Tax Invoice

Invoice Number :- UP11000325V00040 DO No:

Reference Invoice Number :- VEHINV-UP110003-2526-00040 Invoice Date:- 06/04/2025
Supplier Details (Ship From): Ship To(Place of Delivery):
Legal Name: MASCOT AUTOMOTIVE INDIA PVT. LTD. Legal Name: MASCOT AUTOMOTIVE INDIA PVT. LTD.
Dealer Name: MASCOT AUTOMOTIVE INDIA PVT. LTD. Dealer Name: MASCOT AUTOMOTIVE INDIA PVT. LTD.
Address : GRAND MELROSE, DELHI G.T. ROAD ALIGARH ALIGARH UP Address : GRAND MELROSE, DELHI G.T. ROAD ALIGARH ALIGARH UP
202001 202001
fPin Code: 202001 Pin Code: 202001
State: UP
GSTIN No:
09AAHCM3648Q1ZO
Phone: 8449435000 Email: [email protected] State Code: 9

PAN No: AAHCM3648Q CIN No:

GSTIN:
09AAHCM3648Q1ZO
State: UP State Code: 9
Customer Care No: 8449437000
Place of Supply Bill To (Details of Recipient)
Legal Name: YAMEEN C/O KALLUMAN KHAN Legal Name: YAMEEN C/O KALLUMAN KHAN
Customer Name: YAMEEN C/O KALLUMAN KHAN Customer Name: YAMEEN C/O KALLUMAN KHAN
Address : NADA .WAJEEDPUR, KHAIR ROAD KOIL. ALIGARH UP Address : NADA .WAJEEDPUR, KHAIR ROAD KOIL. ALIGARH UP 202001
202001
Pin Code: 202001 Pin Code: 202001
Email Address: Email Address:
State: UP State Code: 9 State: UP State Code: 9
GSTIN No: UIN No: GSTIN No: UIN No:
Phone(M): 9690312528 Phone(O): Phone(M): 9690312528 Phone(O):
Customer GST No: PAN Number: Customer GST No: PAN Number:
Cust/Enq Category: Individual / Individual LS Order No: Service No:
Booking No: VEHBK-UP110003-1-2526-00045 Purchase Type: Finance LS Order Date:
Battery No:192869 Booklet No: ok Whether Supply is service or not:
Invoice Type: Tax Invoice Invoice Type Code: INV Key No: 00
Reverse Charge: Not Applicable Supply Type: Transaction mode:
Salesman Name: KAMAL PRATAP SINGH Mobile No: 9639022444 E-Way Bill No:
Hypothecation With: HDB FINANCIAL SERVICES LTD, E-Way Bill Valid Upto Date:
Model(Model Code) HSN Code Type / Variant Colour Frame no. Loyalty ID Engine no./ Motor no.

ACTIVA OBD2B
4ID/ACTIVA DLX
(SCV110S) 87112019 P S BLUE ME4JK362CSD029649 JK36ED2029704

Description Qty UOM Unit Price (Rs.) Tax % Amount(Rs.)

Basic Price 1 Nos. 71,943.16 71,943.16
Discount 0.01
Taxable Amount 71,943.15
IGST 0.00 % 0.00
CGST 14.00 % 10,072.04
SGST/UTGST 14.00 % 10,072.04
CESS 0.00 % 0.00
Ex Showroom Price (Rs.) 92,087.23
Concession 0.00
Total Amount 92,087.00
Discount Remarks:-
S.no Scheme Name
1 Free 3 Year Service Maintenance Package
Customer Temp Address :

