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Survey Form Mail

The document is a survey form for the condemnation of vehicles, to be filled out by the concerned department. It includes sections for details such as the owner's information, vehicle registration, specifications, and reasons for condemnation. The form requires certification that the provided information is accurate and that the vehicle is not involved in any legal issues.

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Anish Chib
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19 views2 pages

Survey Form Mail

The document is a survey form for the condemnation of vehicles, to be filled out by the concerned department. It includes sections for details such as the owner's information, vehicle registration, specifications, and reasons for condemnation. The form requires certification that the provided information is accurate and that the vehicle is not involved in any legal issues.

Uploaded by

Anish Chib
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Form- 1

Survey Form for Condemnation of Vehicle(s)

(To be filled by the Concerned Department)

No:________________

1. Name of the Department


2. Name & address of the
registered owner of the
vehicle
3. Registration Number of the
Vehicle
4. Date of Registration
5. Date of Stalling
6. Engine Number
7. Chassis Number
8. Make of Vehicle
9. Year of Manufacture/Model
10. Book Value
11. Un-ladden weight
12. Mileage covered as on Date
13. Fuel used
14. Token Tax paid up to
15. Revenue Account Head of the
Department
16. Reason of Condemnation
It is certified that:-
i) Information given herein above is correct.
ii) The vehicle is not involved in any accident case/court
case/hypothecation.
iii)No vehicle has been purchased in replacement against the
aforementioned vehicle till date.

Seal & Signature of the Registered Owner


As per Registration Certificate (RC)

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