FORM F T
[See Rule 54 (3) ]
Intimation of arrival of Motor Vehicle in Maharashtra State.
I, __________________________________________________________________ residing (temporarily)
at ___________________________________________________________________________________________
(permanently) at _______________________________________________________________________________
_____________________________________________________________________________________________
hereby declare that I have brought the undermentioned motor vehicle into the state of Maharashtra on ___________
_________________and that I intend to keep it in the state upto _________________________________________
____________ for use solely* within the limits of the local authority viz, (here mention the name of local authority)
which has levied a tax on the motor vehicle /* both [ (here mentioned the name of local authority ) ] and outside
these limits :-
1) Class of Motor Vehicle
_________________________________________________________
2) Registration mark
_________________________________________________________
3) Makers name
_________________________________________________________
4) Type of body
_________________________________________________________
5) Number of chassis
_________________________________________________________
6) Number of engine
_________________________________________________________
7) Unladen weight
_________________________________________________________
8) Whether used for carriage of
persons or goods .
_________________________________________________________
9) If used for carriage of persons :
a) Whether plying for hire
_________________________________________________________
b) Carrying capacity
i)
ii)
Seated (including driver)
Standees
_____________________
Total
_____________________
_____________________________________________________________________________________________
* Strike out which is not applicable
10) If used for carriage of goods
__________________________________________________
(a) Gross vehicle
__________________________________________________
(b) Carrying capacity i.e. the difference
between the gross weight and the
unladen weight.
__________________________________________________
11) (a) Date on which the motor vehicle
was last brought into the state of
Maharashtra
__________________________________________________
And
(b) Date on which it was last removed
from the State of Maharashtra.
__________________________________________________
12) The fuel used in the vehicle
__________________________________________________
13) Name of Insurer
__________________________________________________
14) Insurance Certificate No.
__________________________________________________
15) Date of validity of Insurance Certificate
__________________________________________________
From _________________________________to _______________________________
I tender herewith Rs . __________________________________________ by * Cash / Cheque / Demand Draft/
Money Order / Treasury Chalan being the tax due in respect of the vehicle described above .
_____________________________________________________________________________________________
(*Strike out which is not applicable )
_____________________________________________________________________________________________
The said vehicle is exempted from payment of tax by Government Notification, Home
Department No. ______________________________dated the __________________________________________
For the period ending ___________________________________________________________________________
By virtue of having paid the tax for the said period in the State of ________________________________________
________________________________________________________________
Dated the ___________________________________
_____________________
Signature of the Declarant
