FORM ALA

Application for Agents Licence

(See Rule 235)

To
The Secretary,
Regional Transport Authority.

...............................................

I / We apply for an Agent’s Licence under rule 235 of the TamilNadu Motor Vehicle Rules, 1989.

1. Full name (in block letter) : .........................................................................

2. Name of father or husband (in the

case of an individual) : .........................................................................

3. Address : .........................................................................

: .........................................................................

4. Date of birth (in the case of an

individual) : .........................................................................

5. Educational Qualification or Experience in the management of transport business (in the case
of partnership firm, private or public limited company, the qualification and experience of
the Managing Partner or Managing Director)

...........................................................................................................................................

6. Place or places where the applicant is engaged or proposes to engage as agent (here
particulars of all branches should be given with full address)

.........................................................................................................................................

7. Nature and extent of financial

resources of the applicant : ........................................................................

8. Period for which the licence is

required : ........................................................................

9. (a) Description of the premises in headquarters and branches (nature of buildings, extent of

the site, etc.) ................................................................................................................

(b) Whether the premises is owned by him or is his possession or proposed to be rented

.....................................................................................................................................

10. I / We am/are fully conversant with conditions of goods carriage permit and the provisions
of the Motor Vehicles Act and the rules made thereunder so far as they relate to the
restrictions regarding the routes weight loading and unloading of goods and the duties
and functions of agents. : ........................................................................

11. I/We enclose a treasury receipt

for rupees : ........................................................................
12. I/We hereby declare that to best of my/our knowledge and belief the particulars given above
are true.
.........................................
Station: .................................... Signature of the applicant

........................................................
Date: ....................................... Duplicate signature of the applicant