Printed On: 22-Apr-2017 15:29:16

Customer Copy
GOVERNMENT OF MAHARASHTRA
Motor Vehicle Department
NAGPUR (RURAL), MH
RECEIPTIAPPL No: MH40D17040003822/MH17040003185004
Vehicle Class: M-Cycle/Scooter
Received From: RANJANA KAPSE
Receipt Date: 22-Apr-2017 MH-40 BH- 683
Vehicle No: NEW Chassis No: ME4JF507DHU140775
Sale Amount: 53972/ Transaction ld: MHY17040263274
Bank Ref No: 000545975
Particular Amount Penalty Total
300 0 300
New Registration
Inspection of Dealer Regn 50 0 50
50 50
Postal Fee
MV Tax(19-Apr-2017 tp One Time ONErI i4C4858 4858
Road Safety Tax(19-Apr-2017 to One Time) 98 98
GRAND TOTAL (Gin'RS) 5356/-(FIVETHOUSAND THREE HUNDRED AND FIFTY SX ONLn
Note Ths is computer generated slip, no need of signature (https:/parivahan.gov.in).
ACCOUNTS
SUDARASHAN MOTORS
 Original - Buyer 's Copy
Tax invoice
Invoice No. Dated
AUDARSHAN MOTORS
sKANORIA HOUSE,PALM ROAD SM\0355\17-18 19-Apr-2017
CIVIL LINES, NAGPUR - 440 001 Booking Number Date
E-Mail: [email protected] SMI0679
Model Name |Model Color
ACTIVA 4G MAJESTIC BROWN METAL
Chasis/Frame No. Engine No.
Owner ME4JF507DHU140775 JF50EU5140825
Code :SM\0679 Battery Number Key Number
RANJANA GOPAL KAPSE Z41129C70452 S-3059
S/W/D: GOPAL KAPSE Insurance Cover Note Insurance Period
WIN-03 HIN-416 PAKHIDDE 19-4-2017 To 18-4-2018
LAYOUT, NR-SHIVMANDIR Insurer Name Tyre Mfg. Name
MAHADULLA KORADI, IF-HFFCO TOKIO GEN INS
NAGPUR-441111 Front Tyre No Rear Tyre No

Contact 8806427421 Service Book No

|Hypothication : Not Applicable 23499
S Description of Goods
No
Quantity Rate per Amount

|1 ACTIVA 4G SELF 1 No 47,552.80 No 47,552.80

(SERVICETAX)

Output VAT @13.5% 13.50% 6,419.60

R.T.O.Tax Payable 4,857.60
R.T.O. REGN CHARGES (Imv) 400.00
ROAD SAFETY CESS
97.20
Less
INSURANCE CHARGES (|FFCO TOKIO) 2,296.00
Round Off
(SERVICE TAX) (-)0.20

Total 1 No
Amount Chargeable (in words) 61,623.00
INR Sixty One Thousand Six Hundred E &OE
Only Twenty Three

Company's
compny's Servi
PANce Tax No.: AANFS9853LSTO01
Decdaraion : AANFS9853 L
Company's tBT No.
We
goodsdeclare that this
for sDARSHAN MOTORS
Correct. described and invoice
shows the actual price of the
that all particulars are true and
Authonised Signatory
SUBJECT TO NAGPUR JURISDICTION
This is a Computer Generated Invoice
 Issuing Ofice address:
IFFCO-TOKIO GENERAL INSURANCE CO.LTD. IFFCO-TOKIO
Covernote No. 73827306
Co. Ltd.
|FFCO-TOKIO Genen Insurance muskurate kaho
7th Floor, Fidvi
Tower, IFFCO-TOKIO GENERAL INSURANCE CO. LTD.
Ofice 4th &5th Floor "1FFCo TOWER:
Agent number 220003S
Opo. Saraf Chamber, Mounbp
Sadar, Nagpur -440001 Plot No-3 Sector-29,Gurgaon, Haryana- 122001 Ernployee rnumber
MOTOR VEHICLE INSURANCE
COVERNOTE Dealers Name

The nsured referred to below havng proposed for insuran.e nrespect of Motor Vehicle (s) described therein and havrg pad the sum of Rs 22Y6
as premium, the risk is hereby held covered under the terms of the Company's u^ual forn of Policy applicable thereto (subject to an special conditions mentioned
below) unless the cOver be lerminated by the Company by notice in writing, in which case the Insurance wil thereupyr ease and a proportionate part of the premium
othenwise payable tof SuCh insurance shall be charged for the time the Company had been on risk
FORM 52 (India) 1989 See Rule 142 (1) of Motor Vehicle Rules, 1989
1. Name and address of insured
|RANJ AA RAPsE
| o WRsH
MALND2 MAHolo|
City / State

