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1. |
Full Name of person to be registred as Registered owner |
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Son/Wife/Daughter of |
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2. |
Age of person to be registered as Registered owner |
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3. |
Permanent Address (Proof to be enclosed)
(Electoral 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) |
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4.
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Termporary/Official Address (if any)
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4(A) Ownership type |
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5. |
Duration of stay at the present address |
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6. |
The
annual income and PAN/GIR number of the owner
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7. |
(a) Place of Birth |
Village/Town/City: |
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Mandal/Zone: |
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District: |
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State: |
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(b) Date of Birth |
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8. |
If place of birth outside India, when migrated to India |
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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) |
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(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 by registration, certificate to be enclosed) |
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(iii) If citizenship by Naturalization (Certificate of Naturalization
and certificate of registration to be enclosed) |
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(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) |
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10. |
Name and address of the Dealer or Manufacturer from whom the vechile was purchased(sale
certificate and certificate of road worthiness issued by the manufacturer to be
enclosed) |
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11. |
If ex-army vechile or imported vechile,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 |
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12. |
Class of vechile
(if motor cycle,whether with or without gear) |
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13. |
The motor vehicle is
(a) a new vehicle
(b) ex-army vehicle
(c) imported vehicle |
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14. |
Type of body |
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15. |
Type of vehicle |
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16. |
Makers name |
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17. |
Month and year of manufacture
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18. |
Number of cylinders |
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19. |
Horse power |
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20. |
Cubic capacity |
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21. |
Maker's classification or if not known,wheel base |
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22. |
Chassis No.(Affix pencil print) |
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23. |
Engin Number or Motor Number in case of Battery Operated Vehicles |
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24. |
Seating capacity (including driver) |
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25. |
Fuel used in the engine |
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26. |
Unladen weight |
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27. |
Particulars of previous registration and registered number(if any) |
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28. |
Colour or colours of body wings and front end |
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I here by declare that the motor vechile has not been registered in any state in
India |
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ADDITIONAL PARTICULARS TO BE COMPLETED ONLY IN THE CASE OF TRANSPORT VEHICLES OTHER
THAN MOTOR CAB |