यातायात पुलिस कर्नाटक

Traffic Po lice Karnataka

( 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)

ಕ ಚೇರಿ / ಸ್ಥಳ / O ffice Name : Tumkur

ಚಲನ್ ದಿನಾಂಕ/Challan Date 29-07-2022 15:05:00

:
ವಾಹನ ವರ್ಗ/ Vehicle Class: M- ಮಾಲೀಕರ ಹೆಸರು/Challan no: KA458965220730115123
C ycle /Sco o te r(2WN)
ನೋಂದಣಿ ಸಂಖ್ಯೆ./Vehicle no KA06HK7786 ಚಾಸಿಸ್ ಸಂಖ್ಯೆ/Chassis no: ME1RG6619L00*****
ಪುಸ್ತಕ ಸಂಖ್ಯೆ/Book no ......... Engine no / Motor No: G3N3E00*****
ಮಾಲೀಕರ ಹೆಸರು / Owner's Name: M*H*M*E* *H*U*E*T*F
ಫಾರ್ಮ್ ಸಂಖ್ಯೆ /Form no: .........
: *******726
Owner's Address 2*D*C *O*S*N*W*M*L*K*T* *O*D*N*A* * *S*R*
*H*D*M*H*L*S*D*S*I*A*A*A*A*T*M*U* *A*A*U*,*T*m*u* *5*2*0*

Driver's name ........

ತಂದೆಯ ಹೆಸರು/ Father's name ........
Age ........
DL no. ........ Validity .........
ಉಲ್ಲಂಘನೆಯ ಸ್ಥಳ / Place of incident LAKKAPPA C IRC LE

Document Impounded:
No Document Impounded
Offences Charged with:-
1: Riding witho ut He lme t ( Se ctio n 177 o f the M.V.Act )[Fine - 500]
:- 500/-
Penalty specified against above offences charged (in numerals and words): 500/-
Rupees: Five Hundre d Rupe e s o nly
/ Remarks: ........
.........................
T he temporary authorization of impounded document shall be valid till (date)...................... or till the validity of the original document,
whichever is earlier.
Fo r Online Payme nt
https://echallan.parivahan.gov.in/index/accused-challan / Signature : ..................................
Name and signature of Officer
DSP_T OWN PS
(dsp_tmktown_eo@ katp.in)
DSP

(Bo nd unde r se c 213(5)(e ) o f Mo to r Ve hicle s Act,1988)

................. ......................... ..................... 500
I solemnly affirm that I shall be present at.............(place) on the specified date.............. and time........and, in case of failure to do so, shall
be responsible to pay Rs 500 in favour of Government of State.

Name and signature of Violator (Driver/Owner)

 M*H*M*E* *H*U*E*T *F/.........

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