FORM – 2 (Refer rule 10(1))

APPLICATION FOR VEHICLE SCRAPPING

1. OWNER DETAILS
A Name Ankita Dargude
B ADDRESS MUMBAI SUBURBAN MAHARASHTRA
C MOBILE NO. 9834146894
D E MAIL ankita.dargude@mmcm.in
E PAN ASDPR2343D
F BANK ACCOUNT
i NAME OF BANK HDFC
ii BRANCH Mumbai
iii ACCOUNT NUMBER 351244441512
iv IFSC HDFC0001234
v CONSIDERATION RECEIVED (Rs) 45000
vi RECEIPT NO AND DATE 123DE Jul 24, 2023

2. VEHICLE DETAILS
A REGISTRATION NO MH03AD0010
B MAKE
C MODEL Jeep Wrangler Unlimited 4x4 Petrol
D VEHICLE CATEGORY Light Motor Vehicle
E CHASSIS NO CH6368899
F ENGINE NO E67676900
G MONTH/YEAR OF MANUFACTURE Jul 24, 2023

3. DOCUMENTS
A Original Certificate of Registration. Attached
B Authorization from the registered owner on stamp paper Attached
C Identity and address proof of the authorized representative, if applicable Attached
D Identity and address proof of the owner Attached

4. UNDERTAKING BY APPLICANT AT TIME OF FORM-2 SUBMISSION

I/We Ankita Dargude Resident of MUMBAI SUBURBAN MAHARASHTRA hereby declare that all the particulars furnished
by me / us in this form are true and correct; the subject vehicle is not engaged in any kind of criminal activity/litigation and
realize that I/WE are fully liable for any false declaration furnished above.

5. LETTER OF AUTHORISATION

1. I Ankita Dargude resident of MUMBAI SUBURBAN MAHARASHTRA owner of MH03AD0010 do hereby authorize
son/ daughter of resident of as my legal authority to deposit the above
stated vehicle for the purpose of scrapping at the MTC group RVSF 2. That the above stated vehicle deposited by the
above stated authorized person shall be deemed as if deposited by me only for all legal purposes and intents

(Registered ELV owner)

(Authorized Representative)
Ankita Dargude

Signature Attested
Date: Nov 24, 2023
Place: