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    Application For Provisional Driver'S Licence: Form H3A

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    Angel Krypton
    This document is an application form for a provisional driver's license in Jamaica. It requests personal information from the applicant such as name, address, date of birth, and contact details. It also requires the applicant to declare that the information is true and correct. Additionally, it provides spaces for an attached photograph of the applicant, results of a road code test, payment details, and sections for certification and signatures from licensing authorities.

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    Application For Provisional Driver'S Licence: Form H3A

    Uploaded by

    Angel Krypton
    37 views1 page
    This document is an application form for a provisional driver's license in Jamaica. It requests personal information from the applicant such as name, address, date of birth, and contact details. It also requires the applicant to declare that the information is true and correct. Additionally, it provides spaces for an attached photograph of the applicant, results of a road code test, payment details, and sections for certification and signatures from licensing authorities.

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    This document is an application form for a provisional driver's license in Jamaica. It requests personal information from the applicant such as name, address, date of birth, and contact details. It also requires the applicant to declare that the information is true and correct. Additionally, it provides spaces for an attached photograph of the applicant, results of a road code test, payment details, and sections for certification and signatures from licensing authorities.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    37 views1 page

    Application For Provisional Driver'S Licence: Form H3A

    Uploaded by

    Angel Krypton
    This document is an application form for a provisional driver's license in Jamaica. It requests personal information from the applicant such as name, address, date of birth, and contact details. It also requires the applicant to declare that the information is true and correct. Additionally, it provides spaces for an attached photograph of the applicant, results of a road code test, payment details, and sections for certification and signatures from licensing authorities.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    RESET THE ROAD TRAFFIC ACT SAVE PRINT

    FORM H3A
    APPLICATION FOR PROVISIONAL DRIVER'S LICENCE
    Section A - PERSONAL INFORMATION
    1. Name (Last, First, Middle) 2. Taxpayer Registration Number (TRN)

    3. Address (Apt. No., Street No. & Name, Postal Zone, Parish ) 4. Date of Birth
    Year Month Day

    5. Telephone Number(s) 6. Email Address

    -
    Section B - DECLARATION
    To: The Licensing Authority / Collector of Taxes

    (State Collectorate eg. Kingston/May Pen etc. )

    PLACE
    APPLICANT'S
    I hereby apply for a Provisional Driver's Licence.The vehicle to be used is a
    PHOTOGRAPH
    Motorcycle, Motor Car, Truck or Tractor (delete whichever is not applicable). I have
    HERE
    attained at least the age of seventeen (17). I am tendering three (3) identical
    certified passport size photographs of myself, which are less than six (6) months
    old.
    I declare that the above information is true and correct.
    (To be certified by a Justice of the
    Peace or a Superintendent of Police)

    Applicant's Signature Date


    FOR OFFICIAL USE ONLY
    Road Code Test Result

    Remarks:
    STAMP/SEAL

    Certifying Officer (Island Traffic Authority)

    Payment Information For Provisional Driver's Licence:


    STAMP/SEAL

    Fee Paid $

    Receipt Number

    Permit Number
    Year Month Day
    . . . .
    Expiry Date 
    Collections Officer's Name Collections Officer's Signature Date

    Form No. H3A (Revised 2019/12) Island Traffic Authority

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