APPLICATION FOR AFFIXATION OF HSRP

To,
The Registering Authority
Chandigarh ( U.T )
Sir,
Kindly affix the High Security Registration Plate in my vehicle with the following
details:
Full name of owner.. Son/Wife/
Daughter of .

Permanent address of the owner.

Temporary address of the owner.
Registration number of vehicle .
In case of old vehicle, whether affixed with HSRP earlier (Y/N).
Class of vehicle (If motor cycle, whether with or without gear).......
Makers name.
Month and year of manufacture...
Chassis No..
Engine No. ....
Colour or colour of body, wings and front end..
In case affixed with HSRP earlier, laser code of
Front number plateRear number plate
Date
Signature of owner
For office use only
VERIFICATION OF DATA
Signature Name & Designation of verifier

(Note: if not verified give details of discrepancies)

AUTHORISATION
Signature Name & Designation of officer
(Note: if not authorized give reason thereof)
This portion is to be filled in at the time of actual affixation of HSRP)
City in which Affixation Centre is located. The
components for which charges are being collected... Amount of
Gross charges collected ...

Date and time of collection of advance .

Date and time of actual affixation of HSRP
Number of days by which the service has been delayed...

Signature of Contractors authorized representative Signature of motor vehicle

owner/authorized representative

Receipt of application for affixation of HSRP

Reference No..
Signature of receiver and designation

AUTHORITY LETTER FOR GETTING HSRP AFFIXED

To,
THE REGISTERING AUTHORITY
......
..
I ..(name of owner of vehicle), resident of
..., owner of vehicle number
bearing chassis number and engine
number. do hereby authorize Mr./Ms
. Resident of ....
whose signatures are attested below to pay the charges for High Security
Registration Plates and get such plates affixed to my vehicle.
Signature of AUTHORISED PERSON
Signature/Thumb
Impression of Owner