MOTOR VEHICLES DEPARTMENT

FORM CFA/CFRA
Application for Certificate of Fitness / Application for Renewal of Certificate of Fitness
See KMV Rule 105(2)
   
Transaction ID : B/51007/2018 Date: 09-04-2018
Table ID          : 7  
Test Date         : 10/04/2018  
Test Time         : 10AM
 
To
The Registering Authority / The Inspector of Motor Vehicles
SRTO, TRIPUNITHURA
I here by apply for the issue of a certificate of fitness / renewal of the
certificate of fitness as required by section 56 of Motor Vehicle Act 1988
   
Registration Mark of Vehicle     : KL-39-B-8398
Name of Owner     : SATHEESAN
Permanent Address     : 195, PUTHENMADAM,
        21, TRIPUNITHURA
        ERNAKULAM DIST
      
Temporary Address     : FARE METER NO 38171
        MAKE:SUPER
      
      
Place where the vehicle is normaly kept :
Name of the manufacture of vehicle : PIAGGIO VEHICLES P LTD
Manufacturer's Model, or, if not known,
: 2010
wheel base
LMV - 3 WHEELED VEHICLE
Type of Vehicle : FOR TRANSPORT- PASSENGER
(A/R)
Chassis Number : MBX0000DFMD027292
Engine Number : R0D2780749
Number of the certificate of fitness and date
: 39 / 24061 / 2017
of issue or last renewal
Authority by which the certificate of fitness
: Jt.RTO, SRTO, TRIPUNITHURA
was issued or last renewed
Date of expiry of last certificate of fitness : 08-04-2018
Exemption if any sought for :  
     
      Signature of Applicant