Madhya Pradesh Transport Department
[See Rule 47]
Application for Registration of a Motor Vehicle
(To be made in duplicate if the vehicle is held under an agreement of Hire Purchase/Lease/Hypothecation and duplicate copy with the endorsement of the Registering Authority to be returned to the Financier simultaneously on Registration of motor vehicle).
The Registering Authority,
Full Name of Person to be registerted as registered owner
Age of the person to be registered as Registered owner
(Proof of age to be attached)
Permanent address of the person to be registered as
(Evidence to be produced)
Temprory address of the person to be registered as
Name and address of the Dealer or manufacture from whom the vehicle was purchased
(Sale Certificate and the certificate of road worthiness is issued by the manufacturer to be enclosed)
If ex-army vehicle, or imported vehicle, enclose proof If locally manufactured Trailer/Semi-trailer,enclose the approval of design by the STA and note the proceedings No. and date of approval
Class of vehicle
(if motor cycle, whether with or without gear)
The motor vehicle is
a) new Vehicle b) Ex-army Vehicle c) Imported Vehicle
Type of body
Type of Vehicle
Maker’ s Name
Month and Year of Manufacture
Number of Cylinders
Maker’s Classification or if not known wheel-base
Chassis Number (Affix pencil print)
Fuel used in the engine
Particulars of previous registration and registered number
Colour or colours of body, wings and front end
I hereby declare that the vehicle has not been registered in any State in India.
The vehicle is covered by valid certificate of insurance
under Chapter XI of the Act
Insurance certificate or cover note No.
(Name of Company)Valid
The vehicle is exempted from Insurance.
The relevant order is enclosed
I have paid the prescribed fee of rupees
(fill it before submission)
Signature of the Registered Owner:
The motor vehicle above described is
(1) Subject to Hire-Purchase/Lease agreement with
(2) Subject to Hypothecation in favour of
(3) Not held under Hire-Purchase agreement or Lease agreement or subject to Hypothecation.
Strike out whatever is inapplicable. If the vehicle is subject to any such agreement the signature of the Financier with whom such agreement has been entered into is to be obtained.
Signature of the Financier with whom an agreement of the
Hire-purchase,Lease or Hypothecation has been entered into.
Signature of the Registered owner:
CERTIFICATE OF INSPECTION OF MOTOR VEHICLE
Certified that the particulars contained in the application are true and that the vehicle complies with the requirements of the Motor Vehicle Act 1988 and the Rules made thereunder.
Signature of the INSPECTING AUTHORITY
(Check List of the documents to be submitted along with this Form)
1. Sale certificate in Form 21
2. Form 22
5. Address Proof
6. Computer generated cash receipts
(To be used by Transport Department officer)
I______________________________Designation_____________________ certified that all the tax and fee details mentioned in this form are correct and all other mandatory information provided by the authorised dealer in his capacity of being registering authority are correct.
Signature and seal of RTO: