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Date:

Delivery Note

The following car is delivered today to

Mr./Mrs/ M/s……………………………………………………………………………………………………………………………..

R/o …………………………………………………………………………………………………………………………………………….

1. Model/Make ……………………………………………………………………………………..………………………….

2. Vehicle Registration No. ……………………………………………………………………..…………………………

3. Engine No. …………………………………………… Chassis No.…………………………………………………..

4. Colour ………………………………………………… Odometer reading ……………………………………

5. Delivery location / State.......................................................

I am taking delivery of the above said vehicleon this date…..……………………………. on as is where is basis
for my personal conveyance only. The said vehicle has been duly approved by me and found to my
entire satisfaction. I am from Date & Time onwards responsible to pay all types of Traffic Offence, Police
Legal Litigation, Accident and R.T.O taxes and Premium of Insurance of the said vehicle.

Regards,

(Name & Signature of person taking custody of the Vehicle)

On behalf of (Buyer Name & Contact Number)

Time:

Date:

Contact No.

Driving Licence No.

Aadhar No. / PAN number

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