APPLICATION FOR AFFIXATION OF HSRP

To,

The Registering Authority

Chandigarh ( U.T )

Sir,

Kindly affix the High Security Registration Plate in my vehicle with the following details:

Full name of owner.. Son/Wife/ Daughter of .

Permanent address of the owner.

Temporary address of the owner.

Registration number of vehicle .

In case of old vehicle, whether affixed with HSRP earlier (Y/N).

Class of vehicle (If motor cycle, whether with or without gear).......

Makers name.

Month and year of manufacture...

Chassis No..

Engine No. ....

Colour or colour of body, wings and front end..

In case affixed with HSRP earlier, laser code of

Front number plateRear number plate

Date

Signature of owner

For office use only

VERIFICATION OF DATA

Signature Name & Designation of verifier

(Note: if not verified give details of discrepancies)

AUTHORISATION

Signature Name & Designation of officer

(Note: if not authorized give reason thereof)

This portion is to be filled in at the time of actual affixation of HSRP)

City in which Affixation Centre is located. The components for which charges are being collected... Amount of Gross charges collected ...

Date and time of collection of advance .

Date and time of actual affixation of HSRP Number of days by which the service has been delayed...

Signature of Contractors authorized representative Signature of motor vehicle owner/authorized representative

Receipt of application for affixation of HSRP

Reference No..

Signature of receiver and designation

AUTHORITY LETTER FOR GETTING HSRP AFFIXED

To,

THE REGISTERING AUTHORITY

......

..

I ..(name of owner of vehicle), resident of

..., owner of vehicle number

bearing chassis number and engine number. do hereby authorize Mr./Ms

. Resident of .... whose signatures are attested below to pay the charges for High Security Registration Plates and get such plates affixed to my vehicle.

Signature of AUTHORISED PERSON

Signature/Thumb

Impression of Owner