Application for registration of a motor vehicle

(To be made in duplicate if the vehicle is held under an agreement of hire-purchase/lease/hypothecation and duplicate copy with the endorsement of the Registering Authority to be returned to the Financier simultaneously on registration of motor vehicle)
To
The Licensing Authority,
1. Full name of person to be registered as registered owner
Son/Wife/daughter of
2. Age of person to be registered as registered owner
3. Permanent address
(Electro Roll/Life Insurance Policy/ Passport/Pay slip issued by any office of the Central Government/ State Government or a local body/ any other document or documents as may be prescribed by the State Government/Affidavit sworn before an Executive Magistrate or a First Class Judicial Magistrate or a Notary Public to be enclosed)
4. Temporary address/Official address, if any
5. Duration of stay at the present address
6. The annual income and PAN/GIR number of the owner
7. Place of birth
8. If place of birth is outside India, when migrated to India
9. Declaration of citizenship status
(i) If deemed citizen or citizen by birth (Birth certificate and school certificate in support of citizenship as Indian to be enclosed)
(ii) If citizenship is acquired by descent/registration (In case citizenship acquired by descent, birth certificate, land/property document of parent/in case of citizenship acquired to registration, certificate to be enclosed)
(iii) It citizenship by naturalization (Certificate of naturalization and certificate of registration to be enclosed)
(iv) If non-Indian citizen (Valid passport or other travel documents and such other document or authority as  may be prescribed by law to be enclosed)
10. Name and address of the dealer or manufacturer from whom the vehicle was purchased (sale certificate and certificate of road worthiness issued by the manufacturer to be enclosed)
11. If ex-army vehicle or imported vehicle, enclose proof. If locally manufactured trailer/semi-trailer, enclose the approval of design by the State Transport Authority and note the proceedings number and date of approval
12. Class of vehicle (if motor cycle, whether with or without gear)
13. The motor vehicle is

(a) a new vehicle,
(b) ex-army vehicle,
(c) imported vehicle
14. Type of body
15. Type of vehicle
16. Maker’s name
17. Month and year of manufacture
18. Number of cylinders
19. Horse power
20. Cubic capacity
21. Maker’s classification or if not known, wheel base
22. Chassis No. (Affix Pencil print)
23. Engine Number or Motor Number in case of Battery Operated Vehicles
24. Seating capacity (including driver)
25. Fuel used in the engine
26. Unladen weight
27. Particulars of previous registration and registered number (if any)
28. Colour or colours of body wings and front end
I hereby declare that the motor 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
29. Number, description, size and ply rating of tyres, as declared by the manufacturer

(a) Front axle=..........................................
(b) Rear axle=..........................................
(c) Any other axle=................................
(d) Tandem axle=....................................

30. Gross vehicle weight
(a) as certified by manufacturer ........................ kgms
(b) to be registered ............................................... kgms

31. Maximum axle weight
(a) Front axle=........................................................ kgms
(b) Rear axle=.......................................................... kgms
(c) Any other axle=.................................................kgms
(d) Tandem axle=.................................................... kgms

(a) Overall length ..................................
(b) Overall width ..................................
(c) Overall 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 vehicle 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 to be furnished for each such semi-trailer.
33. Type of body
34. Unladen weight
35. Number, description and size of tyres on each axle
36. Maximum axle weight in respect of each axle
37. The vehicle is covered by a valid certificate of insurance under Chapter XI of the Act
Insurance Certificate or Cover Note

No...........................

Date........................

of.............................

(Name of company) valid from

38. The vehicle is exempted from insurance. The relevant order is enclosed
39. I have paid the prescribed fee of Rs.

Signature or thumb impression of the person to be registered as registered owner

Note.-The motor vehicle above described is-

(i) Subject to hire-purchase agreement/lease agreement with ........
(ii) Subject to hypothecation in favour of .............
(iii) 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 financier with whom an agreement of hire-purchase, lease or hypothecation has been entered into
Signature or thumb impression of the registered owner

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 Vehicles Act, 1988 and the Rules made thereunder.
Signature of the Inspecting Authority
Date .............................
Name ........................
Ref. No.........................
Designation........................
Office Endorsement
Office of the ........................
The above-said motor vehicle has been assigned the Registration Number ........................ and registered in the name of the 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 acknowledgement 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 Regis tered Owner