The motor vehicle bearning Registration No.____________________________________
is the subject of an agreement of Hire - purchase / Lease / Hypothecation between _______________________________________ ____________________________________________________________________________________________________________ the Registered Owner / Person to be registered as owner and _________________________________________________________ ____________________________________________________________________________________________________________

We request that an Entry of the agreement be made in the certificate of Registration & relevant records in your office.

The certificate of registration together with the appropriate fee is enclosed.

Date	________________________ Signature/thumb impression of Registered owner ________________________ Signature of Financier.

*STRIKE OUT WHICHEVER IS NOT APPLICABLE.

R.No______________________________

Date        Office of the ________________________________

The entry of the agreement of hire - purchase / lease / hypothecation as requested above is recorded in this office Registration record in Form 24 and Certificate of Registration on       

D D   M M   Y Y Y Y

Date	________________________ Signature of the Registering Authority

To
The Financier
_____________________________________

_____________________________________


To
The Registering Authority,
__________________________

    ( To be sent to both the above parties by Regd. Post Ack. Due)

Specimen signatures or thumb impressions of the registered owner and Financier are to be obtained for affixing and attestation be the Registering Authority with official seal in Form 23 & 24 in such manner that part of impression of the seal or a stamp and attestation shall fall upon each signature)

__________________________ Specimen Signature of Financier

______________________________ Specimen signature of Reg. Owner