Form 4 - Form Of Applicant For Licence To Drive A Motor Vehicle Page 3

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CERTIFICATE OF TEST OF COMPETENCE TO DRIVE
The applicant has passed the test prescribed under Rule 15 of the Central Motor Vehicles Rules, 1989. The
test
was
conducted
on
(here
enter
the
registration
mark
and
description
of
the
vehicle)……………………………………………………………………………. on (date)…………………………
The applicant has failed in the test.
(The details of the deficiency to be listed out)
Date:……………………….
Signature of Testing Authority
………………………………..
………………………………..
Full name and designation
Two specimen signatures of Applicant
1…………………………………………………….
2…………………………………………………….
*Strike out whichever is inapplicable
.- The application along with the scanned copies of the required documents may also be sent to the concerned
Note
Licensing Authority through Electronic Mail, if allowed by the concerned State Government / Union Territory
Administration.
In such cases, the Licensing Authority shall scrutinise the application and intimate the applicant about the
acceptance/any discrepancy.
In case the application is accepted, the applicant shall be intimated through Electronic Mail to report to the Authority
concerned on an appointed date along with the documents for further verification, submission of application fee and
examination of the applicant.

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