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VEH 65 Applikazzjoni g all- enituri li ju aw it-trasport tal-iskola bi las g all-ulied tag hom Application Form for parents using approved School Transport Operators for their children Transport Malta Land Transport Directorate Telephone 00356 2556 0000 Website www. transport. gov*mt WARNING to all applicants - Any false statements misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution* INFORMATION PROTECTED - Personal information provided on your application form is protected and used in accordance with the provisions of the Data Protection Act. Sezzjoni A Dettalji tal-Applikant / Applicant s Details Isem Name Kunjom Surname Numru tal-identita I. D Card No* Data tat-Twelid Date of Birth Ammont M allas Amount Paid In-Numru tal-li enzja tal-operatur Operator s Licence Number Isem tal-operatur li jipprovdi s-servizz ta trasport Name of the operator providing the School Sena li fiha sar l- las Year of Payment Numru tar-Re istrazzjoni tat-Taxxa Income TAX Registration number Sezzjoni D Dikjarazzjoni / Declaration Nikkonferma li l-informazzjoni f dan id-dokument hija skont l-a jar tag rif tieg i vera u korretta I confirm that the information provided is true and correct according to my knowledge Firma tal-Operatur Isem u Kunjom tal-operatur Data Timbru tal-Entita This document should be sent to Transport Malta by post addressed Driver Passenger Operator Licensing Unit Hornworks Ditch Floriana FRN 1230 Version 1 - 1/1/2016. transport. gov*mt WARNING to all applicants - Any false statements misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution* INFORMATION PROTECTED - Personal information provided on your application form is protected and used in accordance with the provisions of the Data Protection Act. Sezzjoni A Dettalji tal-Applikant / Applicant s Details Isem Name Kunjom Surname Numru tal-identita I. Sezzjoni A Dettalji tal-Applikant / Applicant s Details Isem Name Kunjom Surname Numru tal-identita I. D Card No* Data tat-Twelid Date of Birth Ammont M allas Amount Paid In-Numru tal-li enzja tal-operatur Operator s Licence Number Isem tal-operatur li jipprovdi s-servizz ta trasport Name of the operator providing the School Sena li fiha sar l- las Year of Payment Numru tar-Re istrazzjoni tat-Taxxa Income TAX Registration number Sezzjoni D Dikjarazzjoni / Declaration Nikkonferma li l-informazzjoni f dan id-dokument hija skont l-a jar tag rif tieg i vera u korretta I confirm that the information provided is true and correct according to my knowledge Firma tal-Operatur Isem u Kunjom tal-operatur Data Timbru tal-Entita This document should be sent to Transport Malta by post addressed Driver Passenger Operator Licensing Unit Hornworks Ditch Floriana FRN 1230 Version 1 - 1/1/2016. transport. gov*mt WARNING to all applicants - Any false statements misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution* INFORMATION PROTECTED - Personal information provided on your application form is protected and used in accordance with the provisions of the Data Protection Act. Sezzjoni A Dettalji tal-Applikant / Applicant s Details Isem Name Kunjom Surname Numru tal-identita I. D Card No* Data tat-Twelid Date of Birth Ammont M allas Amount Paid In-Numru tal-li enzja tal-operatur Operator s Licence Number Isem tal-operatur li jipprovdi s-servizz ta trasport Name of the operator providing the School Sena li fiha sar l- las Year of Payment Numru tar-Re istrazzjoni tat-Taxxa Income TAX Registration number Sezzjoni D Dikjarazzjoni / Declaration Nikkonferma li l-informazzjoni f dan id-dokument hija skont l-a jar tag rif tieg i vera u korretta I confirm that the information provided is true and correct according to my knowledge Firma tal-Operatur Isem u Kunjom tal-operatur Data Timbru tal-Entita This document should be sent to Transport Malta by post addressed Driver Passenger Operator Licensing Unit Hornworks Ditch Floriana FRN 1230 Version 1 - 1/1/2016.