Vehicle information Proforma

(The form should be printed in hard copy and then filled)

1. Please indicate the following information:

vehicle
a. Model of the : TATA INDIGO
b. Year of manufacture : APRIL 2011
c. Year of registration : 16105120ll

2. Indicate whether the vehicle in suap condition or is it in running condition : Scrap condition

3. If running condition indicate the following :

a. were you the first owner or a subsequent one FIRST OWNER

b. Registration Number of the vehicle KL-04- AA6969
c. Engine Number of the Vehicle 14CRAILO8DYYWO8939
d. Chassis Number of the vehicle MAT601462BPD30l4l
e. Is the RC Book available YES
f. The date up to Road tax is paid 3U03t2026
g. The date up to which insurance is present 29104t2020
h. Total Kms run by the vehicle 2,25,357

4. If the vehicle is in Scrap condition indicate the following:

a. is registration canceled ( RC Book surrendered to RTO) and all taxes / duties paid :
b. Engine Number of the vehicle :

c. Chassis number of the vehicle :

5. Indicate the applicable GST percentage for the vehicle: lZ%

6. In case of a passenger vehicle the following may also be indicated:

a. What is the seating capacity : FIVE

b. is the permit for running the vehicle within the state or otherwise : NiA

7. Exact location of the vehicle : K.s.D.p, KALAVOOR, ALApptJZHA

8. Contact details of the person in charge of inspection:

a. Name : NAVEEN KUMAR T

b.Address: K.S.D.P, KALAVOOR, ALApptJZHA,pIN-6gg522
c. Contact Number : 9400044587

(The above particulars may kindly be verified and signed below

by competent Authority of the seller)

Name: NAVEEN KUMAR.T

Designation: DM,|\4ANT (VC)
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