FORM 21

[ See Rule 47(a) and (d) ]

Sale Certificate
(To be issued by Manufacturer or Dealer or registered E-rickshaw or E-cart Association (in case of E-rickshaw or E-
cart) or officer of Defence Department (In case of Military auctioned vehicle)
for presentation along with the application for registration of a motor vehicle)
Part I- In case of application for registration of fully built motor vehicle made by owner
Certified that DOLPHIN (brand name of the vehicle) has been delivered by us to GOLU KUMAR on 16-Dec-2022.
Part II- In case of application for registration of fully built motor vehicle made by dealer
Certified that DOLPHIN (brand name of the vehicle) has been agreed to be sold by us to GOLU KUMAR on 16-Dec-2022 and
the vehicle will be delivered by us to 16-Dec-2022 only after the registration mark assigned by the registering authority under
Section 41(6) is displayed on the motor vehicle as per proviso to sub-section (6) of Section 41.
Part III- In case of purchase of chassis
Certified that MOTKVHFER19F00472 (chassis) has been temporarily delivered by us on 16-Dec-2022 to GOLU KUMAR .
Part IV- Applicable in case of Part I, Part II and Part III
Name of the buyer : GOLU KUMAR
Mobile Number : 7857028144
Son/wife/daughter of : S/O- ARUN PATEL
Address(Permanent) : BANS GHAT NORTH MANDIR MOR, BUDDHA COLONY, PATNA, Patna, Bihar-800001
Address(Temporary) : BANS GHAT NORTH MANDIR MOR, BUDDHA COLONY, PATNA, Patna, Bihar-800001
The vehicle is held under agreement of Hire Purhcase/Lease/Hypothecation with:
The details of the vehicle are given below:
1. Class of vehicle : e-Rickshaw(P)
2. Maker's Name : KRISHNA VEHICALS
3. Chassis No : MOTKVHFER19F00472
4. Engine no/motor no : 20190440472
in the case of Battery operated Vehicles
5. Horse power(B.H.P.)/Cubic Capacity : 1.89/0.00
6. Fuel used : ELECTRIC(BOV)
7. Number of Cylinders :0
8. Month and Year of Manufacture : Jun-2019
9. Seating cap(inc driver) :5
10. Unladen weight (in kgs) : 333
Axle Details: Maximum axle weight and number and description of types (In case of Transport vehicle)
Description Weight(in kgs)
a) Front axle :
b) Rear axle :
c) Any Other axle :
d) Tandem axle :
11. Colour or colours of the body : RED
12. Gross vehicle weight (in kgs) : 713
13. Type of body : SOLO
14. AC Fitted : NO
15. Dealer : SHREE AUTOMOBILES
16. Model Manufactured Location : Manufactured in India

Signature of the manufacturer or dealer or Officer of Defence Department or registered E-rickshaw or E-cart Association

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