FORM OF APPLICATION FOR THE REGISTRATION OF MOTOR VEHICLE
Reg No : Date : Prev.Reg.No(if any) :
Issue No : Date : Issue by :
Dairy No : Date : Received by :
Customer ID : District : Vehicle ID :
Veh.Description : Call on date :
Refusal : Refusal Code : Refusal by :
P.O./Bank : Index :
Remarks(if any) : Index No.
To be filled in by the office
Section- I
To be filled in by the Owner
Section-II
(Owner Information)
1.Name of Owner: KANTAR RESEARCH BANGLADESH 2. Date of Birth:
PRIVATE LIMITED
3. Father/Husband: 4. Nationality:
5. Sex: 6. Guardian’s Name:
7. Owner’s Address: BUILDING-05, RD-11, BLOCK-G, BANANI, DHAKA
8. Phone No.(if any) : 9. P.O/Bank :
10: Joint Owner: 11. Owner Type :
12. Hire: 13.Hire Purchase:NO
To be filled in by Owner
Section-III
(Vehicle Information)
14. Vehicle or Trailor : Vehicle 15. Prev.Reg.No.(if any) :
14(a). Class of Vehicle : Private Pass 15(a). Maker’s Name : Saic Motor Corporation Limited
16. Type of Body : Hard Jeep 17. Maker’s Country : China
18. Color (cabin/body) : RED 19. Year of Manufacture : 2021
20. Number of Cylinders : 04 21. Chassis Number : LSJA24U9XNN020635
22. Engine Number : 15E4E5MGMA050112 23. Fuel Used : Petrol
24. Horse Power : 119 25. R.P.M :
26. Cubic Capacity : 1500 cc 27. Seat(incl driver) : 05
28. No. of Standee : 29. Wheel Base : 2720
30. Unladen Weight (kg) : 1725 31. Maximum Laden Weight (kg): 2001
Section-IV
32. No. of Types : 04 33. Tyres Size : 235/50 R18
34. No. of Axle : 02 35. Maximum Axle Weight (kg):
(Additional information for transport vehicle)
(a) Front axle (1) (2)
(b) Central axle (1) (2) (3)
(c) Real axle (1) (2) (3)
36. Dimensions (mm)
(a) Overall Length : 4574 (b) Overall Width : 1876 (c) Overall Height : 1685
37. Overhangs(%)
(a) Front (b) Rear (c) Other
38. A copy of the drawing the showing the specification of the body and of the seating arrangements
approved ..............on....................... is attracted herewith.
OWNER'S PARTICULARS / SPECIMEN SIGNATURE
1.Owner’s Name: KANTAR RESEARCH BANGLADESH
PRIVATE LIMITED
2. Father / Husband:
3. Address: BUILDING-05, RD-11, BLOCK-G, BANANI, DHAKA
4. Sex:
5. Mobile No:
6. Nationality: 15. NID No:
7. Date of Birth: 16. ETIN No:
8. Chassis No: LSJA24U9XNN020635 17. Price:
10. Engine No: 15E4E5MGMA050112 18. Double Vehicle: Yes
11. Year of Manufacture: 2021
12. Preview Eng. No:
13. P.O. Box No:
14. SPECIMEN SIGNATURE: -
