(Rule 171 (v) of the Telangana Motor Vehicles Rules, 1989)


The Regional Transport Authority.


I/We the undersigned hereby apply for the special permit under section 88(8) of the Motor Vehicles Act. 1988, in respect of the vehicle as hereunder set out :
1. Full Name :
2. Name of the Father
(in case of an individual)
3. Place of residence and business with full postal address :
4. Type of vehicle :
5. Registration Marks :
6. Seating capacity :

Particulars of permit already possessed in respect of the above.

a. Permit No :
b. Validity :

Particulars of person engaging the Service.

i) Full Name :
ii) Name of father or husband :
iii) Age :
iv) Place of residence with full postal address :
v) No. of persons included in the party :
vi) Copy of the contract is enclosed in duplicate :

9. Name of place to be visited :
10. I/We enclosed challan/cash/cheque for Rs being the prescribed fee.
11. I am/we are in possession of the Vehicle the certificate of registration of which is enclosed.
12. I/We desire a permit valid from to
13. I/We hereby declare that the above statements are true.

Date Secretary,
State/Regional Transport Authority

          Note : Strike out inapplicable entries or alterations throughout.