Form PUCA.
Application in respect of Goods Carriage Permit
(Rule 171 (iii) of Vehicles Rules, 1989)


The Regional Transport Authority.


I/We the undersigned hereby apply for a public carrier's permit/private carrier's permit under section 66 of the Motor Vehicles Act. 1988 as hereunder set out :
  1. Full Name :
  2. Name of the Father
    (in case of an individual) :
  3. Address
  4. The route, routes or area for which the permit is
    desired :
  5. Type and capacity of vehicles including trailer and alternative trailers of articulated vehicle :
Registration mark Unladen weight Gross Vehicle weight Type Make and Model
(1) (2) (3) (4) (5)

Kgs Kgs . .
6. Description of goods to be carried : .
7. Particulars of any other permits held by the applicant : .
8. Arrangement for housing the vehicles and storage of goods to be carried : .
9. Applicant's previous experience of goods transport business and the rate charged by him, if any : .
10. Nature of applicant's business and grounds on which the necessity for the permit to use the vehicle is claimed : .
11. If the applicant holds a valid driving licence to drive transport vehicles, enclose a certificate to that effect issued by the licensing authority concened : .
12. I/We enclose a challan/cash for Rs : .
13. I/We hereby declare that the above statements are true : .

Date ................. Signature or thumb impression of the applicant