GOVERNMENT OF ARUNACHAL PRADESH
APPLICATION FORM FOR ISSUE OF VEHICLE PASS FOR ESSENTIAL SERVICES

Application Processing Location

Select District *

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Service Specific Information

From/Start Date of Journey *

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Upto/End Date of Journey *

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Movement Pass Type *

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Purpose of Travel *

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Type of Journey *

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Applicant Details

Type of Applicant *

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Applicant/Vehicle Owner Name *

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Applicant/Vehicle Owner Mobile Number *

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Applicant/Vehicle Owner E-Mail *

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Type of Vehicle *

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Vehicle Registration No. *

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Driver Mobile Number

Driver Name *

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Area of Operation *

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Starting/ Source Location Name *

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Ending/ Destination Location Name *

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Name of Persons to be allowed in the Vehicle

1. Name of Person

2. Name of Person

3. Name of Person

4. Name of Person

Name of Persons to be allowed in the Vehicle including Driver

Driver Name

First Person Name

Second Person Name

Declaration

I do hereby declare that the above particulars are true and correct to the best of my knowledge and belief and in case of any false statement/information shall be liable for any action under the appropriate section of the law.

I Agree *