Place*

Name of the Employer*

Name of Motor Transport Undertaking *

Address of the Employer *

Full address to which communications relating to :
the motor transport undertaking should be sent*

Nature of Motor Transport service*

Total number of routes*

No. of Male Workers *

Total number of motor transport vehicles :
on the date of application*

No. of Female Workers

Name of Proprietor of the motor transport :
undertaking in case of a firm not registered
under the Companies Act, 1956.*

Maximum number of motor transport workers :
employed on any day during the preceding year*

Residential Address*

Maximum number of motor transport :
workers proposed to be employed during
the period of registration / renewal*

Name of Partner of the motor transport :
undertaking in case of a firm not registered
under the Companies Act, 1956.*

General Manager in case of Public :
Sector undertaking*

Residential Address*

Mobile Number *