Surrender of registration certificate and tokens
(To be completed by the owner of the motor vehicle when surrendering the registration certificate)
I, …………………… residing at …………………… hereby declare that I have withdrawn/intend to withdraw from use my motor vehicle of which the registration No. is …………………… and that for the reasons specified below I do not intend to use the said vehicle again for a period of not less than three months commencing from ……………………
Reasons for non-use in detail
I shall keep the said motor vehicle during the aforesaid period at the following place. Location of Garage ……………………
(Here insert the full address of the place or garage where the motor vehicle is kept or will be kept during the period of its non-use).
I further declare that I shall not remove the said vehicle from the above- mentioned place without the previous permission of the Taxation Officer except in case of any unforeseen occurrence like flood, fire or similar other cause and in which case intimation thereof shall be sent to the Taxation Officer within twenty-four hours of such removal.
I hereby surrender the certificate of registration and token including permit in the case of a transport vehicle issued in respect of the vehicle.
Date………………
Signature of applicant
PART II
(To be completed by the Taxation Officer when returning the form to the owner)
Received from …………………… Registration Certificate No. …………………… and Token No. Book No. …………………… valid for the period commencing on …………………… 20. and ending …………………… Medical certificate in respect of an applicant for obtaining a learner’s licence/driving licence or renewal of a driving licence………
Date………20…..
Signature of Taxation Officer
PART III
(To be completed by the owner of the motor vehicle when applying for return of the registration certificate)
I, …………………… hereby apply for the return of the registration certificate described in Part I above.
*An application for the renewal of token in From “D” is also attached hereto.
Dated……………..
Signature of Applicant
*To be struck out if not necessary.