Owner: MUKESH KEWAT Mobile: 7974799855 Chassis: MD9LDR01123330306
FORM 20
APPLICATION FOR REGISTRATION OR TEMPORARY REGISTRSTION OF A MOTOR VEHICLE
To,
The REGISTERING AUTHORITY
GWALIOR RTO
............................
1. Full Name of the Person to be registered as :
MUKESH KEWAT
registered owner
Son/Wife/Daughter of : BETAL KEWAT
2. Age of the Person to be registered as registered :
owner
3. Permanent address (Electoral Roll / Life :
Insurance Policy / Passport / Pay Slip issued by
any office of the Central Government/State
GRAM UNCHIYA
Government or a local body/Any other
DATIA, Datia
document or documents as may be prescribed
Madhya Pradesh
by the State Government/Affidavit sworn
475675
before an Executive Magistrate or a First Class
Judicial Magistrate or a Notary Public to be
enclosed)
4. : GRAM UNCHIYA DATIA, Datia Madhya
Temporary address/Official address, if any
Pradesh 475675
4A. Ownership Type : INDIVIDUAL
5. Duration of stay at the present address :
6. PAN Number (Optional) :
7. Place of birth :
8. If place of birth is outside India, when migrated to :
India
9A. Nominee Name :
9B. Relationship with the nominee :
10. Name and address of Dealer or :
Manufacturer from whom the vehicle was
SHRI VIHARSH TRADERS 266 TULSI
purchased (sale certificate and certificate of
VIHAR COLONY CITY CENTRE GWALIOR
road worthiness issued by the manufacturer to
be enclosed)
11. If ex-army vehicle or imported vehicle, enclose :
proof. If locally manufactured Trailer/Semi-
Trailer, enclose the approval of design by the
State Transport Authority and note the
proceedings number and date of approval
12. Class of Vehicle (If motor cycle, whether with or :
e-Rickshaw with Cart (G)
without gear)
13. The Motor vehicle is (a) a new vehicle (b) Ex-Army :
vehicle (c) Imported vehicle (d) in-use E-rickshaw or NEW
E-cart
14. Type of Body : E CART
15. Type of vehicle : 3WT
16. Makers Name : LAKSHYA AUTO SALES CORPORATION
17. Month and year of Manufacturer : Nov-2023
18. Number of Cylinder : 0
19. Horse power : 1.98
20. Cubic Capacity : 0.00
21. Maker’s classification or if not known, wheel base : LAKSHYA LDR 2060
22. Chassis No(Affix Pencil print) : MD9LDR01123330306
23. Engine Number or Motor Number in case of Battery :
LM01106
Operated Vehicles
24. Seating Cap(Including Driver) : 1
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Owner: MUKESH KEWAT Mobile No: 7974799855 Chassis: MD9LDR01123330306
25. Fuel used in the engine : ELECTRIC(BOV)
26. Unladen weight(kgs) : 352
27. Particulars of Previous Registration and :
Registered Number(if any)
28. Colour or colours of body wings and front :
GREY
end
29. Model Manufactured Location : Manufactured in India
I hereby declare that the Motor vehicle has not been registered in any state in India. Additional particulars to be
completed only in the case of transport vehicles other than motor
30. Number Description size and ply rating of tyres, as declared by the manufacturer
a) Front axle :
b) Rear axle :
c) Any Other axle :
d) Tandem axle :
31. Gross vehicle
a )As certified by :
manufacturer
b) To be registered :
32. Maximum axle weight in (Kg.)
a) Front axle :
b) Rear axle :
c) Any Other axle :
d) Tandem axle :
33. a) Overall length :
b) Overall width: :
c) Overall height: :
d) Over hang: :
The above particulars are to be filled in for a rigid frame motor vehicle of two or more axles for an articulated
vehicle of three or more axles, or to the extend applicable for trailer, where a second semi-trailer or additional
semi-trailer are to be registered with an articulated motor vehicle
The following particulars are to be furnished for each semi-trailer
34. Type of body :
35. Unladen weight :
36. Number, description and size of tyres on each axle
a) Front axle :
b) Rear axle :
c) Any Other axle :
d) Tandem axle :
37. Maximum axle weight in (Kg.)
a) Front axle :
b) Rear axle :
c) Any Other axle :
d) Tandem axle :
38. AC Fitted : NO
39. Gross Vehicle Weight(kgs) : 734
40. : SHRIRAM GENERAL INSURANCE CO LTD. Covernote
The vehicle is covered by a valid certificate
No.-214007/31/26/005873, Valid From 30-Aug-2025 To
of Insurance under Chapter XI of the Act
29-Aug-2026
41. The vehicle is exempted from Insurance. :
The relevant order is enclosed. :
42. I have paid the prescribed fee of :
rupees.............................
Signature or thumb impression of the dealer
Date: ....... ....... .......
Signature or thumb impression of the owner.
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Owner: MUKESH KEWAT Mobile No: 7974799855 Chassis: MD9LDR01123330306
Note: The Motor Vehicle above described is :
i. Subject to Hire-Purchase agreement/Lease agreement with
ii. Subject to Hypothecation in favour of
iii. Not held under Hire-Purchase agreement or Lease agreement or subject to Hypothecation
Hypothecation Details: (1) Hypothecation Type :HT, Financier's Name :MADHYA PRADESH GRAMIN BANK RARUARAI
Strike out whatever is inapplicable. If the vehicle is subject to any such agreement the signature of the Financier with whom such agreement has been
entered into is to be obtained.
..................... .....................
Signature of the financier with whom an Agreement of Hire-purchase, Signature or thumb impression of the
Lease or Hypothecation has been entered into registered owner
CERTIFICATE OF INSPECTION OF MOTOR VEHICLE WHOSE BODY HAS BEEN FABRICATED
SEPARATELY TO THE PURCHASED CHASSIS
Certified that the particulars contained in the application are true and that the vehicle complies with the requirement of the Motor Vehicle Act, 1988 and
the Rules made there under.
Signature of the INSPECTING AUTHORITY
Name: ....... ....... ....... .......
Date: ....... ....... ....... Designation:....... ....... ....... .......
Ref.No ....... ....... .......
(FOR OFFICE ENDORSEMENT)
Office of the ...... ....... ....... ....... .......
The above said motor vehicle has been assigned the Registration number NEW . and registered in the name of the applicant and the vehicle is subject
to an agreement of Hire-purchase/ Lease/ Hypothecation with the Financier referred above.
Date: ....... ....... ....... Signature of the Registering Authority
To,
The Financier ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... ....... .......
....... ....... ....... .......
(TO BE SENT BY REGISTERED POST ACKNOWLEDGMENT DUE)
Specimen signature or thumb-impression of the person to be registered as Registered Owner and Financier are to be obtained in original application for
affixing and attestation by the Registering Authority with office seal in Forms 23 and 24 in such a manner that the part of impression of seal or a stamp
and attestation shall fall upon each signature.
Specimen signature of the Financier Specimen signature of the Registered Owner
(1)……………………………………………………… (1)………………………………………………………
(2)……………………………………………………… (2)………………………………………………………
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