Pin
|NAGPlUe Phone
2. Registration mark, number and description of the vehicle insured
Registration Number:
Mobile

Email
Lalslolss242 Make:

Model:
HOnDA
Hypothecation :
Engine No:
3. Effective Date &Time of Commencement of
Chassis No:
Sl40825
Insurance for the purpose of the Act.
I4077S
From/:49R (Dae) /9.92017 Year of
Manufacture
Cubic
Capac1ty
Licensed carrying capacity
Goods(GVw) Passengers
4. Date of Expiry of Insurance
To Mdn1ght of./8.s.04.201 20/7//o
5. Person or Classes of persons entitled to drive.(please see overleaf)
Calculation of premium:
6. Limit HISRUS a9RFRGPEeegl)0i
insured'
1
DetkbdIauRLISSUED AFTER
Veicle

Non-elscpccqe017 Rs
2
Elecrical accessSories Rs ******.*****

Total Su Insured
Value of hly those acessornes to be indicated which aE
not
sS|279H
included tne 0antecurer's listed selling price.
in
Additional risk, if any
Special Conditions
Ihe period of validity of this
1.,
296
COvernote will expire on
Premium received byCheque No. Dated .ICash Rs
/ We heereby çertify that this Covernote is issued in acCordance with the provisIon of Chapter Xl GIAOFVehicle Act 1988
Date of lssue:(O for IFFCO TOKGenea urance Co. Ltd.
Place.29L
Time 2.cako
For claims, call: 1800 103 5499 (ANetiseSnatory)
 INVOICE
Invoice No Dated
GARSH.N MOTORS
NORIA HOUSE,PALM ROAD ASI0133117-18 18-Apr-2017
Delivery Note Mode Terms of Payrnenl
ENIL LINES, NAGPUR -440 001
E-Mail: [email protected]
Supplier's Ref. Other Reference(s)
ACT-4G BROWN (APARNA)
Buyer's Order No. Dated
Consignee
RANJANAGOPAL KAPSE
WIN-03 H/N-416 PAKHIDDE LAYOUT Despatch Document No. Delivery Note Date
NR-SHIV MANDIR MAHADULLAKORADI
NAGPUR Despatched through Destination
Terms of Delivery
Buyer (if other than consignee)
RANJANA GOPAL KAPSE
WIN-03 HIN-416 PAKHIDDE LAYOUT
NR-SHIV MANDIR MAHADULLA KORADI
NAGPUR

Description of Goods Quantity Rate per Amount

No

1 FRONT NUMBER PLATE 1 No 114.54 No

2 REARNUMBER PLATE 114.54
1 No 96.92 No 96.92
3 STAND SET SIDE 1 No 284.58 No
4 F8ÚJRÉST COMPLETE 284.58
5 GUARD KIT (ACTIVA)-STAINLESS S 1 No 740.97 No 740.97
6 (BUyZER 1No 1,904.85 No 1,904.85
7/GBIP OVER -HONDA"TYPE 3"(SET 1No 61.67 No 61.67
1 No 61.67 No 61.67
3.265.20
VAT or Ascess ies 13.50 % 440.90

Total 7 No
Amount Chargeable (in words) 73,706.00
INR Three Thousand Seven Hundred Six Only E. &
OE

Company's Service Tax No.:

Company's PAN AANFS9853LST001
:AANFS9853L
Dedaration Company's LBT NO. for SuDARSHAN MOTORS
We declare that this invoice shows the
goods described and that all particularsactual price of the
are true and corect.
Authorised Signatory
This is a Computer Generated Invoice
 IFHCO-TOKI0

