(To be made in quadruplicate if the vehicle is held under an agreement of Hire-Purchase/Lease/Hypothication, in duplicate copy the triplicate copy and the quadruplicate copy with the endorsement of the Registering Authority to be returned to the Registered owner of the Vehicle, the Registering Authority in whose jurisdiction the vehicle is to be removed and the Financier simultaneously on grant, refusal of a "No Objection Certificate".)

I / We intend to transfer the vehicle to the jurisdiction of the Registering Authority.

I / We intend to sell the Vehicle to Sri / Smt / Kumari________________________________________________ who resides in the jurisdiction of the Registering Authority______________________________________________ of I / We therefore request for the issue of a No Objection Certificate for my / our vehicle, the particulars of which are furnished below:

1. Name
   
   
2. Son / Wife / Daughter of  
   
   

3. Address	PERMANENT	TEMPORARY
   Door No.
   Village/town/city
   Mandal
   Dist.
   Pincode

   
   
   
4. Registration Number of the Vehicle         ____________________________________________
   
   
5. Class of Vehicle                                    ____________________________________________
   
   
6. Registering Authority which originally
   Registered the Vehicle                           ____________________________________________
   
   
7. Engine Number                                      ____________________________________________
   
   
8. Chassis Number
   (Affix also pencil print)                            ____________________________________________
   
   
9. Period of stay in the State                      ____________________________________________
   
   
10. Period up to which Motor Vehicle Tax
    has been paid                                        ____________________________________________
    
    
11. Whether any demand for tax is pending,
    if so, give details                                    ____________________________________________
    
    
12. Whether the vehicle is involved in any
    theft cases, if so, give details                  ____________________________________________
    
    
13. Whether any action under Section 53,54, or 55
    of the Motor Vehicles Act, 1988 is pending
    before any Registering Authority or other
    prescribed Authority, if so give details        ___________________________________________
    
    
14. Whether the Vehicle is involved in any case of
    transport of prohibited goods, if so, give details ________________________________________
    
    
15. Whether the vehicle is held under an agreement
    of Hire - Purchase / Lease / Hypothecation, if
    so give full name and address of the Financier_________________________________________
    
    

We solemnly declare that the above statement is true.

Date__________________________

________________________ Signature or thumb impression of Registered owner.

I / We being a party to an agreement of the Hire - Purchase / Lease / Hypothecation in respect of the above said vehicle hereby,

1. Give consent to issue the No Objection certificate for the said vehicle only for the purpose referred above.
2. Refuse to give consent for issue of No Objection Certificate for the said vehicle due to the reasons furnished hereunder:_____________________________________________________________________________
   
   
   
   

   Date ___________________

   ____________________ Signature of the Financier.

   
   
   
   PART III
   OFFICE ENDORSEMENT
   
   ( GRANT / REFUSAL OF NO OBJECTION CERTIFICATE UNDER SECTION 48 (3) OF MOTOR VEHICLES ACT, 1988)
   
   
   1. No Objection Certificate in respect of the Vehicle, the detailed particulars whereof recorded over above is hereby granted under Section 48 (3) of Motor Vehicles Act, 1988 ( (Valid for use at the Registering Authority on whom it is issued.
   2. No Objection Certificate in respect of the Motor Vehicle, the detailed particulars whereof recorded over above is hereby, refused under Section 48 (3) of Motor Vehicles Act, 1988 for the reasons recorded as under.
   
   
   
   

   Date ____________________

   Signature with seal of Registering Authority. Address ________________________               ________________________               ________________________

   
   
   To
   The Registered Owner ____________________________
   _______________________________________________
   _______________________________________________
   _______________________________________________
   
   
   The Financier____________________________________
   _______________________________________________
   _______________________________________________