T,'ri1 sharrme('ndha r No.
3177-53 09-7819) spn of Shri Som Dutt
Sha rne , rsident of iiouse No.2626/9, Kumher Geli,Ng han, District
Sirma r,H.P do hereby solemnly a ffirm and declare a 8 unde r: -
1. Tha t the deponent is owner in posse ssion of t he vehicle,
vehicle registration No,HP-18-B-B277, Cha ssis No. MALA841 CLEM1 02425
Fngine No,G4LAFM655032.
to Shri
2. That the deponent today sold the ebove vehicle
Sat Dev singh
Armol Tha kur( (Aadhar No.3009-6265-0689) son of Sh,
District sirma ur, i, P
resident of House No.330/6, Naya Bezzar, Ng h¡ n,
physicel v0ssession
3. That the deponent todsy delivered the ve hi cle
bilities,if any of the g bove
of the a bove vehile , so the 1ig named
efter this exe cution of affida vi t is of the purchas r abo Ve
boVe vehi cle mbefore this
and the liabilities,if any of the a
seller,hence this affidavit.
execution of affida vit is of the
r ights be
That I h¡ Ve no objec tion,1f the ownershiD
purchaser.
trengfered in the name of the above
Deponent
Ver1fication
hereby verify that
I, the above ngmed deponent do
dnclaration pre true a nd correct to
the contentB of this
belief, no part of it is felse
the best of my knowledge end
concealed therefrom,
end not hing meterie1 has be en
of March,2025
Verified at Na ha n on thig the 19th day
Deponent
SELE DECLARAION
I,4 nmol Th¡ kur( Aadhar No.3009-6265-0689) son of Shri
Snt Dev ingh, reside nt of ouse No.330/6 Naya Bazzar, Nahan,
District simaur,H.P. do he reby sole mnly a ffirm and de clare
as under: -
1. That the deponent purcha sed the vehi cle, bea ring
ve hicle Registration No,HP -18-B-8277.Cha ssis Number
MALA841 CL M1 02425, Engine No. GlL,A FM655032 from Shri Anil
Sha rma( Aadhar No.3177-5309-7819) son of Shri Som Dutt shaa,
resident of House No.2626/9, Kumhar Gali,a han, District
Sirma ur,H.P..
possession of
2. That the deD^nent received the physi cal
above named, S0 the li¡bi21ties
the a bove vehicle rom theseller
exe cution of affidavi t ig of
of t he vehicle ,if any a fter this
vehicle, be fore t his
devonent ,and the 1ia bilities,i any of th¹
sell er , hence this affida vit.
exe cution of affidavit is of t}e
in the n¡me of
3. Tha t the owne- rstip rights be transfered
the denonent.
Deponent
AJ
Verification
I, the a bove named deponent do here by verify that
are true and cOrrect to the
the contents of this affidavit
and
best of my knowbedge a nd belief, no part of it iB false
nothing material hag been concraled therefr om.
Verified at ahon on this the 19th day of March, 2c25
FORM 29
[See Rule 55 (1)]
Form of Notice of Transfer of Ownership
of A Motor Vechicle
(To be made in duplicate and the duplicate copy with the indorsement of the registering
authority to be return to the transfer or immediately on making entries of transfer of
ownership)
To
The Registering Authority,
Nahan, Dist rict Sirma ur,H,P.
(In whose jurisdiction the transferee resides)
Sharma
/WeAnil Sharna son 0f Shr.Som.Dutt.esident at.. Kumha r Gall,.
s...have on the 19th
9tnMarch,day of the year .2.925.
sold and delivered my/our vehicle No. HP-18-B-8277 Make. Hundai Chassis
MALA841 C1FM1 02lR5in No GLAM655032 to
No.
Shri/Smt.o.A.
(name)Son/wife/daughter of hr Bat Dex Singh,resident..0 ayeDazzer.
resident at.aha nPHouse No.. Street Village/town Distt.
and State).
The registration certificate and insurance have been handed over to him/her/them.
Date.. Signature of kegi_iefed Owner
(Transferor)
CC.
1)... --(Transferee)
Copy to the Registering Authority in whose jurisdiction the transferor reside.
Note:
To be sent to the Registering Authority by Regd. Acknowledgement due.
For Office Endorsement
No. ...Date.. Office of the.
The ownership of the vehicle has been transferred to th name of...
with effect from. (date)
(Registering Authority)
(Office seal)
To
(The transteror)
By registered post or delivered under proper acknowledgment. Strike out whichever is inapplicable.
