Page 917 - The Central Motor Vehicles Rules, 1989

MOTOR VEHICLE AGGREGATOR GUIDELINES, 2020 889

FORM-IV
[See Clause 3(7)]
APPLICATION FOR THE ISSUE OF DUPLICATE LICENCE

To,
The [Designation],
[Name of State] Competent Authority,
[Name of City]
Sir/Madam,
The licence issued to [Name of the Licensee] under Clause 3(5) of the Motor
Vehicle Aggregator Guidelines, 2019 bearing No. [....................................] has been
lost/destroyed/completely written off/soiled/torn/mutilated in the following
circumstances.

[.......................................................................]
I/Wehereby declare that to the best of my/our knowledge the Licence has
not been suspended or cancelled under the provisions of the Act or rules made
thereunder and the circumstances explained above are true.
I/We do hereby apply for the issue of a duplicate Licence.
The written off/soiled/torn/mutilated Certificate of registration is enclosed/
Copy of the FIR filed against the loss of the Licence is enclosed.
Place:
Date: Signature of the Applicant/Authorised Signatory
(alongwith company seal, as applicable)