(To be made in duplicate and the duplicate copy with the endorsement of the Registering Authority to be
returned on the transfer or immediately on making entries of Transfer of Ownership in certificate of
Registration and Form 24)
To
The Registering Authority,
__________________________
I / We
| Resident of | PERMANENT | TEMPORARY |
| Door No. | ||
| Village/town/city | ||
| Mandal | ||
| Dist. | ||
| Pincode |
| Resident of | PERMANENT | TEMPORARY |
| Door No. | ||
| Village/town/city | ||
| Mandal | ||
| Dist. | ||
| Pincode |
The Registration certificate & Insurance certificate have been handed over to him / her / them.
To the best of my/our knowledge & belief the vehicle is not superdari & free from all encumbrances and
information furnished is true. I/We undertake to hold my/our self responsible for any inaccuracy or suppression
of information.
| Date__________________________ | ________________________ Signature or thumb impression of Transferor. |
Ref. No.____________________________ Date._________________________ Office of the _________________________________
The ownership of the vehicle has been transferred to the Name of _______________________________________________________
with the note of above said agreement with effect from ________________________________(date)
| Date ___________________ | ____________________________ Signature of the Registering Authority with office seal. |