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गुजरात मोटर वाहन विभाग

Gujarat Motor Vehicles Department


(डीए शाखा / DA Branch)
(मोटर यान अधिनियम, 1988 व इसके अधीन बने नियमों को भंग करने की सूचना (Infringement report under Motor
Vehicles Act, 1988 and Rules made thereunder)

कार्यालय का नाम/ Office Name : PANCHMAHAL

(https://echallan.parivahan.gov.in/www/img/no_image.png)
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(HTTPS://echallan.parivahan.gov.in/www/img/no_imag

चालान दिनांक/Challan Date : 13-07-2022 14:15:00


पुस्तक संख्या/ Book Number: 36863 फॉर्म संख्या /Form no: 0
वाहन श्रेणी/ Vehicle Class: M-Cycle/Scooter चालान संख्या/Challan no: GJ54167220714021893
वाहन संख्या/Vehicle no GJ20B***** चेसिस नं०/Chassis no: MD634AE85N2F*****
पुस्तक संख्या/Book no 36863 इंजन नं० / मोटर नं०/ Engine no / AE8FN2X*****
Motor No:
वाहनस्वामी का नाम/ Owner's Name: S*N*A*B*A*
फॉर्म संख्या /Form no: .........
Violator Contact No: *******999
वाहनस्वामी का पता/ Owner's Address BAMNYA FALIYU,DHANPUR, DHANPUR, DAHOD, Dahod-389382

चालक का नाम/ Driver's name b*m*i*a*r*m*n*h*i


पिता का नाम/ Father's name bachubhai
आयु/ Age ........
ड्राइविंग लाइसेंस नं/ DL no. ........ वैधता/ Validity .........
घटनास्थल/ Place of incident godhra
स्रोत/ Source ........
गंतव्य/ Destination ........

अभिगृहीत दस्तावेज Document Impounded:


No Document Impounded
आरोपित अपराध/ Offences Charged with:-
1: 180.0.1a[Owner] (Allowing unauthorized person to drive vehicles) Whoever,being the owner or person in charge of motor vehicle,causes
or permits,any other person who does not satisfy the provisions of section 3 of section 4 to drive the vehicle-Two Wheeler ( 180 )[Fine -
2000]
2: 181.0.1a[2019][driver] (Driving Vehicle-Two Wheeler in contravention of Section 3 or Section 4)-Drives vehicle without holding driving
license. ( 181 )[Fine - 2000]
ई-चालान प्रशमन शुल्क जमा का विवरण/ e-challan compounding fee deposit details

रसीद नं०/Receipt no. ................. दिनांक/Date 14-07-2022


प्राप्त धनराशिReceived Amount Rs 4000 (in Words Four Thousand Rupees only)
टिप्पणी/Remarks: gj20bb2785
ड्राईवर/ वाहन स्वामी का नाम एवं हस्ताक्षर        हस्ताक्षर/ Signature : ..................................
Name and signature of Violator (Driver/Owner) प्रवर्तन अधिकारी का नाम व पदनाम/Name and signature of Officer
bamniya ramanbhai/bamniya ramanbhai Traffic Police
(tp01gj17@nic.in)
Police Officer

Reasons as to why no legal proceedings shall be initiated against owner/driver for aforementioned offence/s shall be
submitted to RTO.....................................within 14 days

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