason.
15. Particular's of any learners licence previously held by applicant in
        respect of the description of vehicle to which the applicant has
16. Have you been disqualified for holding ar obtaining driving licence
      or learners  licence.
      If so for what reasons.
17. Upload Recent Passport Size photograph
(only .jpg file Max size 50KB)
18. Upload Form 1       (only .pdf file Max size 500KB)
19. Upload Form 1A
(only .pdf file Max size 500KB)
20. Parents Consent (in case of minor) (only .pdf file Max size 500KB)
21. Upload Address Proof               (only .pdf file Max size 500KB)
22. Upload Date of Birth Proof            (only .pdf file Max size 500KB)
23. I am exempted from the medical test under rule 6 of CMV Rules 1989.
24. I am exempted from the preliminary test under rule 11(2) of CMV
Enter the code
[1] Address Proof: Electoral Roll/Life Insurance Policy/Passport/Pay slip issued by any office of the central government/ State Government
     or a local  body/any  other document or documents as may be prescribed by the state state government/affidavit sworn before an
     executive Magistrate or a first class judical Magistrate or a notary Public to be enclose
[2] Date of birth Proof:Birth certificate/ school certificate/ affidavit sworn before an executive magistrate of first class judical magistrate 
      or a  Notary Public  to be enclosed
[3] Parents Consent: The written consent of parent guardian (in the case of applicant being a minor)
[4] Medical Certificate: Medical Certificate issued by qualified doctor needs to be enclosed.
[5] Photos: One Passport photo size to be  uploaded as attachment.
[6] Forms can be downloaded from
NOTE: e-Service is an attempt to take the service delivery at your doorstep. This site at present does not generate any online certificate/record. It provides a means to submit the application online. The Applicant is requested to retain the Application Reference Number that shall be provided on successful submission of the application. The status of the same shall be made available through SMS/Email.