FormNo.
19 (See Rules 43)
F'orm cf Register of Trade Certlficate
Li-ON Mobility
No 19, Grauxd FloorrBKM ?lazar 5th B Main Road,
Tata Silk Barm, KR Road, Banglore-560070
No.
Date I
Trade Certificate
Number
and in case of rrehicle 2 KA51TC1811t
registered the
registration
number if tlre vehicle
Description
Motor Vehicle 3 Chassis No. P60C2512500007635
Motor l\o. T481 0D1 1 2503030060
Putpose fcr u,hich
Vehicle sent out 4 For Registratirn.
0r bouglrt
Driver's name
Licence
No. and address and 5 Licence No. Valid &p to..............
Whether he is the
employee
of the holder of Trade
Certiticate
I{ours oi leaving the
Pretnises bi, the 6 10 AM
vehicle
Hours of leaving the
Premises by the 7 6PM
vehicle
Mileage covered
Between the hours I
noted
In columns (6) & (7)
Signature &
designation 9
nf the persoll
autl-rorized
bv the holder