Assessable Value: 92,087.23

Amount in words Rupees Ninety Two Thousand Eighty Seven Only.
If reverse charge applicable then specify amount of tax
Declaration :
I/We hereby certify that my/our registration certificate under the -ALIGARH Jurisdiction is in force on the date on which the sale of goods specified in this Tax Invoice is made by me/us and that the transaction in the turnover of sales while filling of
the return and the due tax, if any payable on the sale has been paid or shall be paid. Also I/We hereby give consent that all personal or other information (information's) provided herein or otherwise can be used for the business purposes or for
performance of agreement between us, if any and shall not be disclosed to any third party except to the extent its disclosure is essential as per the applicable laws or for any business requirement. The above said information may be shared or
transferred with HMSI or its Dealers or group companies within or outside India for improvement of product, service quality, marketing promotion, development of our products, services, etc. However, the same shall be transmitted, handled &
destroyed as per the applicable law or in a manner that will preserve its confidentiality. Further, all or any of the information's provided herein or otherwise can be withdrawn/corrected by giving notice.
Customer Signature
Payment Receipt No : RCT-UP110003-2526-00043 Payment Method : Cash Payment Receipt Date: 06/04/2025
For MASCOT AUTOMOTIVE INDIA PVT. LTD.
Authorized Signatory

Note : Service Schedule for your BSVI and EV model is available on next page.
 Free Service Schedule Kms* Days*
1st Free Service 750-1000 15~30
2nd Free Service 5500-6000 165~180 * Kms or Days, whichever comes
earlier
3rd Free service 11500-12000 350~365
Paid Service Frequency Every 6000 Kms or Within 6 months
Please Note : Applicable for Domestic BSVI and EV Vehicle Only

Delivery Note
(Invoice/Form 21/Form 22/Owner's manual/Free service coupon/Tool kit)
Received the above mentioned vehicle complete with tools, accessories & necessary documents to my satisfaction
Invoice Number: UP11000325V00040 Invoice Date: 06/04/2025 Frame No: ME4JK362CSD029649

Customer Signature with Date Authorized Signatory with Date

*Strike out whichever is not applicable.

 FORM 20
APPLICATION FOR REGISTRATION OF A MOTOR VEHICLE
[See Rule 47]

(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 Registering Authority to be returned to the Financier
simultaneous on Registration of motor vehicle)
To
THE REGISTERING AUTHORITY
1. Full name of person to be registered as registered YAMEEN
owner Son/Wife/Daughter of

C/O KALLUMAN KHAN

2. Age of the person to be registered as registered owner

3. Permanent address of the person to be registered as NADA .WAJEEDPUR, KHAIR ROAD KOIL. ALIGARH
Registered owner (Evidence to be produced) UP 202001

Mobile #
9690312528

4. Temporary address of the person to be registered as Mobile #

registered owner

5. Name and address of the Dealer or Manufacturer from MASCOT AUTOMOTIVE INDIA PVT. LTD.
whom the vehicle was purchased GRAND MELROSE, DELHI G.T. ROAD ALIGARH
ALIGARH UP 202001
Contact #
8449435000
6. If ex-army vehicles or imported vehicle, enclose proof.
If approval of design by the State Transport Authority and
7. Class of vehicle
(If motor cycle, whether with or without gear)
8 The Motor vehicle is
(a) a new vehicle NEW VEHICLE
(b) Ex-army vehicle NA
(c) imported vehicle NA

9. Type of body FULLY BUILD

10. Type of vehicle 4ID

11 .Maker's name Honda Motorcycle & Scooter India Pvt. Ltd

12. Month and year of manufacturer March 2025

13. Number of cylinders 1

14. Horse power 8bhp

15. Cubic capacity 109.51 cc

16. Maker's classification or if not known ACTIVA OBD2B ( ACTIVA DLX)4ID

17. Wheel base

18. Chassis No. (Affix Pencil print) ME4JK362CSD029649

19. Engine No. JK36ED2029704

20. Seating capacity (including driver) 2

21. Fuel used in the engine PETROL

22. Unladen weight 106

23. Particulars of previous registration and registered

number (if any)
24. Colour or colour of body, wings and front end P S BLUE

I hereby declare that the Motor Vehicle has not been registered in any State in India.
Additional particulars to be completed only in the case of transport vehicles other than motor cab.
25. Number, description and size of tyres
(a) Front axle
(b) Rear axle
(c) Any other axle
(d) Tandem axle

