BANGALORE METROPOLITAN TRANSPORT CORPORATION

(Students Concessional Bus Pass Application)

To be filled in Block letters
Full Name:
Affix a recent
DoB:.Age:
stamp size
Gender:
Photo of the
Present Postal address:. applicant with
Door #: Street:..
seal & sign of
Locality:.pin code:.
institution
Name of the Parent/guardian: .
Permanent address...
.
.

Contact Tel.No: ..
Email Address:
Aadhar No (If available )

Students Requirement : Ordinary pass / Travel as you like pass / Renewal / Extension
Travel Details
Class:.. Educational Institution:
From:
To:
Place of Changeover:.....Distance (in KM)..
Validity Period: . . to
Signature of Parent/Guardian
Students Signature
--------------------------------------------------------------------------------------------------------------------------Certificate from Educational Institution
The above information furnished by the student studying in our Educational Institution is true as
per our record.
Students Registration No:

Signature of Head of the

Institution with seal & Date
--------------------------------------------------------------------------------------------------------------------------Terms& Conditions
Production of the following document is compulsory :
1) Original fee Receipt for the current academic year.
2) Identity Card issued by the Educational Institution.
3) 2 Photo 4) Copy of the Aadhar Card ( If available please enclose)
Rules to be followed
Pass not transferable to be produced for inspection on demand by BMTC authorities Rs.100/-+ fee for the balance validity period to be paid for obtaining Duplicate Pass after due Police
formalities in case of loss during the validity period.
Office use only ( To be filled in by the official deployed for scrutinizing pass application)
Total distance travelled by student in KMs ______________
Total stages travelled by Student _______________________
Examined person name & signature