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Form 21

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137 views1 page

Form 21

Uploaded by

prashik.komaki
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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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 CAT 3.0 NXT (brand name of the vehicle) has been delivered by us to SHAIKH MOHAMMED YUNUS ARIF on
26-Aug-2024.
Part II- In case of application for registration of fully built motor vehicle made by dealer
Certified that CAT 3.0 NXT (brand name of the vehicle) has been agreed to be sold by us to SHAIKH MOHAMMED YUNUS
ARIF on 26-Aug-2024 and the vehicle will be delivered by us to 26-Aug-2024 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 M0EB10CWURA000818 (chassis) has been temporarily delivered by us on 26-Aug-2024 to SHAIKH
MOHAMMED YUNUS ARIF .
Part IV- Applicable in case of Part I, Part II and Part III
Name of the buyer : SHAIKH MOHAMMED YUNUS ARIF
Mobile Number : 9850456666
Son/wife/daughter of : ARIF SHAIKH
Address(Permanent) : AHMADNAGAR 118-SHIREEN BAGH,, FAKIR WADA MAULANA AZAD SCHOOL, JAVAL,
Ahmadnagar, Maharashtra-414001
Address(Temporary) : AHMADNAGAR 118-SHIREEN BAGH,, FAKIR WADA MAULANA AZAD SCHOOL, JAVAL,
Ahmadnagar, Maharashtra-414001
The vehicle is held under agreement of Hire Purhcase/Lease/Hypothecation with:
The details of the vehicle are given below:
1. Class of vehicle : M-Cycle/Scooter
2. Maker's Name : KLB KOMAKI PVT LTD
3. Chassis No : M0EB10CWURA000818
4. Engine no/motor no : KL72V1000W2023101007
in the case of Battery operated Vehicles
5. Horse power(B.H.P.)/Cubic Capacity : 1.74/0.00
6. Fuel used : ELECTRIC(BOV)
7. Number of Cylinders :0
8. Month and Year of Manufacture : Jan-2024
9. Seating cap(inc driver) :1
10. Unladen weight (in kgs) : 154
11. Colour or colours of the body : BROWN
12. Gross vehicle weight (in kgs) : 532
13. Type of body : E CART
14. AC Fitted : NO
15. Dealer : JUST CLEAN LANDROMATES KOMAKI ELECTRIC
VEHICLES
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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