Government of Karnataka


APPLICATION FOR THE GRANT OF LEARNER'S LICENCE.

Please go through the GUIDELINES before filling up this form

RTO Office *
Available Test Dates

Class of Vehicle *
Motor Cycle Without Gear below 50cc Motor Cycle Without Gear
Motor Cycle With Gear Light Motor Vehicle NonTransport
Light Motor Vehicle NonTransport-Auto Light Motor Vehicle Tractor/Trailer
Invalid Carriage

Full Name *
Son/Wife/Daughter of *
Permanent Address
*
Temporary Address (Optional)
Proof of Address *
Date of Birth (YYYY)*
Proof of Age :*
Educational Qualification *
Identification Marks(Optional)
Blood Group & RH factor (Optional)

I Enclose 3 copies of Passport Size Photos Yes*
Fee Payment By CashDD

DD No.                                DD Date : (YYYY)
DD Bank Name

Medical Certificate Dated (YYYY)
Doctor Name

I have Enrolled in Driving
School Dated (YYYY)
Driving School Name
Driving School Address