Form C - Application For Reference Of Charge printable pdf download

Form C - Application For Reference Of Charge

FORM C

APPLICATION FOR REFERENCE OF CHARGE

(For official use) LRC Number:

Date:

Payment:

Received by:

___________________________________________________________

APPLICATION AFFECTING:

Insert number of charge certificate together with the number of the

Certificate of Title.

___________________________________________________________

NATURE OF THE APPLICATION:

Insert the information that is to be inserted in the charge certificate in the

manner that it shall reflect what is agreed by the contracting parties.

These details are to contain the details of the contracting parties.

___________________________________________________________

LIST OF DOCUMENTS SUBMITTED WITH THIS

APPLICATION:

_______________________________________________

DECLARATION:

I hereunder signed, declare that all that is stated in this form as far as I

know is true, and that I have verified the relative documents, and that

there is no fact that I know of that is contrary to that brought in the

documents.

Form C - Application For Reference Of Charge