The Registering Authority,
The Certificate of Registration of my / our Motor Vehicle, with the Registration Mark
has been lost /destroyed completely written off / soiled / torn / mutilated
in the following circumstances.
I / We hereby declare that to the best of my / our knowledge the Registration of the Vehicle has not
been suspended or cancelled under the provisions of the Act or Rules made thereunder and the circumstances explained above are true. I / We do hereby apply for the issue of a duplciate certificate registration.
The written off / soiled / torn / mutilated Certificate of Registration is enclosed.
The Vehicle is not held under any agreement of Hire - Purchase / Lease / Hypothecation.
The Vehicle is also not superdari and free from all encumbrances.
* I / We hereby declare that I / We on (date) have filed a complaint (copy enclosed)
with the police about the loss of Certificate of Registration immediately after the loss has been noticed.
The Vehicle is held under Hire - Purchase / Lease / Hypothecation agreement with
and the "No Objection Certificate" has been granted / refused by the Financier hereunder:
Where "No Objection Certificate" is refused applicant shall make a declaration as required under sub-section (8) of Section 51
Full particulars of the circumstances shall be furnished in the case of loss or destruction
of the Registration Certificate.
Strike out whichever is inapplicable.
Consent of the Financier for grant of "No Objection Certificate" under section 51(6)
*I / We being a party to an agreement of Hire - Purchase / Lease / Hypothecation in respect of
Motor Vehicle specified above:
have "No Objection" in issue of the duplicate Certificate of Registration of the said Vehicle.
have " Objection" in issue of the duplicate Registration Certificate of the said Vehicle for the
reasons given hereunder
office of the
A duplicate Certificate of Registration as requested above is issued with the note of agreement of
Hire - Purchase / Lease / Hypothecation on
and is noted in the original Registration Records in Form 24.
Specimen signature or thumb impression of the Registered Owner and Financier are to be obtained in
original Application for affixing and attestation by the Registering Authority with the 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
Specimen Signature of the Financier
2. __________________________ Specimen Signature of the Registered Owner