APPLICATION FOR INTERNATIONAL DRIVING PERMIT 1. Surname in block letters : (State if Mr./Mrs./Miss) 2. Father's Name : 3. Other names (ie. Explain initials) 4. Year and Date of Birth: 5. Town where born : 6. Full name and address in India : (in block letters) 7. Full Details of Indian licence held : 8. Issued by : 9. Valid till date 10. Number of Licence : 11. Class of vehicle for which it is valid : 12. Endorsement regarding conviction if any : (State if previously examined for driving the same class of vehicles) 13. Passport Number : 14. Date of Issue : 15. Issued by : 16. Date of Expiry : Requirements 1. Three passport size photos should be enclosed. 2. Chalan in original for Rs.200/- should be enclosed. 3. Signature in duplicate. 4. Civil Driving Licence 5. Passport Signature of the Applicant Place: Date :
