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BANGALORE METROPOLITAN TRANSPORT CORPORATION

(Students Concessional Bus Pass Application)


To be filled in Block letters
Full Name:
DoB:.Age:
Gender:
Religion:. Caste :.
Postal address:.
Door #: Street:..
Locality:.pin code:.
Name of the Parent/guardian: .
Permanent address...
.
.
.

Affix a recent
stamp size
Photo of the
applicant with
seal & sign of
institution

Contact
Tel.No: ..
Email Address:

Students Requirement : Ordinary pass / Travel as you like pass / Renewal / Extension
Travel Details
Class:.. Educational Institution:
From: To:
Place of Changeover:......
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 knowledge.
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. Address proof.
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.

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