Application form LLD which is for notification of loss or destruction of the driving license and is an application for duplicate driving license.

1. FORM - L.L.D.
[See rule 13(1)]
Application for a duplicate driving licence
To,
The Licencing Authority, Full Name ………………………
Address of the ………………….
applicant ………………………..
1. I hereby report that the driving licence held by me is lost/destroyed/torn/defaced/mutilated in
the following circumstance ……………
2. I hereby apply for a duplicate driving licence and tender the fee prescribed in rule 6.
3. The particulars of such driving licence held by me is as follows :-
Driving licence no…………….. issued for …………… (here enter the class of motor
vehicles) in the name of …………… by the licencing authority …………….. on
……………….. and expiring on ……………...
4. I hereby declare that my driving licence is not impounded by any authority and that
there have been no/following endorsement by the court since the date of
grant/renewal.
Signature of the applicant.
Date :
Place :
Specimen signature of the applicant
1.
2.
*Strike out whichever is either required or not applicable.