STATE of PUNJAB DRIVING LICENSE APPLIKASON PHAROM

NOTE : If you dont know the answers, please copy
from another
applikason phorom and submit. For further
instructions, see bottom
applikason kounter.
He will give you the lisence immediately.
(Check all appropriate box)

Last Name

Kaur SinghDon't Know
First name

Balwinder Jaswinder Surinder Joginder Maninder Don't know
Age

Less than zeroZeroGreater than zeroDon't know
Sex:

MaleFemaleNot SureNot Applicable
Chappal Size Left Right
Occupation

Farmer Mechanic Pehelwaan ( Punjabi for "wrestler") House wife Un-employed
Spouse's Name

Relationship with spouse

Sister Brother Aunt Uncle Cousin Mother Father Son Daughter Pet
Number of children living in household

Number that are yours

Mother's Name

Father's Name

Education

1 2 3 4 (Circle highest grade completed)
Do you

own or rent your mobile home? (Check appropriate box)
Total number of vehicles you own

Number of vehicles that still crank

Number of vehicles in front yard

Number of vehicles in back yard

Firearms you own and where you keep them

truck bedroom bathroom kitchen shed
Model and year of your pickup

194
Do you have a gun rack?

Yes No; If no, please explain:

Newspapers/magazines you subscribe to

Champak Indrajal Star and style The great Punjab Dairy Blank sheets
Number of times you've SHOT a UFO

Number of times you've SHOT another person exactly like you

Number of times you've SHOT yourself.

(SHOOTING YOURSELF IN MIRROR IS POOR SHOOTING)
Do you bathe?

Yes No Not applicable
How often do you bathe?

Weekly Monthly Not Applicable
Color of teeth

Yellow Brownish-Yellow Brown Black Others - Give exact color (call nearest Asian Paints dealer if U dont know the color of your teeth) Not applicable
How far is your home from a paved road?

1 mile 2 miles don't know

Your thumb impresson
(If you are copying from another applikason pharom,
please do not copy thumb impression also. Please provide your own thumb impression
PLEASE DO NOT USE FINGERS ON YOUR LEGS.
Use thumb on your left hand only. If you dont have left hand, use your thumb on right hand. If you do not have right hand,
use thumb on left hand.
NOTE : IF YOU DONT HAVE BOTH HANDS, YOU CANNOT
DRIVE.)

For instructions to fill this applikason pharom, see
beginning of
applikason phorom


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