FORM - M. V. Rep. A [See rule 70 (5) (i)] Application for replacement of a vehicle covered by permit / countersignature To, The State/Regional Transport Authority Full name and Gujarat State Region address of the applicant I hereby apply for a replacement of the vehicle covered by the permit / countersignature held by me, as herein under set out : 1. Particulars of permit/countersignature held by the applicant : (a) Permit/Countersignature No. (b) Issued by (c) Valid from (d) Type of permit to 2. Particulars of registration countersignature and of the r of eplac present vehicle er vehicle : covered by such permit Present vehicle Replace v ehicle (i) Registration Mark (ii) Make (iii) Date of initial registration (iv) Type of vehicle (v) Seating capacity G.V.W. (vi) Validity of C. F. (vii) Validity of Insurance 3. Whether the present vehicle is held under a hire-purchase/lease/hypothecation agreement if yes, no objection certificate from the financier must be attached. 4. Whether the applicant is in possession of replacer vehicle if yes, the certificate of registration must be attached. If no, the details of arrangement made/to be made to acquire the vehicle 5. Reasons for replacement 6. I hereby declare that the above statements are true and that I have supplied all the information and documents necessary to support the statements made in this application. 7. I herewith tender the fee prescribed in rule 71. Date : Place : Signature of the applicant Note : Where the space is not sufficient, the applicant should furnish the information, item-wise separates sheets, must sign each sheet, and must attach them with the application. Strike out whichever is either not require or not applicable.
