(See Rule 47) Application for Registration of a Motor Vehicle To The Registering Authority, ................................................................. 1. Full Name of person to be registered as Registered owner Son / Wife / Daughter of 2. Age of the person to be registered as Registered owner (Proof of age to be attached) 3. Permanent address of the person to be registered as Registered owner (Evidence to be produced) 4. Temporary address of the person to be registered as Registered owner : ...................................................... : ...................................................... : ...................................................... ...................................................... : ..................................................... ..................................................... 5. Name and address of the Dealer of manufacture from whom the vehicle was purchased (Sale Certificate and the certificate 6. If ex-army vehicle, or imported vehicle, enclose proof if locally manufactured Trailer/Semi-trailer, enclose the approval of design by the STA and note the proceedings No. and date of of road worthiness is issued by the manufacturer to be enclosed) : .................................................... .................................................... .................................................... approval : .................................................... 7. Class of vehicle (if motor cycle, whether with or without gear) : .................................................... 8. The motor vehicle is a) a new Vehicle b) Ex-army Vehicle : .................................................... c) Imported Vehicle 9. Type of body : ................................................... 10. Type of Vehicle : .................................................... 11. Maker' s Name : ................................................... 12. Month and Year of Manufacture : ................................................... 13. Number of Cylinders : ................................................... 14. Horse Power : ................................................... 15. Cubic Capacity : ................................................... 16. Maker's Classification or if not known wheel-base : ................................................... 17. Chassis Number (Affix pencil print) : ................................................... 18. Engine Number : ................................................... 19. Seating Capacity (including Driver) : ................................................... 20. Fuel used in the engine : ................................................... 21. Unladen Weight : ................................................... 22. Particulars of previous registration and registered number (if any) : ................................................... 23. Colour or colours of body, wings and front end : ................................................... I hereby declare that the vehicle has not been registered in any State in India. Additional particulars to be completed only in the case of transport vehicles other than motor cab. 24. Number, description and size of tyres: a) Front axle b) Rear axle c) Any other axle d) Tandem axle ... ... ... ... ..................................... ..................................... ..................................... ..................................... 25. Gross vehicle weight a) as certified by the manufacturer b) To be registered ... ... Kgms Kgms 26. Maximum axle weight a) Front axle b) Rear axle c) Any other axle d) Tandem axle ... ... ... ... KgmsKgms KgmsKgms 27. a) Over all length b) Over all Width c) Over all height d) Over hang ... ... ... ... The above particulars are to be filled in for a rigid frame motor vehicle of two or more axles for an articulated vehicles of three or more axles, or, to the extent applicable for trailer, where a second semi-trailer or additional semi-trailer are to be registered with an articulated motor vehicle. The following particulars are be furnished for each such semi-trailer: 28. Type of Body ... ................................................................................... 29. Unladen weight ... ................................................................................... 30. Number, description and size of tyres on each axle ... ................................................................................... 31. Maximum axle weight in respect of each axle ... ................................................................................... 32. The vehicle is covered by valid Insurance certificate or cover note ............................. . certificate of insurance under No ................................... date ................................ Chapter XI of the Act of ............................................ (Name of Company) valid from ................................. to .......................... 33. The vehicle is exempted from Insurance. The relevant order is enclosed ... ................................................................................. 34. I have paid the prescribed fee of rupees..................................................................................... Date: ......................... ................................................................. Signature of the person to be registered as registered Owner Note: The motor vehicle above described is 1) Subject to Hire-Purchase agreement / Lease agreement with............................................... 2) Subject to Hypothecation in favour of .................................................................................... 3) Not held under Hire-Purchase agreement or Lease agreement or subject to Hypothecation. *Strike out whatever is inapplicable. If the vehicle is subject to any such agreement the signature of the Financier with whom such agreement has been entered into is to be obtained. .......................................................... Signature of the Registered owner Signature of the Financier with whom an agreement of the Hire-purchase, Lease or Hypothecation has been entered into. CERTIFICATE OF INSPECTION OF MOTOR VEHICLE Certified that the particulars contained in the application are true and that the vehicle complies with the requirements of the Motor Vehicle Act 1988 and the Rules made thereunder. .......................................................... Signature of the Inspecting Authority Name.................................................. Designation........................................ For Office Endorsement Ref No. ............................................Office of the ............................................................................... The above said motor vehicle has been assigned the Registration number..........................................and registered in the name of applicant and the Vehicle is subject to an agreement of Hire-Purchase / Lease/ Hypothecation with the Financier referred above. ............................................................ Date:.............................. Signature of the Registering Authority To The financier: ............................................................................. (To be sent by Registered Post acknowledgment due) Specimen signature or thumb impression of the person to be registered as Registered owner and Financier are to be obtained in original application for affixing and attestation by the Registering Authority with office seal in Forms 23 and 24 in such a manner that the part of impression of seal or a stamp and attestation shall fall upon each signature Specimen signature of the Financier Specimen signature of the Registered owner (1) (1) (2) (2)