26. Gross vehicle weight

(a) As certified by the manufacture .........................................................................................Kg
(b) To be registered .................................................................................................................Kg

27. Maximum axle weight

(a) Front axle ...........................................................................................................................Kg
(b) Rear axle ............................................................................................................................Kg
(c) Any other axle.....................................................................................................................Kg
(d) Tandem axle.......................................................................................................................Kg

28.(a) Overall length .................................................................................................................

(b) Overall width ..................................................................................................................
(c) Overall height..................................................................................................................
(d) Over hang........................................................................................................................
The above particulars are to be filled in for a rigid frame motor vehicle of two or more axles for an articulated vehicles of
three or more axles, or, to the extent applicable for trailer, where a second semi-trailer or additional semi-trailer are to be
registered with an articulated motor vehicle.

The following particulars are to be furnished for each semi-trailer.

29. Type of body........................................................................................................................

30. Unladen weight.....................................................................................................................

31. Number, description and size of tyres on each axle .............................................................

32. Maximum axle weight in respect of each axle .....................................................................

33. The Vehicle is covered by a valid certificate Insurance certificate or Cover note of insurance under Chapter XI of the
Act................ .No............... Date................of............... (Name of Company) valid from ................to..............

34. The vehicle is exempted from Insurance.

The relevant order is enclosed..............................................................................................

35. I have paid the prescribed fee of rupees ..............................................................................

Date Signature or thumb impression of the person

to
be registered as registered owner.

Note : The Motor Vehicle above described is :

(i) Subject to Hire-Purchase agreement/Lease agreement with
(ii) Subject to hypothecation in favour of HDB FINANCIAL SERVICES LTD,
(iii) Not held under Hire-Purchase agreement, or lease agreement, or subject 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 in to is to be obtained

Signature of the financier with whom an

Agreement of Hire-Purchase, Lease or Signature or thumb impression
Hypothecation has been entered into of the registered owner
 CERTIFICATE
INSPECTION OF MOTOR VEHICLE

Certified that the particulars contained in the application are the true and that the vehicle
Complies with the requirements of the Motor Vehicle Act, 1988 and the Rules made there under.

Signature of the INSPECTING AUTHORITY

Name
Designation
(For OFFICE ENDORSEMENT)
Ref. No.
Office of the
Dated
The vehicle bearing chassis number and engine/motor number has been assigned the registration
number / and registered in the name of and the vehicle is subject to an agreement of hire purchase
lease/hypothecation.
Registering Authority
TO
Name and address of the financer

By registered post or deliver under proper acknowledgment.

Specimen signature or thumb-impression of the person to be registered as Registered Owner and Financier are to be
obtained in original application for affixing and attestation by the Registering stamp and attestation shall fall upon each
signature.
Specimen signature of the Financier Specimen signature of the Registered Owner

(1) --------------------------------------------------------------------- (1) ------------------------------------------------------------

(2) --------------------------------------------------------------------- (2) ------------------------------------------------------------

(3) -------------------------------------------------------------------- (3) ------------------------------------------------------------

 Form 22
[See rules 47 (1)(g)]
ROAD-WORTHINESS CERTIFICATE

For

Compliance to Emission and Noise Standards

(To be issued by the Manufacturer or Importer or Registered Association in case of E-rickshaw or E-cart, along with the vehicle)

It is certified that the following vehicle complies with the provisions of the Motor Vehicles Act, 1988, and the rules made
thereunder:
1. Model / Commercial Name of the vehicle : ACTIVA OBD2B

