Access Pass Application Form: PSU 03

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Operational Area

Lorry Access Pass

Boatman Pass

Customs Verification Area

Taxi Drivers Pass

From *

Day

Month

Year

To *

Day

Month

Year

Surname *

Name *

E-mail *

NIC No. *

Occupation *

Address *

Access Zone *

Vehicle No *

Name of Company/ Agent *

Employer's Address *

Telephone No.

Mobile No

Fax No

Lorry Pass

Prime Mover(s) No. *

Trailer(s) No.

MRA Registration No.

Name of Drivers

Customs Verification Area

Customs Card No.

Expiry Date

Day

Month

Year

Boatman Pass

Boat Licence

Boatman Licence

Boat Licence Expiry

Day

Month

Year

Police Clearance

Approval

Approved

Not Approved

Name

Port Master's Approval:

Date

Day

Month

Year

Port Area Taxi

Registration No

Driver's Name

Base of operation

Base Licence No

NTA Licence

Supporting Documents

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png bmp doc docx.

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