FORM 26
(See Rule 53)
INTIMATION OF LOSS OR DESTRUCTIONS ETC. OF THE CERTIFICATE OF
REGISTRATION AND APPLICATION FOR THE ISSUE OF DUPLICATE CERTIFICATE
REGISTRATION.
(To be made in duplicate if the vehicle is held under an agreement of hire
purchase/hyp othecation/lease and the duplicate copy with the endorsement of the Registering
Authority to be returned to the Financier simultaneously on the issue of duplicate).
To
The Registering Authority,
……………………………
Sir,
The Certificate of Registration of my/our Motor Vehicle Registration Mark of which
is ……….……………………………….. has been lost / destroyed / completely written off soiled /
torn/mutilated in the following circumstances.
………………………..………………………………………….
………………………..………………………………………….
I/We hereby declare that to the best of my/our knowledge the registration of the vehicle has
not been suspended or cancelled under the provision of the Act or Rules made thereunder and the
circumstances explained above are true.
I/ We do hereby apply for the issue of a duplicate certificate of registration.
The written off/ soiled/ torn/ mutilated certificate of Registration is enclosed.
The vehicle is not held under any agreement of hire-purchased/ leased/ hypothecation.
I/ We have reported the lost to the Police station ……………………………… ………(date).
Date …………………
Signature/ Thumb impression of applicant
alongwith full address.
Strike out whichever inapplicable
The vehicle is held under hire-purchase/ lease/ hypothecation agreement with ………………………
…………………… and the “ No objection Certificate” obtained from the Financier is enclosed.
(Where “No Objection Certificate” is enclosed, the applicant shall make a declaration as required
under sub-section (3) of section 51).
Signature of the Owner
Name: …………………………………………..
Full Address: …………………………………..
…………………………………..
Specimen signature of the Owner:
1.
2.
Note – (1) Full particulars of the circumstances shall be furnished in the case of
loss or destruction of the Registration Certificate.
(2) Strike out whichever is inapplicable.
OFFICE ENDORESMENT
Number…………………………. dated ……………… Office of the …………………………………
A duplicate Certificate of registration as requested above is issued with the note of agreement
of hire-purchase/lease/hypothecation on ……………………………. and is noted in the Original
Registration records in Form 24.
Signature of the Registering
Authority
To
……………………………………….
……………………………………….
(Name & Address of the Financier)
(By registered post or delivered under proper acknowledgement)