FORM 25

FORM OF APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATION OF A MOTOR

VEHICLE, OTHER THAN A TRANSPORT VEHICLE. Application No:
[See Rule 52(1)] GJ230406V1410742
Receipt No:
GJ230406C8347218

To
THE REGISTERING AUTHORITY,
SURAT
GUJARAT

I RAJESH PURANI having mobile number 9898475011 hereby apply for the renewal of the certificate of registration which is attached, the particulars of which are as follows:­
(a) Registered number : GJ05CG5258
(b) Date of issue : 19-May-2006
(c) Date of expiry : 18-May-2021
(d) Registering authority by which the certificate was issued/last renewed : SURAT
My present address is CIVIL JUDGE SAHEB,NR ANKUR HOSPITAL,MANDAVI,Surat,Gujarat-384275 If this address is not entered in the certificate of registration, I do/do not wish that
it should be so entered. The renewal of the certificate has not been refused by any registering authority. I hereby declare that the certificate of registration has not been cancelled or
suspended by any registering authority.

1. Class of vehicle :Motor Car

2. The motor vehicle was registered as : NEW
(a) A new vehicle :
(b) Ex-Army vehicle :
(c) Imported vehicle :No
3. Type of body : SALOON
4. Maker’s name : MARUTI UDYOG LTD
5. Month & Year of manufacture : 4/2006
6. Number of Cylinders :3
7. Cubic capacity/Horse power : 796.00
8. Maker’s classification : ALTO LXI E-3
9. Chassis number-Affix pencil print : MA3EYD81S00686095
10. Engine number : F8DN3271025
11. Seating capacity (including driver) :5
12. Unladen weight : 735
13. Fuel used : PETROL/LPG
I enclose the certificate of insurance for perusal and return.
I have paid the fee of rupees : 5000
Dated: ____________________ Signature or Thumb impression of the applicant.

Note :- The motor vehicle above described is not subject to an agreement of hire purchase, lease or hypothecation.
The vehicle is:
(i) Subject to hire purchase agreement/lease agreement with ...................
(ii) Subject to hypothecation in favour of ...................
Signature or Thumb impression of registered owner
Specimen signature or thumb impression of registered owner:
1.
2.
3.

CERTIFICATE
Inspected the vehicle-verified the chassis number and engine number. Certificate that the particulars contained in the application and the corresponding particulars declared in the
certificate of registration of the vehicle are true and that the ve hicle complies with the requirement of the Motor vehicle Act, 1988 and rules made thereunder.
Signature of the Inspecting Authority.
Name .................
Designation .................
 Payment Details
Transport Department, Government of Gujarat

Registration Authority SURAT

Application No./RECEIPT No: GJ230406V1410742 / GJ230406C8347218 Receipt Date: 06-Apr-2023

Vehicle Class: Motor Car Owner Name: RAJESH PURANI

Vehicle No: GJ05CG5258 Chasis No: MA3EYD81S00686095

Vehicle Registration Date: 19-05-2006 Payment Transaction No: GJY2304067277808

GRN No: 1788623923122 Bank Reference Number: 309677248645

Servicing Authority: SURAT

Particular Period Amount Penalty Total

Plastic Card Fee 200 0 200

Renewal of Registration 5000 0 5000

Total 5200

GRAND TOTAL (in Rs): 5200/- (FIVE THOUSAND TWO HUNDRED ONLY)

Note:Application for this service is applied via ONLINEFEE .In case of any data discrepancy, please contact respective State/RTO department.