गुजरात मोटर वाहन िवभाग
Gujarat Motor Vehicles Department
(डीए शाखा / DA Branch)
(मोटर यान अिधिनयम, 1988 व इसके अधीन बने िनयमों को भंग करने की सूचना (Infringement
report under Motor Vehicles Act, 1988 and Rules made thereunder)
कायार्लय का नाम/ Office Name : SURAT
चालान िदनांक/Challan 06-10-2023 13:45:00
Date :
वाहन श्रेणी/ Vehicle Class: Motor Car चालान संख्या/Challan no: GJ515128231007014781
वाहन संख्या/Vehicle no GJ05JB2760 चेिसस नं०/Chassis no: MA3FHEB1S003*****
पुस्तक संख्या/Book no TRA R03 इं जन नं० / मोटर नं०/ Engine D13A19*****
055042/23 no / Motor No:
(tel:055042/23)
वाहनस्वामी का नाम/ Owner's Name: B*A*I*K*M*R
फॉमर् संख्या /Form no: PI M B ZALA
Violator Contact No: *******473
वाहनस्वामी का पता/ Owner's Address 1*9*,*C*I*I*A*A*I* *R* * *,*T* *A*A*P*R*,*N*v*a*i* *3*6*5*
चालक का नाम/ Driver's name R*D*E*
िपता का नाम/ Father's name D*L*P
आयु/ Age ........
ड्राइिवं ग लाइसेंस नं/ DL no. ........ वैधता/ Validity .........
घटनास्थल/ Place of incident SRT
स्रोत/ Source ........
गंतव्य/ Destination ........
अिभगृहीत दस्तावेज Document Impounded:
No Document Impounded
आरोिपत अपराध/ Offences Charged with:-
1: DARK FILM[Fine - 500]
2: 177.0.3[2019][driver]PUC certificate not obtained. ( 177 )[Fine - 500]
3: 180.0.2a[Owner] (Allowing unauthorized person to drive vehicles) Whoever,being the owner or person in
charge of motor vehicle,causes or permits,any other person who does not satisfy the provisions of section 3
of section 4 to drive the vehicle - Other than Two Wheeler ( 180 )[Fine - 3000]
4: 181.0.3b[2019][driver] ( Driving Vehicle-Other than Two Wheeler in contravention of Section 3 or Section
4)-Under age driver driving the vehicle. ( 181 )[Fine - 3000]
ई-चालान प्रशमन शुल्क जमा का िववरण/ e-challan compounding fee deposit details
रसीद नं०/Receipt no. ................. िदनांक/Date 07-10-2023
प्राप्त धनरािशReceived Amount Rs 7000 (in Words Seven Thousand Rupees only)
िटप्पणी/Remarks: Not Available
ड्राईवर/ वाहन स्वामी का नाम एवं हस्ताक्षर हस्ताक्षर/ Signature : ..................................
https://echallan.parivahan.gov.in/mparivahan-api/print-page 1EKKJb0EnvjvY7GUpDy%2FowDdvhOSCIlvTQlGJBMeBs%3D 29/03/24, 10 21 PM
Page 1 of 2
:
?
Name and signature of Violator (Driver/Owner) प्रवतर्न अिधकारी का नाम व पदनाम/Name and signature of Officer
R*D*E*/R*D*E* ACP Traffic surat
(acptrafficsurat@nic.in)
Police Officer
Reasons as to why no legal proceedings shall be initiated against owner/driver for aforementioned
offence/s shall be submitted to RTO.....................................within 14 days
Copyright © 2018 National Informatics Centre
https://echallan.parivahan.gov.in/mparivahan-api/print-page 1EKKJb0EnvjvY7GUpDy%2FowDdvhOSCIlvTQlGJBMeBs%3D 29/03/24, 10 21 PM
Page 2 of 2
:
?
