Before the Regional Transport Officer, ………………………………….…………….
Affidavit of ………………………………. age ……………… years,
S/O …………………………………………………………………………………………..…………
resi……………………………………………………………………………………………………..
I, …………………………………..……..age ………………………..
S/O………………………………………………………………………………….…………………
resi …………………………………………………………………………………………………:
1. That I am the applicant in application for the issue of duplicate driving licence and as such fully conversant with the facts deposed to below.
2. That I was issued driving licence No………………. ………………… on …………………………. by this authority, to drive scooter with gears.
3. That my driving licence No……………………………………….. has been lost on or about…………… for which I have
lodged FIR with Police Station, ………….. …………. vide FIR No. …………………….. dated …………………
4. That I have not deposited the said licence with any court or anywhere or my licence has not been cancelled. I have not been convicted of any offence by any court.
5. That no charge sheet has been filed against me for any offence under the Motor Vehicles Act or Rules made thereunder or any other law in force.
6. That I am not addicted to wine and I do not suffer from any of the diseases disqualifying me to hold the driving licence.
7. That if the original licence will be found, I shall deposit the same with the Office of Regional Transport Officer.
8. That in view of the above, it is necessary that a duplicate driving licence may be issued to me.
I, A, the abovenamed deponent do hereby declare and verify that the contents of paras 1 to 7 are true to my knowledge and the contents of para 8 are my submissions to this authority and nothing has been concealed and no part of it is false.
Verified at ………………… this …………………… day of ……………….. .
Deponent
Date ………………….

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