FORM 29 [Refer Rule53(1)] NOTICE OF TRANSFER OF OWNERSHIP OF A MOTOR VEHICLE. (To be made in duplicate and the duplicate copy with the endorsement of the registering authority to be returned to the transferor or immediately on making entries of transfer of ownership in certificate of registration and Form 24.) To The Registering Authority RTO ANGUL. {in whose jurisdiction the transferee resides) \We Bishnu Prasad Pati resident of At '-Injana, PO:- Kalarahanga, Via:-Kiit, PS:- Mancheswar, Dist:- Khordha, Pin: 751024 have on the 12! April day of the year 2023 sold and delivered my/our vehicle no DL10SC8354 make 07/2012 chassis No MD2A 14AZ8CPD95835 engine No. or motor number in the case of Battery Operated Vehicles JBZPCD03951 to Shri/Smt. Ajay Rath (Name) Son/wife/daughter of residing at wove (house No./street village/town, distt. and State) under an agreement of hire/purchase/ lease/hypothecation with The registration certificate and insurance certificate have been handed over to him/herithem. To the best of my/our knowledge and belief the vehicle is not ‘superdari and free from all encumbrances and information furnished is true. I/We undertake to hold my/our self-responsible for any inaccuracy or suppression of information, Signature of the financier (to give his consent) Bishou Prasad fase’ Date. Signature /digital signature/e-signature of owner of motor vehicle or authorised dealer of registered vehicle Date. We (Transferee) Copy to the registering authority. in whose jurisdiction the transferor resides, Note : To be sent to the registering authority by registered post acknowledgment due. OFFICE ENDORSEMENT Ref. No. Office of the. The ownership of the vehicle has been transferred to the name of with the note of the above said agreement with effect from.............. (date) Date. Signature of the registering authority with office seal ‘Strikeout whichever is inapplicable. To The transferor . isl : (to be sent by Regd. post acknowledgement due)FORM 30 [Refer Rule 55(2) and (3)] FORM APPLICATION FOR INTIMATION AND TRANSFER OF OWNERSHIP OF MOTOR VEHICLE (To be made in duplicate if the vehicle is held under an agreement of hire- Purchase/lease/hypothecation. The duplicate copy with the endorsement of the fegistening authority to be returned to the financier simultaneously on making the entry Of the transfer of ownership in the certificate of registration and registration record in Form 24.) To The Registering Authority PART I-FOR THE usp Je yTHE TR, ro At Name of the transferor Bithnu /oeredodiwiteidaughter of. puna. Chandos — Full address. +.- Tojana, fo: Kelacahaaga,.via-kitd, fe Mancherua 2, 2"). 2 Kho wl "Mie hereby declare that /We have on this......274 Afor> 02-Sep-2022 Bate) RTOlecaton New DehiDELM Ake BAJA vote oncovenetecrnc jean yee ISCO Engine No Do: Chassis No, _mDvaseazacongseas Tyee START Body Type Moter Cele Foal ipo Peal Year ology 2012 seating Copacity 2 Cubic Capacity 100 CC Year of Mfg, 2012 Faste ance Odometer fasta OY bale enoonseMenr : thie Winber ViaieDate_NaPronion tt Vig as GrssPrendm corn tarR09-82 7140012882 00 000 —ansa uasRiTY PREM é Bosic Third-Party Liability (8 S* 714.00 PA cover for Owner-Oriver | Pa cover lor 2unamed passengers eaeh0 (9 = Pee era Lego! Liability Employees @ ‘Legal Liability to Poid Driver (2) Necreemben 8 714.00 rere lows e252 . as? Final Premium 84252 o1nen oeraus Previous Insurer - > Previous Policy No. /3008/A/225050931/00/800 . Previous Policy (25-May-2022 I = Endorsements Boy Bate GSTIN/UIN No, Unregistered ‘State Code, 7 feat raarasaez4? Reet Date 2-sep-2022 Noninee Def = Geegiaohical Area: Any lab ineuered within hia shall be covered bj ‘cucrest Limitatin a to use: The ple cavers ae ofthe vehi for any Dd se foray purpose in connection wth the Mtr Trade "ded that a parson ding hola vob lective dng heer ‘uliense. 2 rowed ol that he pe'son heling eae he regen Vetus Aa, 1988 and any subsequent mene oP aL Gewoaletance nt Ades Alas, 95,4018 Coss toes, orames Cr teaiamaOUah Ciera St Reg ha DOES cnr He nde} Colestom, G28A/2, Rute Vihape Loken Ferg Brehm Paced aby 30°. Gover or Oues Deve under Seca (Sh per cone) rettantlasr to naar eae eet to Policy Terms and Conditions unless special agreed ond pose othe than ie or eva. tcing, pace moka ee ton o Cats ef persons anti tose Any person mc we at the time of the accent ard snot squad rom hak oo sb ot i etlective Learners License ay asa tabi 1) Unser Seton "1 (yo he pokey Grath af pean rk rent amendmen as appticbie Limits of ovy to meet the requirements ofthe Mek 1) of the poly: Damage to Turd Perty Property. st ree Seed Cot Rasen ase iohorahs 8S “é eee /aigit Go Digit General Insurance Ltd. a B Digit Two- Wheeler Liability Only Potcy SeheduleReceipt UIN Nos IRDANI5eRPO003VO1201738 Pe Ouiner Driver Dedaration The Policy hos been sued without Compulsory Peteona Accident Cover to Qwmer Driver on te bast of put ceslovation tot you donot ha vad rang cence ono ble he eae f Commencement ofthis Poy 7 a¥ead Nav onal ecient insurance cove f Re, 15 Loe Important Not: ease infor the Company incase of change n account of atton of CNGPNG Kt Tes aCeclaration:The Policy has been isued subject to vad Pollution Under Contr (PUC)Certlicote caclosed by you ae an insuted on Of Bs the ote connenearan te By Chau ean newseptt seymertpam gl iokCneme pertain ahs of cheque or nonraeti ef pyment Wilton of Meter Vice Az Thi poy esuteinacordance wth te proton pte X ar Chaser Hof MV oct 1969 an ay sunwequet ome aplcose,Any olin wl fate al bel ser the Policy, the nsued no nda the wai ured or den erwin tan acevaatce wth ts Sched: Ay Boye ‘ae by he Company by reason of mar trms appearing Cecoem ser to cmap wi) re water Veil ct 1968 recoverable (0 the insured, Soe the Clouse headed (Avoidance Of Certain Terms And Right OF Recovery) nthe policy. Tis poly i abject to the tenis ey wring, ras and conditions agile rhe rode nodaon to overages ar escoos peced the moto eRRLS fois by Al Pokey wed be vou one una et es one nove sone etl fas orb ee ne po rms ond Note: The poly i issued in utmast good faith, yng onthe infermation share by insure atthe te of obtaining the poy. TET Cons stn thpacy sche ono ely doce shy gas preven axe on ape ee re soioga cp mtronoct aa In case of claim or any other query. please =e contact our 24-hour Call Centre at ao Sr emolus et or visit our website oD Send nsronce Lic Ades doris 95. 4th Crots Road. KoamaneoaInuol Layout, St Boo cu Kerntoka 560095 ROA BYR cat SeLsNOERSies Cloreig OST eg ins 27 SaCCouIsoQscU HON Sariukcanstalinctonee Souees GTN acres For Bose {Rain or, Coue Cokenum, 626802 Kus lage Lokmonye Pan Bavar Sion anba lahore PR -#0003