Form PSCA
Application for the permit in respect of a particular State Carriage Service of State Carriages
(Rule 171(i) and Rule 179 of Vehicles Rules, 1989)


To

     The Regional Transport Authority,

     State.

Sir,

I / We the undersigned hereby apply for a permit in respect of a stage carriage under Section 70 of the Motor Vehicles Act, 1988 as hereunder set out:
  1. Full Name :
    1. Name of father (in case of an Individual) :
    2. If representing a Company or Firm :
    1. Name of the Company or Firm :
    2. Head Office of the Company or Firm :
    3. Branch Office of the Company or Firm, if any :
    4. In the case of a partnership firm, names and addresses of all partners of the firm and the name of the person representing :
  2. Permanent addresses :
  3. Place of residence, House Number, Name of Street, Village, Taluk, District and State :
  4. The route for which the permit is desired :
  5. No. of vehicles for which permit / permits is / are desired :
  6. The type of vehicle / vehicles:
  7. Registration Mark (s) :
    1. Seating Capacity :
    2. Gross Vehicle Weight :
  8. A time table is appended / not appended :

    Note :- No time table need be appended in cases in which timings have already been fixed by the competent authority.

  9. Number of vehicle inteded to be kept in reserve to maintain the service and to provide for special occasions:
  10. The arrangements proposed and convenience of passengers for the storage and safe custody of luggage :
  11. The arrangements proposed for the housing of the vehicle (s) :
  12. The classification under which the route in Item (5) falls under length of the route :
  13. Number of stage carriage permits and other class of permits, the applicant is having and has had at any time in the past or wheyher the applicant is a new entrant (particulars of the routes with the length and the date of grant of permit should be furnished).
  14. Whether the applicant is insolvent or has 'undischarged decrees' :
  15. Transfer of permits :
    1. The No. of permits transferred to others during last five years. If so, give brief details :
    2. The authority for the transfer Brief reasons for the transfer :
  16. Residential Qualifications :
    Whether the applicant has residence or place of business at either terminus of the route or on the route, if so, furnish :
    1. Door number of the place, village, taluk and district :
    2. Name of the owner of the place :
    3. The period of stay of the applicant at such place :
    4. Certificate and other evidence in support of the claims made above :
  17. Sector Qualification :
    1. Whether the applicant is already providing service on the same route now applied for :
    2. Whether he is providing service exclusively, or with others (names of other operators to be mentioned) :
    3. Whether he is operating any longer route covering as its sector the entire route now applied for. What is the extent of his sector (in K.Ms) common with the route now applied for ?
  18. Business or Technical experience :
    1. Describe the nature and length of experience (Certificate and evidence to be enclosed) :
    2. Particulars of Diploma or Degree in Mechanical or automobile Engineering, if any, held(evidence to be enclosed).
  19. Possession of Workshop :
    1. Particulars of the Workshop owned or possessed with full address of the premises.
    2. Has it the minimum equipment specified in the Rule.
  20. Is the applicant an ex - serviceman associated with motor transport while in such service.
    (Certificates issued by Secretary, Soldiers and Sailor's Board to be enclosed).
    1. Is he a displaced operator (Details and proof to be enclosed).
    2. Was he granted a Stage Carriage permit on an alternative route or area?
  21. Particulars of stage carriage permits :
    1. Held on the date of application.
    2. Number lost due to nationalisation.
    3. Surrenderd voluntarily.
    4. Transferred to others.
    1. If the applicant is a Scheduled Caste / Scheduled Tribe, he shall state to that effect and enclose a certificate in proof thereof issued by Tahsildar in independent charge concerned.
    2. If the applicant holds a valid driving licence to drive transport vehicle, he shall enclose certificate to that effect issued by the Licensing Authority concerned.
  22. If the applicant is a member of a joint family, details of the permits held by each of the members of the Joint Family may be furnished.
.
S.No Route R.T.A that issued permits, Permit No & date of issue Names of the members of the family Relationship of the member with the applicant
(1) (2) (3) (4) (5)
. . . . .
26. A. Particulars of reservation claimed under Sec. 71. .
27. I / We enclose a challan for Rs........ being the prescribed fee. (Amount paid, No and date of the challan should be furnished). .
28. I / We declare that the particulars given in the above statement are true and I am / we are aware that if on verification any of the particulars in the statement are found to be false, the application will be summarily rejected and the permit, if any, granted in pursuance of this application will be cancelled. .

Signature of (or thumb impression
of) the applicant