FORM 30
(See Rule 65(2)& (3)1
Report of Transfer ownership of Motor Vehicle
PART -1 For the use of a Transfer
To be made in dyolicate nthe vehlcle as under an agreement of hire purchase /lease /hyprothecation and the
Dublicate copy with the endorsement of the registering to be returned to the financer simultaneoulsy on the
entry of transfer of the ownership ln certificate to registration.
The Registering Authority,
Na h¡ n,Digtriot Sirma ur,H. P.
Name of the transfer. Ani1..Shatma
ShriSom Dutt
Son/wile/Daugnterröent
Full Address.
of Kumhar Ga li,N¡ he n
District..sirnyD
19th day of March,2025. day of the
Ihereby declare that I/we have on his mark
sold my/our motor vehicle haring registration
yea..
HP-1.8-B8222. of Shri/Smt... A mol Thak urso....£.Stri.setDeyingh
Son/Wife/Daughter of. reslde nt of NaNa..Ba.zzar,Na han HPa
residence at her/them.
registration and the certificate of insurance to him
full address hand drive the certificate of
certificate of the vehicle has been /has not
I/Wehereby them to the best îny/our kiowledge the
been suspended or cancelled.
lenclose the No objection certificate issued by the Registering
Authority.
authority is do enclose the transfer sold file
Ienclose the No objection certificate from the registering
along with his application a declarations as
50.
required under sub-section (1) of section
Date..-3-2 r Signafure of theTanster
Detail of suspension or cancellation.
Strike out whichever in applicable.
Part-ll For the use of Transferee
To
The Registering Authority
Name of the T r a n s f e r e .
Son/Wife/Daughter.ofA l
PulAddres..tt|N 33.Aooge eeAeahen Hf
I hereby declare that we have on this.
day or that year. purchased the motor vehicle hearing and request.
that necessary entries regarding the transfer ship of vehicle inmy/our name may be recorded in
the certificate of registration/certificate of fitness of the vehicle which is enclosed.
The certificate if Insurance is also.
Signature of the Transfer
Speciman,Signature of the Transfer
1)..
2).-alolue
Consent of financer in the case of Motor Vehicle to and agreement of hire purchase/
hypothecations.
I/We being a party to a party to an agreement of hire/purchase/hypothecation in respect
of motor vehicle.. -give consent to transfer.
(...
Date
Signature of Financer
OFFICE ENDORSEMENT
No. s*.Daté..
Office of the
The transfer of ownership vehicle has been recorded with
effect from...
..on registration certificate of vehicle
and in the registration recorded of this office.
Registering Authority
To
(Name &Address of the Financer)
(By registered post of delivered under
acknowledgement.
Govenmentofndiaay
Anil Kumar Sharma
gH fAe/DOB: 10/11/1954
goy/ MALE
3177 5309 7819
VID; 9109 5086 86O8 4985
gottndia
arrErR
fRArA HÈg - 173001
Addre9Si
Dutt Shama, House NO 2626/9.
S/O Som Gali, Tehsil Nahan, Nahan(T),
Sirmaur,
Himachal Pradesh - 173001
3177 5309 7819
VID: 9109 50B6 8608 4985
1WW
Government of Himachal Pradesh HP) (NT)
Certificate of Registration(Form 23)
Date of Regn Regn.Validity
Regn. No 02-Dec-2030
HP18B8277 03-Dec-2015
Owner
Chassis No Sr.No
MALA841CLFM102425 HPT
Tax upto Engine, No
30-Sep-2030 G4LAFM655032
Fuel Used Qwnet Nane.
PETROL ANILSHARMAH
Emission Norms SoniDatgi'er/Wite.or
Not Availablé. SOM DGALT SAARMA
HP,
HN 2626/9:KDMHAR GANAHAN DISSIRMOUR
NAHANAGHALRRADESEA-R
Vehicle Class
(HP) (NT MOTOR CAR
Maker's Name
Regn.No OTHERS
HP18B8277 Model name
Month &Yr,of Mfg XCENT
04/2015 Colour
Wheel Base(mm) SLEEKSILVR
Body type
Cublc Capacity
0.00
SALOON
No of Cylinders Seatinglin all) Cap¡oity
4 5
ULW(Kgs)
1018
Registaring Authority
RLANAHAN
Amol Thakur
GrH a | Year of Birth: 1978
yT/ Male
3009 6265 0689
KNIOUEIDENE
qT: S/O HT }4
fz SHT, RISH
4Írt, A AH, AIaH, AIRR,
ATIONTAUTAARAOANDIA
Address: SIO Sat Dev Singh
Thakur,
uHA gaur, 173001 fATHT, Bazaar, House No
Near PG 330/6, Naya
Nahan, Nahan(T), College,
Nahan, Teh
Sirmaur, Himachal Pradesh,
173001
94
1800 180 1947 help @uidai.gov.in www
Www.uidal.gov.in P.O. Box No.1947,
Bengalur-560 001
|TATA
LAIG
| NSURARE Auto Secure - Private Car Package Policy
WITH YOU ALWAYS
Name MRANIL SHARMA
|+91 701813I345 shubhamnahan@gmal.com
Valid from Valid til)
Address H NO 2626/9 KUMAR GALI NAHAN SIRMAUR,
-173001, OD Cover Period
30 Oct '24 (00:00 Hrs) 29 Oct '25
HIMACHAL PRADESH TP COver Period
(Midnight)
30 Oct 24 (00:00 Hrs) 29
Oct '25 (Midnight)
CPA Cover for Owner
30Oct 24 (00:00 Hrs) 29 Oct 25
Driver Period (Midnight)
Dear MR ANIL SHARMA.
