FORM 25

FORM OF APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATION OF A MOTOR

VEHICLE, OTHER THAN A TRANSPORT VEHICLE. Application No:
[See Rule 52(1)] KA220425V7409920
Receipt No:
KA220425C8927116

To
THE REGISTERING AUTHORITY,

JNANABHARATHI RTO

KARNATAKA

I RAGAV V
having mobile number
9945681491
hereby apply for the renewal of the certificate of registration which
is attached, the particulars of which are as follows:­
(a)
Registered number : KA02EC1545
(b) Date of issue : 04-Feb-2000
(c) Date of expiry : 27-Apr-2022
(d) Registering authority by which the certificate was
issued/last renewed : JNANABHARATHI RTO
My present address is
# 9, 1ST CROSS,,SRINIVASA COLONY,,BENGALURU WEF 31.07.2013,,Karnataka-560027
If this address is not entered in the certificate of registration, I
do/do not wish that it should be so entered. The renewal of the
certificate has not been refused by any registering authority. I
hereby declare that the certificate of registration has not
been
cancelled or suspended by any registering authority.

1. Class of vehicle :M-Cycle/Scooter

2. The motor vehicle was registered as : NEW
(a) A new vehicle :
(b) Ex-Army vehicle :
(c) Imported vehicle :No
3. Type of body : SOLO
4. Maker’s name : INDIA YAMAHA MOTOR PVT LTD
5. Month & Year of manufacture : 2/2000
6. Number of Cylinders :1
7. Cubic capacity/Horse power : 135.00
8. Maker’s classification : YAMAHA RX 135 S SPEED
9. Chassis number-Affix pencil print : 00J1L7013860
10. Engine number : 1L7013860
11. Seating capacity (including driver) :2
12. Unladen weight : 108
13. Fuel used : PETROL
I
enclose the certificate of insurance for perusal and return.
I have paid the fee of rupees
: 1000
Dated: ____________________ Signature or Thumb impression of the
applicant.

Note :- The motor vehicle above described is not

subject to an agreement of hire purchase, lease or hypothecation.
The vehicle is:
(i) Subject to hire purchase agreement/lease agreement with
...................
(ii) Subject to hypothecation in favour of ...................
Signature or Thumb impression of
registered owner
Specimen signature or thumb impression of registered owner:

1.
2.
3.

CERTIFICATE
Inspected the
vehicle-verified the chassis number and engine number. Certificate
that the particulars contained in the application and the
corresponding particulars declared in the
certificate of registration
of the vehicle are true and that the ve hicle complies with the
requirement of the Motor vehicle Act, 1988 and rules made thereunder.
Signature of the Inspecting Authority.
Name
.................

Designation
.................

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 Payment Details
Transport Department, Government of Karnataka

Registration Authority Jnanabharathi RTO

Application No./RECEIPT No: KA220425V7409920 / KA220425C8927116 Receipt Date: 25-Apr-2022

Vehicle Class: M-Cycle/Scooter Owner Name: RAGAV V

Vehicle No: KA02EC1545 Chasis No: 00J1L7013860

Vehicle Registration Date: 04-02-2000 Payment Transaction No: KAY2204259351021

GRN No: Bank Reference Number: 1775367895

Servicing Authority: Jnanabharathi RTO

Particular Period Amount Penalty Total

Green Tax 25-Apr-2022 to 24-Apr-2037 250 0 250

Registration Certificate fees 200 0 200

Renewal of Registration 1000 0 1000

Road Safety Tax/Cess 25-Apr-2022 to 31-Mar-2037 500 0 500

Total 1950

GRAND TOTAL (in Rs): 1950/- (ONE THOUSAND NINE HUNDRED AND FIFTY ONLY)

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