Z-FORM

Consultant Name ARYAN Source Walk in

Z Form Date 12/2/2024 Exp.Delivery date
Category Individual
Personal Details
Name of customer PRATIBHABEN DEVARSHI PANDYA

Registrion Address 70 GOYAL PARK ROW HOUSES JUDGE'S PAN No. ANHPP7276P

BUNGLOW ROAD VASTRAPUR AMBAWADI Date of Birth 1/8/1953

VISTAR AHMEDABAD GUJRAT 380015

Contact Person SELF

City AHMEDABAD

Pin Code 380015 Nominee Name DEVARSHI PANDYA

Mobile No. 9824079585

Teliphone No. Relation HUSBAND

E-Mail Id Date of Birth 21/04/1953

Vehicle Information
Model City Pe Mmc Chasis No. MAKGN265KP4201055
Modle Variant VX CVT Engine No. L15ZD2019275
Colour PLATINUM WHITE
Finance Details
Finance thorugh LMH No F/C Name
Hypo in favor of CASH
Insurance Detail
Insurance Honda Assure Ins. Company
Insurace Tariff
Ncb (%)
Receivable Details Out-Flow
Cash Discount :- 114,674.00
Ex - Show room price 1503900

Brokrage :- 0
TCS 13892

Yes
Insurance With H.lock & Key cover SESP Insentive :-
43,896

Total Outflow :-
RSA
0

Applicable
RTO TAX
59035
Exchange Details
Applicable
Municipal Tax
26372 Executive Name :-
Yes
Model :-
LANDMARK 4TH YR. E/W
8,954
Earning :-

DOC Claim Bonus :-

6525
Claim Amount :-
Paid Accessories 500

Fast Tag 500

TOTAL RECEIVABLE 1,548,901

TO BE CLAIMED
SM's Sign :-
Fleet Applicable
Corporate Name
Fleet Amount

Remarks
Remarks
 Amaze Pe Vmt - Honda Assure Amaze Pe Vmt - Honda Assure
Ex.Show Room 725900 Ex.Show Room 725900
Ins. With Nil Dep 35490 Ins. With Nil Dep 28938
Rto 35025 Rto 35025
M.Tax 10500 M.Tax 10500 Insurance
Diff.
Fast Tag + Basic Kit 3699 Fast Tag + Basic Kit 3699
On-Road 810614 On-Road 804062 6552
Discount 50261 Discount 50261
Final On-Road 760353 Final On-Road 753801
Purchase Price 675639 Purchase Price 675639
Invoice Amount 675639 Invoice Amount 675639

Amaze De Vmt O.white

Ex.Show Room 839900
Rto 39849
M.Tax 12109
Fast Tag + Basic Kit 3699
On-Road 895557
Discount 60542
Final On-Road 835015
Purchase Price 779358
Invoice Amount 779358