IFFCO-TOKIO GENERAL NSURANCECO.LTO

Reud Ofce F$C0 fadan C.1t Cerire, Sakel, ien r1117 phrs t
INO WHELLER POLICY CERIFICATE OFJNSURANCE CUM Agent Mee
SCHEDULE
Corporate ldentification Number (CiN) Agent #
U74899DL2000PLC107621, IRDA Reg. No. 105 Agent Mctle s
insureds Name RANJANA GKAPSE Policy # 1-8023JE3
Address W NO. 03 H NO. 416 PAKHIDDE LIO NR SHIV MANDIR MAHADULLA KORADI
Date of isSRNCE 23/4/2017 184334
NAGPUR MAHARASHTR Pin Code 440120
INDIA
Period of nuras 1942917 12 4949
Phone 8806427421 Cover Note # 73827306
To tgs o124/2018 23 59.59
Geograptica Asea Nn na Croy
nsured Motor Vehicle Delaits & Premlum Calculation
Type of Body
Regstratson tMark & yeat ot Manuf. CC
Frgng ir. Seatrg
No Coverage IDV in Rs
FS0EVS 140825
Make of Vehcle
NEWO001 2017 110
Package 51274 00
Non Electrical Accessores ar not Chans No
HONDA ACTIVA 4G SELF Covered as its value is 0
Registi ation Authority MEAJESO7 DHU 140775
de C Accessones Elec Flect Acr
S1274 O B-Fue! KA Totat Vaàse NetPen Rs
000 0 00 51274 00
AOan Damaoe Premium(s.) 7235
. Thig Party remiun(Rs )
Ste Ca Poeme 859nn35 a, E.ol Vit UMT 25 20C9
aca Acoessores (MT 24) PA Owrer Driver CSI Rs 100000
s(NT 33

Add
ogn Vehcke Lasding (MT 19) 000 Legat Liabltly lo Drver (IMT 28)
Seograghical Area Extension {IMT 1) 0 00 Legat Lrablity o Employee (|MT 29)
Dhving Tutons V00PA loPassenger (IMT 16)
Glass Fuel Tan
0 00 Geographucal Area Extension (IMT 1)
lAcertienal Loading
0 00
Less
vntar Excess Less 0% tAT 22A Less:
0.00 Third Party PiOperty Damege (1MT 20)
ceceton (MT 8) 0 00 Limit of Liabäity Under Section I- ()
Handcap Dsoouni (IMT 12)
e e ise (MT 13)
be Cam Sous Dscount
(00%)
Car Compensation Discount
F Oer Laading Disoounl
(40% ) -343 74 Any Olher Loading Discoun
515 61 Net (Al
Co-nsurance Details
Agent No IShare Section 1 (A + B)
No Colnsurer Rs 1285$1
(279 49) "Swachh Bharal Cess(9 98) Krsh Kalyan Cess(9 98)
No Co-Insurer
This poicy of type 'New Vehicle Without NCB' with age of vehicle "0 is issued as a brand
new vehicle and if it is otherwise, the benefits under the present policy will stand
cere Purcase MypothecaledLease Agreement with NA forfeited.
TNom1nees RANJANA GIOwner Driver).
Stutye io tMEndorsement Nos
atcr To Use Use orhy lor socn! domest1c and pleasure purpose and for the insureds business or prolession The polic Prinled here pt atached here to
tha saples o personal luggage) in connechon with any Irade or business or use for any purpose in connecion wthhMoloSno nol cover use for hire or reward, tution racng. pace-mak1ng,rokabity trads, speed lestng carrae
gotstote
ve ase Any person ndudng nsured provded tnal the person driving holds and etfecive dovng bcen one lime of the accdent and is nol disqualifed from holding or obtaang such a kcense Provded also ta he persn Nodng
nee may also dtive the vehde and Ihat such a person salislies the tequrements of Rule 3 ol Motor Vehrdes Rules, 1989
Preceding two consecutive year 25% Preceding trree consecutive vear 35% Precedg louf consecutive ear 45% Precedng tve oonsecutve year 50

os d ri e liowed, provded the policy S renewed wthin 90 days of the expry dale of the prevous polcy
Peine ce at e oromum s ikely to be changed with effect from 1 4.2017 in respect of Thrd Party secton ol the polcy as per IRDA gudelines as well as Servce Tax tn case the premum ales and Sevce Taa a ed yu aro
ieetenet tcreased premum order to avail the conbaly of benefis under your Moto insurance Pohcy
imposed Excess
Such arKOni as s recessary lo reel the regirements of the Motor Vehiclees Act. 1986 Partal Loss
As per pternum computation lable Total Loss
PA Ownet. Drver as per premum compulalion table Vountary Excess
CAess onpuory Exces (IMT 22) Rs 100
Jrsueor, Statut
Inspection Ref No Inspecang Agency
Seclion 2: Value Auto Coverage
Coverages Premium Rs Limt Of Lability
Degrealn Waaver Ces 624 52 As Per Coerge Wordngd
ew Veh kepiacen Cover 61 27 As Pe Cosare VWordr g
ay
0 00
fecieaEapoa
0 00

