FORM -FT
See Rules 56 (2)
It resident
(temporarily) at (permanently) at
hereby declare that I have brought the
undermentioned motor vehicle into the union Territory of Daman & Diu
and that I intend to keep it in the Union Territory up to for use
solely within the limits of the local authority viz.
(here mention the name of local authority)
which has levied at tax on the motor vehicle/both
within the limits of the local authority viz. (here mention the name of
the local authority) and outside
these limits : -
(1) Class of motor Vehicle
(2) Registration mark
(3) Maker's Name
(4) Type of Body
(5) Type of Chasis
(6) Type of Engine
(7) Unladen weight
(8) Whether use for carriage of
persons or goods
(9) If used for carriage of persons
(a) Whether playing for hire
(b) Carrying Capacity
(i) Stated ( including driver)
(ii) Standees
Total
(10) If used for carriage of goods
(a) Whether a private goods
vehicle or a public goods
vehicle
(b) Registered laden weight
(c) Carrying capacity i.e. the
difference between the
registered laden weight and
the unladen weight
(11) (a) Date on which the motor
vehicle was last brought into
the State of Maharashtra
(b) Date on which it was last
removed from the State of
2
(12) The fuel used in vehicle :
(13) Name of Insurer :
(14) Insurance Certificate No. :
(15) Date of validity of Insurance :
Certificate
From to
I tender herewith Rs. by Cash/Cheque/Demand Draft/Money
Order/Treasury Chalan being the tax due in respect of the vehicle described above.
The said vehicle is exempted from payment of tax by Government Notification,
Home Department, No. dated the
for the period in the state of for the
period ending by virtue of having paid the tax for the said
period in the State of
Dated the
Signature of the Declarant.
f Govt. Prrnti !!e ' Daman^l0 2009 -1000.
