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Fast Tag Exemption Application

The document appears to be an application form for exempted category FASTags issued by the Government of India Ministry of Road Transport and Highways. The application requests information such as name, address, vehicle details, and bank account or e-wallet information from applicants seeking exempted category FASTags. It also includes additional details required for applicants who are members of parliament such as their constituency information.

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Vidhan Chandra
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2K views2 pages

Fast Tag Exemption Application

The document appears to be an application form for exempted category FASTags issued by the Government of India Ministry of Road Transport and Highways. The application requests information such as name, address, vehicle details, and bank account or e-wallet information from applicants seeking exempted category FASTags. It also includes additional details required for applicants who are members of parliament such as their constituency information.

Uploaded by

Vidhan Chandra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Government of India

Ministry of Road Transport and Highways


Transport Bhawan, 1, Parliament Street
__________________________________________________________________________________

Standard Application Format for Exempted Category FASTag


Annexure -2

Passport Size
Photograph

APPLICATION FORM
1. Name of the Applicant (in Block Letters)

2. Document (For Self -Identity Proof, For


Authorized Representative Authorization Letter,
as applicable)
3. Exempted Category of Vehicle Code (as per
Annexure - 1*)
4. Present Address with Telephone No

5. Permanent Address with Telephone No

6. Mobile number
7. Email lD
8. Details of Bank Accountl e-Wallet (optional)
9. Details of vehicle for the Exempted Category as
mentioned in Annexure 1*:
a) Ownership - Govt./Personal/Third Party
b) Usage of vehicle - Official/Personal
c) Vehicle Registration Number
10. Validity period requested (maximum 5 years)
Government of India
Ministry of Road Transport and Highways
Transport Bhawan, 1, Parliament Street
__________________________________________________________________________________

11. In case of M.P/MLA/MLC, the following


additional information is to be provided:

a. Identity Card Number


b. Constituency Name
c. State of the Constituency
d. Present tenure end date
e. Vehicle No. at New Delhi (only Car/ Not applicable in
Jeep/Van) respect of MLAIMLC

Vehicle No. at respective Constituency Vehicle RC Copy to be


(only Car/Jeep/Van) enclosed

Date (Signature and seal of Applicant/ Authorized Representative for categories as per
Annexure1*)
__________________________________________________________________________________
(For official purpose)

Remark of RO- NHAI:

Remark of IHMCL:

FASTag validity: Pan India/Within State

*Note: ForAnnexure1-Please refer to the SOP for exempted FASTag issued by MoRTH

__________________________________________________________________________________

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