FORM 25 Application No:
FORM OF APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATION OF A OR241220V2802153
Receipt No:
MOTOR VEHICLE, OTHER THAN A TRANSPORT VEHICLE. OR241220C6565626
[See Rule 52(1)]
To
THE REGISTERING AUTHORITY,
BHUBANESWAR RTO
ODISHA
I DILLIP KUMAR MAHARANA having mobile number 9861462430 hereby apply for the renewal of the certificate of registration which is attached, the particulars of which are as
follows:
(a) Registered number : OR02W1206
(b) Date of issue : 28-Oct-2002
(c) Date of expiry : 21-Nov-2024
(d) Registering authority by which the certificate was issued/last renewed : BHUBANESWAR RTO
My present address is AT/PO-JAGAMOHAN,DHARAKOTE,GANJAM,Ganjam,Odisha-761114 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 :M-Cycle/Scooter
2. The motor vehicle was registered as : NEW
(a) A new vehicle :
(b) Ex-Army vehicle :
(c) Imported vehicle :Yes
3. Type of body : SOLO
4. Maker’s name : HERO MOTOCORP LTD
5. Month & Year of manufacture : 9/2002
6. Number of Cylinders :1
7. Cubic capacity/Horse power : 100.00
8. Maker’s classification : HERO HONDA SPLENDER
9. Chassis number-Affix pencil print : 02J20C07320
10. Engine number : 02J18M05006
11. Seating capacity (including driver) :2
12. Unladen weight : 109
13. Fuel used : PETROL
I enclose the certificate of insurance for perusal and return.
I have paid the fee of rupees : 11000
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 Odisha
Registration Authority BHUBANESWAR RTO
Application No./RECEIPT No: OR241220V2802153 / OR241220C6565626 Receipt Date: 2024-12-20 20:39:40.000000
Vehicle Class: M-Cycle/Scooter Owner Name: DILLIP KUMAR MAHARANA
Vehicle No: OR02W1206 Chasis No: 02J20C07320
Vehicle Registration Date: 28-10-2002 Payment Transaction No: ORY2412205866579
GRN No: 3829E1FF1E Bank Reference Number: ZHD575T08WBE2M
Servicing Authority: GANJAM RTO
Particular Period Amount Penalty Total
Automation and Technology Fe
140 0 140
e
Change of Address in RC 1250 0 1250
Green Tax 20-Dec-2024 to 19-Dec-2039 1000 0 1000
Renewal of Registration 11000 600 11600
Vehicle Inspection Fee 400 0 400
Total 14390
GRAND TOTAL (in Rs): 14390/- (FOURTEEN THOUSAND THREE HUNDRED AND NINTY ONLY)
Note:Application for this service is applied via ONLINEFEE .In case of any data discrepancy, please contact respective State/RTO department.
