APPLICATION FOR STUDENT BUS PASS FREE SUPPLY ( RTC-282/R ) ANDHRA PRADESH STATE ROAD TRANSPORT CORPORATION 1. NAME OF THE STUDENT (Maximum 20 Characters): Name Surname PHOTO 2. Father’s/Mother’s Name: (Maximum 20 Characters): Name Surname D D M M Y Y Y Y 3. Date of Birth: 4. Sex : 5. Type of Pass : 6. Bus Pass Code : 7. Institution Code: Institution Name: 8. Course Code : Course Name: 9. Admission No. : 10. Route Particulars: From To Via 11. Residential Address : H.No. Street Village Mandal District Pin Code Cell No. M F I hereby declare that the particulars given above are true and correct. I will abide by the rules & regulations of APSRTC governing issue of Bus Passes. BONAFIDE CERTIFICATE Signature of the Candidate. I hereby certify that Sri / Kum / Smt. …………..……………………………….…………………… is a bonafide student of ……………………………………………………… (Name of the institution) studying ……….………….. (Name of the course) with Admission No ……….………….…….. & Roll No ……….……………. His / Her Date of Birth is ………. …………….. (DD/MM/YY) as per office records and the course will be completed by ……………………………. (DD/MM/YY). Educational Institute Recognition Code No ………………………. (As per the D.E.O. records). Course Code No …..….………… for the Academic year …..…………..…… Date: Place: Signature of Head of the Institution with Seal.
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