1. GOVERNMENT OF ANDHRA PRADESH
TRANSPORT DEPARTMENT
APPLICATION FORM FOR
Financial Assistance to Self-Owned Auto/Taxi/Maxi Cab Drivers
Note: The owner of the vehicle shall file the application.
1. Name of the Applicant:
2. BPL/White Ration Card Number:
(Enclose copy of White Ration card)
3. Details of Family Members: (Details of spouse & minor children only)
Sl.No Name Aadhar No Relationship Age/D.O.B Gender
1)
2)
3)
4)
4. Aadhar Number: 4. Mobile Number:
(Enclose copy of Aadhar card)
7. Bank Details: (Enclose copy of un encumbered Bank passbook first page)
i) Bank A/c No:
ii) Account Holder Name:
ii) Name of the Bank:
iii) Name of the Branch:
iv) IFSC Code:
6. Present Address:
(i) District: ______________________ (ii) Mandal/Municipality/Municipal
Corporation: ____________________
(iii) Constituency: _________________ (iv) Panchayat/Ward Number: _________
(v) Habitation: ____________________ (vi) Landmark: ____________________
(vii) Street: _______________________ (viii) Door No: _____________________
8. Vehicle Details: (Enclose Copy of RC)
1. Vehicle No:
2. Owner Name:
3. Father Name:
4. FC Valid upto:
5. Vehicle Class:
9. Driving Licence Details:
(Enclose Copy of DL)
1. DL No:
2. DL Holder Name:
3. Father Name:
4. DL Valid Upto:
5. Class of Vehicles:
5. Caste Details: (Please enclose copy of caste certificate in case of SC/ST/BC/Minority)
(i) Religion: ____________ (ii) Caste: __________ (iii) Sub Caste: ______________
vi) Mobile No :
vii) Email Id (Optional) :

2. 10. Xerox copies of documents to be enclosed along with the application by
the applicant:
1. Applicant’s White Ration Card
2. Applicant’s Aadhar Card
3. Applicant’s Caste Certificate issued by competent Authority in case of
SC/ST/BC/Minority
4. Vehicle Registration Certificate in the name of the applicant
5. Driving Licence in the name of the applicant/spouse, if vehicle is registered in the
name of spouse.
6. Unencumbered Bank Account Passbook first page containing Account Number,
Bank Name, Branch Name and IFSC Code.
I hereby declare that the information given by me in the application is correct and
true to my knowledge.
Signature of the Applicant
ACKNOWLEDGEMENT TO THE APPLICANT
I hereby confirm the receipt of application vide no__________________ from
Smt/Sri________________________ for the vehicle registration number
_____________________ linked to Aadhar number ____________________for
financial assistance to self owned Auto Rickshaws/Maxi Cab/Taxi.
Date: Signature of the Village/Ward
Volunteer

3. For Verification Purpose
(This part will be filled by officials only. Applicant shall not fill up this section)
(i) Applicant’s Name: ___________________________________
(ii) Father’s Name : ___________________________________
1 Whether the applicant name is covered in white ration card? Yes No
2 Whether the name of the applicant mentioned in the caste
certificate is matching with applicant name in case of applicant’s
belonging to SC/ST/BC /Minority only
Yes No
3 Whether the name of owner in registration certificate is matching
with applicant name
Yes No
4 Whether the name of driving license is matching with applicant
name?
Yes No
5 Whether the bank account is on the name of the applicant? Yes No
6 Whether the name as per the copy of Aadhar card is matching with
above applicant name.
Yes No
7 Whether the vehicle is the possession of the above applicant? Yes No
8 If the vehicle is registered in applicant name and driving license is
not on his/her name or whether the driving license is on spouse
name.
Yes No
Recommendation/Rejection of the Application by the officials:
I Name of the Official : Village/Ward Volunteer
I have verified the documents mentioned
above, I hereby recommend/reject the
sanction of financial assistance to the
applicant.
Recommended Rejected
If rejected, please select the below mentioned reasons
The applicant is not having white ration card.
Vehicle is not registered in the name of the applicant.
Driving License is not in the name of applicant/spouse.
The applicant is not having Aadhar card.
Applicant’s family as defined in the G.O.Ms.No. 34 Tr. R&B dept. dated:
09.09.2019 has already applied for another vehicle bearing
registration number________________.
The applicant is not having bank account in his/her name.
Signature of the Village/Ward Volunteer
Signature of the Panchayat Secretary/Bill Collector
Signature of the MPDO/Municipal Commissioner