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STATE of BIHAR > DRIVING LICENSE APPLIKASON PHAROM

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NOTE : If you dont know the answers, please copy from another applikason phorom and submit.

For further instructions, see bottom applikason. Please do not shoot the person at the applikason kounter. He will give you the lisence immediately.

a.. Last name

a.. (Yadav/Sinha/Pandey/Mishra/do not know)

b.. Phust name:

a.. (_) Ramprasad

b.. (_) Lakhan

c.. (_) Sivaprasad

d.. (_) Jamnaprasad

e.. (_) Dont know

f.. (Check appropriate box)

c.. Age:

a.. (_) Less than zero

b.. (_) Zero

c.. (_) Greater than zero

d.. (_) Don't know

d.. Sex:

a.. ____ M _____ F _____ not sure _____ not applicable

e.. Chappal Size:

a.. ____ Left ____ Right

f.. Occupassan :

(_) Politician

(_) Doodhwala

(_) Pehelwaan

(_) House wife

(_) Un-employed

g.. Bhife Name: __________________________

h.. Relationship with Bhife :

(_) Sister

(_) Brother

(_) Aunt

(_) Uncle

(_) Cousin

(_) Mother

(_) Father

(_) Son

(_) Daughter

(_) Pet

i.. Number of children living in household: ___

Number that are yours: ___

j.. Mother's Name: _______________________

k.. Phather's Name: _______________________

l.. Heducasson : 1 2 3 4 (Circle highest grade completed)

m.. Do you (_)own or (_)rent your home? (Check appropriate box)

n.. ___ Total number of vehicles you own

___ Number of vehicles that still crank

___ Number of vehicles in front yard

___ Number of vehicles in back yard

___ Number of vehicles on cement blocks

o.. Firearms you own and where you keep them:

____ truck

____ bedroom

____ bathroom

____ kitchen

____ shed

p.. Model and year of your pickup: _____________ 194_

q.. Do you have a gun rack? (_)Yes (_) No; If no, please explain:

r.. Newspapers/magazines you subscribe to:

(_) Champak

(_) Indrajal

(_) Star and style

(_) The great Bihar Dairy

(_) Blank sheets

s.. ___ Number of times you've SHOT a UFO

t.. ___ Number of times you've SHOT another person exactly like you

u.. ___ Number of times you've SHOT yourself.(SHOOTING YOURSELF IN MIRROR IS POOR SHOOTING)

v.. Do you bathe?

(_) Yes

(_) No

(_) Not applicable

w.. If yes, how often do you bathe?

(_) Weekly

(_) Monthly

(_) Yearly

x.. 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

y.. 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 OF 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.

Ishmile and have a Nice Day every day !