0 00 Icat Cs
o
Acden Umd Ot Lably Nnes
CovtdSurad Petons
Clan Bas Protecton
NA
NA Owne Otves
ingred Porson's Ps t00000
3 Froperty NA
Damage
s Reova &Li.
0 00
Uvwing & or RenovIat & Trans Berelt
haaneertCost
25 00
Ommataben& Traveng Sturage O
Expenses oe tsafed Vece 00
anpori Redevey ot
Repalnatoo Repgted vehcle
Of
tPreuam R
Section 1(Rs Sectton 2 (Rs )
Premium Bifurcation (Rs )
Service Ta.GST (Rs) 2295 PBS
1285 6 Gross Premum (Rs )
299 45
1 of 4
710 79 1996 40
Page
Tarritorv et Dei
tationa Capitat
1) "Pokcy tssuing Office Delh .2) "Consolidated Stamp Duty deposited as per the orde: of Government ct
Signature valid
Digtaly Signed by SUBRAÊA MØNDAL
FOR CLAIMS CALL 1600 103 549grToll Free).0124-4285499 or SMS"CLAIM" to 56161
Date 201704 30'
Reason Vald Pocy04.53:17R
Copy
St.aon IFFCO Tohio Genens nsurance Company Ltd. india
 IFFCO-TOKIO

t e "Now Vehicle Without NCB' with age of vehicle '0' is issued as a brand new vehicle and if it is otherwise, the benefits under the present policy will stand forfeited.
der Hite Purchase Hypothecaled/Lease Agreement with NA Nominees RANJANA G{OWner Driver)j
stnet to IMI Endorsement Nos
Prnted her in / attached here to
Limitat1on as to use: Driver Clause
Use orly tor socual domest1C and pleasute purpose and for Ihe nsufed's busuness or profeseion The Ay person incduding nured provded that the person drnng hcids and effactve dvt
alcy does not covet use lor hate ot teward, luion, rac hg. pace- mekung relablty Irals, soed dsquated Ircn hotding or obiainng such a lcerse Provaed alsa trat he necoe
leshng atnage ot goodsi other than samples of personal luggage) n conneclon with any trade or vetacda and Ihat such a person salsfies the requrements ef Re 3 cf the The Centrat kor Vehdes Rules 1999 nse mty alsa drv the
ISiess ot Use ot any purpose t Connection watn Molors Trade

.an honus l onty be alkowed povded Ihe coicy s refewed wiihn 0 days of ihe epry Cate ol the pre vous cCy
!k, Cthn porus The rs:rod s enttled lor a No Cam Bonu (NCB) cn te own damage secton of ihe polcy. dno dam is made or perdmg durng Ihe preceing year(s) 8% per he kknne
tdcttnsurance Percentage o NC8 on 00 Premum Lint of Lisblity

prerg rea 20% Under Secton l-) Such amoynt as is necessarr o meet he requremens of the tokor Vehcies Act 1988
ec tw rorsecute ye: Under Secton (0) As per premum compytaton tatse
cedng thee cosecute eat i5 Under Secion it PA Owner. Dryer as pet premeym comcutaiion table
Copusory Excess (MT 22)Rs 100
Ibut conseculve ye 4 Imposed Excess
Partal Loss
e e0ng lye Conseculeve ya Total Los

the beret undet the pcy walh ot be Preyious

payotle untess Phe polsy s endosed wth popet reg1siration No of the vehde wthin a maximum penod ot 7 days from Ihe date andtne the Regstraion o ha vehcke
Insurer Name and Acdress
peyous Poicy No Previous Exptry Date

1eherety oertdy that Ihe pocy to which the cetdcate related as wel as ihe cerliticale ol insurance are issued in accordance wilh prov1sions af Chapler X XI of AV act 1906
2WaanNed that n cane of Desthonor of oremu chegi is ocune strÛs aulomat1cally cancelled "AB-INITIo"
mgo atNobe Ihus nsued not n than in accordance wilh thrs schedule Anvy oayment made by the conpany by teason of wwder terns sppeanng n he certfcate n order to comply wth
n Ihe nsured See he cdause headed "avoidance o certan lerms and nghi of recovery
e act1 9 n ecoverab
Recept Part1t S.Tax. No AAACI7S73HSTOO1
ay Method Receipt
Arnount instrument lnstrument Date
CashPG
295 00
LAXGS328269120 04/29/2017
Amosnt Rrceived 2296.00
oEFCOokagkral lnsurance Co. Ltd

utherised Signatory
R
Policy Wording for Two-Wheelers
kratun dsted as ated n the Schcduk whuch shall he the basys of this convact and is doemd (nhe incnrperated herein has apphed to the (Ipany or ihe ene thoned
kxati tr unh tranr in np ol avdnal loss o danage ixcuing duning thc period of insurance
Vn THIN t TTIh acplums and(ndtnN conlained herein cndored or capresc bercon,

