12.
Unladen weight…………………………………………………………………………
13.
Fuel used………………………………………………………………………………..
I enclose the certificate of insurance for perusal and return.
Dated:-…………………..
Signature or Thumb impression of the applicant.
Note :- The motor vehicle above described is not subject to an agreement of hire purchase,
lease or hypothecation.
The vehicle is:
(i)
Subject to hire purchase agreement/lease agreement with……………………...
(ii)
Subject to hypothecation in favour of ………………………………………….
Signature or Thumb impression
of registered owner.
Specimen signature or thumb impression of registered owner:
1.
2.
3.
CERTIFICATE
Inspected the vehicle-verified the chassis number and engine number. Certificate that the
particulars contained in the application and the corresponding particulars declared in the
certificate of registration of the vehicle are true and that the ve hicle complies with the
requirement of the Motor vehicle Act, 1988 and rules made thereunder.
Signature of the Inspecting Authority.
Name…………………………………..
Designation…………………………..
………………………………………….