Premlum gmount:6.750
welcome to Tata AIG General Insurance Company
been issued based on the informatior and Limited family &we thank you for choosing our
policy for your motor vehlcle
deckeratien prt. ied by yu. Yeu ara rucuested lc v:si ur insurance. Your Policy No. 3101600280 has
weUsite Vw.tatdaig.com for full policy
wordings
In case of a claim, notify us
first
s900+ network Less deductions on repair
garages claims To Reaister Clait
*No salvage value 4 hr.TAT tor clalms
Downjoad
deducted Inspection
Tata AlG App oR
tatsaiacom oR 1800 266 7780
Certificate of insurance and Policy Schedule
Form 51 of the Central Motor
Vehicle Rules, 1989
Policy Details
Policy No & Certificate Vehicle Details
No:3101600280 03 00
Insured Name: MR ANIL SHARMA Registration no: HP 18 B827
Address:H NO 2626/9 KUMAR GALI NAHAN SIRMAUR, Registration Authority : NAHAN HP 18
-73001
HIMACHAL PRADESH Make/Model: HYUNDAI/XCENT
Fuel Type: PETROL
Period of Insurance OD cover period:30 Oct 24
(00:00 Hrs) to 29 Oct 25 (Mldnight) Variant :S12
TP cover period:30 Oct 24
(00:00 Hra) to 29 Oct25 (MIdnlght)
CPA to Owner driver cover Period: 30 Oct '24 Engine Number/Battery Number:
Policy Issuance Date:24 Oct 24
(00:00 Hrs) to 28"(MIdnight)
Oct 25
Chassis number: MALA841CLFM102425
GAAFM655032/NA
Customer/Lessor GSTIN: NA Engine/Battery Capacity (cc/ Kw): n97
Customer ID:NA Seating Capacity (including driver):5
Customer contact number: 7018131345 Mig Year:2015
Proposal No: PR/24/6202890784 Date of Registration:03/12/2015
Covernote no/Issuance date: NA Body Type: SEDAN
Alternate Policy No: NA Traller
aner HegnNo. / Chassis No,: NA
HPHYP/Lease: NA
Zone: B
Geographical Area: India
Insured Declared Value (IDV)
Vehicle IDV () Electricol Accessories ) Non Electrical
2,36,852.00
0.00
Accessories-Vehicle IDV Bi-Fuel/CNG/LPG Kit (a)
0.00 Trailer/side car IDV () Total lDv ()
0.00
Schedule Of Premium 0.00
2,36,852.00
Section Own Damage (A)
Own Domage Premium On Vehicle & Section I Liabllity (B)
Baslc Own Damage Accessories Third Prirt.
Premium
Premium on yehicle and non Baslc TP premlum
electricol gccessories
Dlscounts under Own Damage Section 2 3,416.00
Less: No claim PA Benetlts
bonus(35%) 2565.58 IYbur(o) Gompulsary PA COvor for
Total Own Domage Premlum (A) Owner Driver 15,00,000 00
2 375.00
SectlonJ Add On Covers Legal Llatblty
(Add) Repir of Glass, Rubber & Add: Legal llablity to pald
Plastic Parts (TA08) driver (IMI 28)
80.00 Number ol persons: 2 50.00
Total Add On Premlurn (c)
0.00
Totol Llablity Premlum (B)
Net Premlum (A+B+C)
3,841.00
IGsTQla% ? 4,873.00
Tatal Polcy Promlum 2877.00
Agent Name : FARIDA
Ayent liccilse Code:15||161
Ayent C'o(act No.
9418618206{or landline) E5,750.00
