ANNEXURE

Government of Tamil Nadu

Home Prohibition & Excise (Transport VI) Department, Secretariat, Chennai - 600 009

MOTOR VEHICLE NUMBER REGISTRATION ALLOTMENT FORM

1. Name of the vehicle owner:

(in case of firm, name of the firm should be specified)

2. Sex: 3. Category: (I - Individual, O - Organization / Firm)

4. Name of the father/husband:

5. Postal address:

6a. Type of vehicle purchased: (1 - Two wheeler, 2 - Three wheeler, 3 - LMV, 4 - HMV)

6b. Engine number:

6c: Chassis number:

7. Ownership type: (P - Private, G - Government)

8. RTO code:

9. Fancy number (or) advance number requested in the order of preference and the series

a. Series __________ No __________ c. Series __________ No __________

b. Series __________ No __________ d. Series __________ No __________

Place:
Date:
Signature of the vehicle owner

For office use only

Allotted series number:
Department current number:
Date:
Signature of the officer