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Application Form

IDP Form -Bangaldesh

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Ehsan Ahmed
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538 views1 page

Application Form

IDP Form -Bangaldesh

Uploaded by

Ehsan Ahmed
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AUTOMOBILE ASSOCIATION OF BANGLADESH

3B, Outer Circular Road, Moghbazar, Dhaka-1217, Bangladesh


Email: [email protected] Website: www.aabangladesh.com
Phone: +8802-222221342, +8802-48311654 Mobile: +8801705518845, +8801722278846
Office Hours: Sunday to Thursday, 09:00 AM – 04:00 PM
I hereby apply for an International Driving Permit (IDP). The requisite information is set out below and the required documents
are attached herewith.
1. APPLICANT’S INFORMATION (The application should be filled up in CAPITAL LETTERS as per BRTA Licence)

Name: ………………………………………………………..…………………………………..…Title:  Mr.  Ms.  Mrs.

Date of Birth: ……………..…………………………Place of Birth: ……………….…………….………Blood Group:………...


Address: ……………………………………..………………….…………………………………………………………………..
………….……………...………………………………………Email Address:……….…………………………….……………..
Phone:……………………………………Occupation:……………………….NID Number:..………………………..…………..
2. PLACE WILLING TO VISIT: City………………………… Country:…...……..…………....Purpose:……………………..
3. LICENCE INFORMATION
Licence Number: …………………………...…………..……. Place of Issue: ………………………..………...………………...
Date of Issue: …………………………….……………….. ... Date of Expiry: ……………………...…...……………………….
4. PASSPORT INFORMATION
Passport Number: ……………………………….…………..……. Place of Issue: …...……………….………..………………...
Date of Issue: …………………………….……………….……... Date of Expiry: …………….…………………...…………….
5. IDP VEHICLE CLASS: Type of vehicle for which IDP is required (please tick) A B C D E
6. Service Required:  Normal  Urgent  Express  AAB Certificate
7. I wish to apply for AAB Membership:  Yes  No I am already an AAB Member:  Yes  No
8. REQUIREMENTS: Avek¨K
1| evsjv‡`kx ‰ea WªvBwfs jvB‡mÝ Gi d‡UvKwc (hw` WªvBwfs
(i) The application should be filled up in capital letter as per BRTA jvB‡mÝ AbjvB‡b hvPvB Kiv m¤¢e bv nq, Zvn‡j
Licence. Av‡e`bKvix‡K mswkøó weAviwUG Awdm ‡_‡K mZ¨vwqZ K‡i
(ii) BRTA Licence photocopy with at least one month validity on the Avb‡Z n‡e)|
date of application. (if the driving licence is not recognized online, 2| RvZxq cwiPq c‡Îi d‡UvKwc|
an attestation from BRTA office is required on the licence copy). 3| cvm‡cv‡U©i Z_¨ m¤^wjZ cvZvi d‡UvKwc|
(iii) NID photocopy. 4| Qwe 3 Kwc (2 Kwc ÷¨v¤ú I 1 Kwc cvm‡cvU© mvBR)
wet`ªt m¤ú~Y© Av‡e`b cÎ mwVKfv‡e c~iY Kivi `vqxZ¡
(iv) Passport information page photocopy.
(v) Photograph – 2 copy stamp size & 1 copy passport size. Av‡e`bKvixi wb‡Ri| fzj nB‡j †Kvb fv‡eB KZ…©cÿ `vqx b‡n|

9. DECLARATION Yes No
(a) Do you suffer from epilepsy or from sudden attack of disabling giddiness of fainting?  
(b) Are you able to distinguish with each eye at a distance of 25 yards in good day-light (with glasses, if
 
worn) a motor car number plate containing seven letters and figures?
(c) Have you lost either hand or foot and or are you suffering from any defect in movement control of
 
muscular power of either arm or leg?
(d) Can you readily distinguish the pigmentary color red and green?  
(e) Do you suffer from night blindness?  
(f) Do you suffer from a defect of hearing?  
(g) Do you suffer from any other disease or disability likely to cause your driving of a motor vehicle to be
source of danger to the public?  

I hereby declared and confirm that the above information provided is correct. I understand that the IDP will only be issued if
this application is approved by AA Bangladesh.

OFFICE USE ONLY


IDP Number: ………………………..
Authorised Signature Applicant’s Signature
Date of Issue: ………………………
For (AA Bangladesh) Date:
Date:

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