2. Chassis number : ME4JK362CSD029649

(Example:- Vehicle Identification Number (VIN) or ATIN or PIN / Trailer Identification Number etc.)
3. Engine number (Motor number, in case of Battery-Operated Vehicles) : JK36ED2029704
BS6 OBD2B
4. Applicable Emission norms :
(Example:- Bharat Stage-IV / VI / TREM-III/ Equivalent, as permitted under the act, Select NA for Battery Operated
Vehicle)
Emission, Sound Level for Horn and Pass by noise values of the above vehicle model, obtained during Type Approval
5.
Testing as per Central Motor Vehicle Rules, 1989 are given below:

(i) Type Approval Certificate No. : CATN 1041 V01

(ii) Type of Fuel : PETROL
(Example:- Petrol / Diesel / CNG / LPG / Dual / Biofuel / Hybrid etc.)
(iii) Emission values for vehicles :

TABLE
Positive Ignition Engine or Compression Ignition Engine Vehicles

Pollutant Units Value

Sr. No.
(as applicable) (as applicable) (upto 3 decimal places)
(1) (2) (3) (4)
1. Carbon Monoxide (CO) mg/ km or mg/kWh or g/kWh 377.595
2. Hydrocarbon, (THC/HC) mg/ km or mg/kWh or g/kWh 59.937
3. Non-Methane Hydrocarbon (NMHC) mg/ km or mg/kWh or g/kWh 51.836
4. Oxides of Nitrogen (NOx) mg/ km or mg/kWh or g/kWh 9.728

(iv) Noise level (as applicable):

(a) Horn (for all vehicles other than agricultural tractors and construction equipment vehicles) as installed on the
vehicle: 73.2 dB(A);
(b) Pass by or Bystander's position: 101.5 dB(A);
(c) Driver-perceived or Operator's ear level (as applicable for agricultural tractors and construction equipment
vehicles): ....Not Applicable.... dB(A);

For Honda Motorcycle & Scooter India (Pvt.) Ltd.

(Facsimile Signature of Manufacturer or Importer or Registered

Association, in case of E-rickshaw or E-cart)
 DEALER: MASCOT AUTOMOTIVE INDIA
PVT. LTD.
FORM 21

(See Rule 47 (a) & D)

SALE CERTIFICATE

Certified that Honda ACTIVA OBD2B ( ACTIVA DLX) BS6 OBD2B has been delivered on 06/04/2025 by us to

1.Name of the buyer : YAMEEN

C/O KALLUMAN KHAN

2.Permanent Address :
NADA .WAJEEDPUR, KHAIR ROAD KOIL. ALIGARH UP 202001

3. Temporary Address:
4. Mobile No. : 9690312528

The vehicle is held under agreement of Hire Purchase/Lease/Hypothecation with HDB FINANCIAL SERVICES LTD, ,
Details of the vehicle are given below :

1. Class of Vehicle SCOOTER

2. Maker's Name Honda Motorcycle & Scooter India Pvt. Ltd.

3 Chassis No ME4JK362CSD029649

4. Engine No. JK36ED2029704

5. Horse Power 8 bhp

6. Fuel Used PETROL

7. No. of Cylinders 1

8. Month & Year of manufacture March 2025

9. Seating Capacity (including 2

driver)
10. Unladen Weight 106
11. Maximum axel weight & number & description of tyres
(In case of Transport vehicle)
a) Front axle : N.A. b) Rear axle : N.A.

c) Front axle : N.A. d) Tandem axle : N.A.

12. Colour Of Body P S BLUE

13. Gross Vehicle Weight 280

14. Type of Body FULLY BUILD

15. Blinkers/Indicators Fitted YES

16. Cubic Capacity 109.51 cc
For : MASCOT AUTOMOTIVE
INDIA PVT. LTD.

Authorised Signatory
STRIKE OUT WHICHEVER IS NOT APPLICABLE.
Registered GRAND MELROSE, DELHI G.T. ROAD ALIGARH ALIGARH UP 202001
Office: