Application_form_for_purchase_vehicles.pdf

APPLICATION FORM FOR CARS/TWO WHEELERS

1.

IRLA/F.No. Rank & Name Unit/formation Identity Card No. Basic Pay Rs. PAN/GIR No.

_______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________ _______________________________________

2.

Present Address of the Applicant

_______________________________________ _______________________________________

3.

Permanent Address of the Applicant

_______________________________________ _______________________________________ _______________________________________

4.

Name & Full address of Demand generating Canteen

_______________________________________ _______________________________________ _______________________________________

5.

Model No. Colour

_______________________________________ _______________________________________

6.

Name of Dealer with Full Address):-

______________________________________ ______________________________________ _______________________________________

7.

Mode of payment with BD No.& Date.

_______________________________________

8.

I affirm that the above details, as submitted, are correct .

Place __________________________ Date __________________________

Signature of the Applicant

It is certified that the information/particulars/details given by the applicant are verified/scrutinized and found correct.

Countersigned by Commandant/ DIG/IG(with stamp) Rank Name Counter signature of I/C Master Canteen With TIN No. and round rubber stamp

Note: If PAN No. is not available, declaration in Form-16 should be furnished as per IT Rules.

UNDERTAKING CERTIFICATE (To be submitted by the customer)

I,

Regt.

Number/IRLA

No.___________________

Rank____________

Name_____________________________________________ undertake that I have not purchased any four wheeler vehicle through CPC either in the name of myself or any member of my family during last 4 years/or have purchased the vehicle through Central Police Canteen in the year……………..vide Vehicle invoice no………dated …………..which have now completed more than 04 years. I shall not sell this vehicle to any person/firm before 2 years from the date of purchase. Beside I also give undertaking that I will submit copy of registration of vehicle to Master Canteen and Central Office CPC New Delhi within two months of purchase of vehicle.

Place :_________ Dated :__________

Signature of the individual Force No./IRLA No.____________ Rank_________Name__________ Unit/Office____________________

Countersigned by Head of Office/officer(Duly stamped)