FORM KMV- T - 14

PAYMENT OF TAX

I, residing at .

..

hereby apply for taxation card/enclose taxation card in respect of a motor vehicle
of the following description.

1. Registered number :

2. Class of Vehicle

3. The name of the Company issuing the Cover Note is :

The Cover Note of Insurance Certificate of Policy No.

and its validity is

I hereby tender Rs. ( in words)

.. being

the tax due for the period from .to

OR

I hereby claim exemption for the vehicle on the following grounds.

Place: Signature
Date:.

FOR THE USE OF TAXATION AUTHORITY

Amount of Rs..Ps. .. credited in challan no.

. at on ........
Tax card no. ../ taxation endorsement for
 .
Date: Taxation Authority

Note: For items 2 please mention the class of vehicle such as motor cycle with or
without side car, motor cab, trailer, etc.

2. This form should be attached to the form of application for registration when
the tax is to be paid for the first time.

Similarly, it should be submitted at the time of each subsequent payment of tax.