mii ghning

huanc um lnpot itndat u cyclne hailtn Irst

d rad n land asraas ln ckvat a

hvem ts pur, tT atd tuh, hatterY an ur gs

den uri ll h a pur the fitlow ing chcdule

%0F DErRECIATION
sntte

ong 3 y
fing 4 ycar

and tsar tchacat ar cls rnal breakek), failres ur rcakaxgy

cha lç n tanwcd at thc am nc n which casc the trabilty ofthe cmpany stall he Inutcd t $u,nf the cost of runlaceent, and

q vi hcas tc taahk ond ot prcnn and renwval t thc nare repairer and rodel1very lo the inured hut c¯coting in all R& -u n t of any nsscel
( onpany nay h lhahie unhr ths Paly prov dd that

de buss e aled utat of the t urat; and

INSIARFD\ALUF (D)
dk hc dnod c ihe SUM INSURTD the prpeg f tu putcy whuh n fiaad at the cummtKNene of eah polsy pTIæ iT the fweal vehk

h ureg of Tal LimNia te Tal L(TL(TLiclams nly

%0F DE.PRECIATION FOR FIINGIDy

t pay n
.keal tahie
fah
h
dal
s
,

&l test s n th.eleml taÀ2 Nav af

thergu t the

Page2 of 4
of Dethi
Captai Territerv
1; "Poticyy Issuing Oice Delhi, 2) "Consldated Stmp Duty deposited as per the order of Government et Matsonata
Signature valid
tizitaliy signed by SUBRAJAMØNDAL FOR CLAINS CALL 1800 103 5499/TollFree),01244285499 or SMS"CLAIM" to 56161
Die 2017.04.30 04:53.17ST
heason Vahd Pohcy Copy
Liation. IFFCO Tokso Cene Insurance Company Ltd. india
 GOVERNMENT OF MAHARASHTRA
MotorVehicle Department NAGPUR (RURAL)
FORM 23
CERTIFICATE OF REGISTRATION

Registration No :MH40BH4683 Registration Date :19-May-2017

Description of Vehicle M-CYCLEISCOOTER Purpose For Printing RC :NEW
Dealer's Name & Address :SUDARASHAN MOTORS,PALM RD. CIVIL LINES, NAGPUR..,.
Owner Name :RANJANA KAPSE Sonlwifeldaughter of GOPAL KAPSE
Full Address: (Permanent) :WIN-03 H/N-416 PAKHIDDE LAYOUT, MAHADULLA KORADI, NR. SHIV MANDIR.
NAGPUR, MAHARASHTRA-441111
FullAddress: (Temporary) :WIN-03 H/N-416 PAKHIDDE LAYOUT, MAHADULLA KORADI, NR. SHIV MANDIR,
NAGPUR-MAHARASHTRA-441111
Fitness UpTo 18-May-2032 Tax UpTo :One Time
Owner Serial No

Detailed Description
Class of Vehicle :M-CYCLEISCOOTER Link Vehicle No
Ownership :INDIVIDUAL Norms :BHARAT STAGE IV
Maker's Name :HONDA MOTORCYCLE AND
SCOOTER INDIA (P) LTD
Front HSRP No Rear HSRP No
Type of Body :FULLY BUILD Month/Year of Manuf. :04 2017
No of Cylinders Chassis No : ME4JF507DHU140775
Engine No :JF50EU5140825 Fuel :PETROL
Horse Power(BHP) :7.85 Cubic Capacity :109.19
Maker's Classification :ACTIVA 4G Wheel base :1238
Seating Cap(in all) 2 Standing Cap :0
Sleepar Cap Unladen Wt (kgs) :108
Colour :MAJESTIC BROWN METAL Ladein/GV W(kgs) :269
Other Criteria AC Fitted :NO
Additional Particulars of all transport vehicles other than motor cabs (Gross Vehicle Weight)
By Manuf. As Regd.
Description Weight(in kgs)
a)Front:
b) Rear:
c) Other:
d) Tandem:
The motor vehicle above described is subject to Hypothecation in favour of w.e.f. .
Purchase dt :19-Apr-2017 Sale Amt
OTT Date
53972/
:19-Apr-2017 Amount/Rcpt No :4858 / MH40D17040003822
TaxUpTo :One Time Vehicle is GovtJ Pvt. PRIVATE
Tax Exempted or Not :NOT EXEMPTED Date of Approval :19-May-2017
Other State/Transfer/Conversion Details
Previous Owner
Old State
Previous RegNo
Entry Date
Transfer Date Conversion Date
This certificate is valid from
19-May-2017 to 18-May-2032
Date:29-May-2017 11:19:02 Signdture of Registering Authorty
Taxation Particulars /Advance Registration Mark Fee Date:29-May-2017
Details