{|
Photograph
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Duplicate Signature or thumb-impression of applicant Form
L.Con. A.
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is licensed as a conductor and has been issued conductor's badge No.. ..
.............................
Licensing Authority
Date.. .. ..20..
Form CLD
[See rule 48(1) of the West Bengal Motor Vehicles Rules, 1989]
Form for intimation in case of loss/destruction of the conductor's licence
To
The Licensing Authority
...............................................
This is to inform you that conductor's licence No... ..dated .. .. .. .. .. issued by you in favour of me has been lost/destroyed in the following incident.. .. .. .. .. .. .. ... .. .. ..
A Formal complaint has been made to the nearest Police Station under No. .. .. .. .. ..dated.. .. ..My address as noted in the said Licence was .. .. .. .. .. ..
Signature or thumb-impression of the applicant.
Form CFA
Application for Certificate of Fitness
[See rule 57(1) of the West Bengal Motor Vehicles Rules, 1989]
To
The Registering Authority
.. .. .. .. .. .. .. .. .. .. .. .. ..
I hereby apply for the issue of a certificate of fitness as required by section 56 of the Motor Vehicle Act, 1988.
Registration mark of vehicle.. ... .. .. .. .. .. ..
Name of owner.. .. ... .. .. .. .. .. ..
Address of owner
.. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
.. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Place where the vehicle is ordinarily kept.
.. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
.. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Name of manufacturer of vehicle :.. .. ... .. .. .. .. .. ..
Manufacturer's model, or, if not known, wheel base : -
Type of vehicle : .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Engine number : .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Chassis number : .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Particulars of any previous certificate of fitness granted in respect of the vehicle : .. ... .. .. .. .. .. ..
Authority by which granted .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Date when certificate was lost or destroyed or ceased to be valid :
Reasons for cessation of validity.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Form CFRA
Application for Renewal of Certificate of Fitness
[See rule 57(6) of the West Bengal Motor Vehicles Rules, 1989]
To
The Registering Authority
.. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
I hereby apply for renewal of the certificate of fitness described below :
Registration mark of vehicle :.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Type of vehicle :.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Name of owner :.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Address of owner :.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Place where the vehicle is ordinarily kept (i.e. Garage address) : .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. .. ..
Number of the certificate of fitness, date of issue or last renewal and date of its expiry :.. .. .. ... .. .. .. .. .. .. .. ... .. .. .. .. ..
Authority by which the certificate of fitness was issued or last renewed... .. .. .. .. ... .. .. .. ..
Signature or thumb-impression of applicant.
Date.. .. ..20..
Form CF (I)
Temporary authorisation of use of vehicle when the Certificate of Fitness has expired
[See rule 57(7) of the West Bengal Motor Vehicles Rules, 1989]
The certificate of fitness of.. .. .. .. .. .. .. ... .. .. .. .. Registration mark .. .. .. .. .. .. ... .. .. .. .. Last renewed by .. .. .. .. .. ... .. .. .. .. on.. .. ..has expired.
I hereby authorise the use of the vehicle until the. .. .. day of.. .. 20.., provided that it is forthwith removed with all reasonable dispatch to the area of the Authority by whom the certificate of fitness is due to be renewed :
carry more than.. .. .. .. .. persons excluding the driver;
carry any goods;
be driven at a speed in excess of.. .. Kilometres per hour.
.. .. .. .. .. .. ..
.. .. .. .. .. .. ..
Dated at.. .. on the .. day of.. 20..
Form CFX
Refusal to renew a Certificate of Fitness
[See rule 57(10) of the West Bengal Motor Vehicles Rules, 1989]
Registration mark of vehicle :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Make and Model :... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Type of body :.. ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Certificate of fitness :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Number :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Issued by : .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Last renewed on : .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
By :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Date of inspection :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Name and address of owner :.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
The vehicle described above fails, in my opinion, to comply with the provisions of Chapter VII of the Motor Vehicles Act, 1988 and the Rules made thereunder, because of the following defects : -
(1)
.. .. .. .. .. .. .. ... ... .. ..
(2)
.. .. .. .. .. .. .. ... ... .. ..
(3)
.. .. .. .. .. .. .. ... ... .. ..
(4)
.. .. .. .. .. .. .. ... ... .. ..
(5)
.. .. .. .. .. .. .. ... ... .. ..
I have therefore impounded the certificate of fitness. The vehicle may be produced for re-examination at.. .. .. ..on or at.. on
On or before the.. .. ..day of.. .. ..20.. the vehicle may be driven to.. .. .. ..for repairs and thereafter to..... ... It shall not be driven at a speed In excess of kilometre per hour and.. .. .. ..passengers and.. .. goods may be carried.
Dated at.. .. .. on the.. .. ..day of.. ..20..
Form CFC
[See rule 57(10) of the West Bengal Motor Vehicles Rules, 1989]
Form for Cancellation of a Certificate of Fitness
Whereas the motor vehicle number.. .. ..does not comply with the provisions of the Chapter VII of the Motor Vehicles Act, 1988 and the rules made thereunder because of the following defects :
And whereas a Certificate of Fitness was earlier issued by......under No. .., dated.. ..
And whereas in view of the above defects. I consider the said motor vehicle to be failing to comply with the provisions of the M.V. Act, 1988. I, therefore, cancel the above Certificate of Fitness with immediate effect under provisions of section 56(4) of the Act and direct that the vehicle be produced for re-examination on.. .. ..at.. ..either before me or before the appropriate authority having jurisdiction.
The vehicle may be driven to.. ..for repairs on or before.. .. ..and thereafter to.. .. ... .. .. .. ..
The vehicle shall not be driven at a speed in excess of.. .. ..per hour and with.. .. ..passengers and.. .. .. ..goods as the case may be.
Date and time
Competent Authority.
Form CFLD
Intimation of loss or destruction of Certificate of Fitness and application for duplicate
[See rules 58 and 59 of the West Bengal Motor Vehicles Rules, 1989]
To
The Registering Authority
....................................................
The certificate of fitness of my vehicle, the registration mark of which is... ..has been lost/destroyed in the following circumstances :
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
I hereby declare that to my knowledge the registration of the vehicle has not been either suspended or cancelled under any of the provisions of the Act or Rules made thereunder and I herewith deposit the fee of Rupees twenty and apply for the issue of a duplicate certificate of fitness.
Signature or thumb-impression of applicant.
Address.. .. .. .. .. .. ..
Date.. .. ..20.. ..
Form CRTEM
Temporary certificate of registration
[See rule 60 of the West Bengal Motor Vehicles Rules, 1989]
Temporary registration mark .. .. .. .. .. .. .. .. ..
Name, name of father and address of owner. .. .. .. .. .. .. .. ..... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..
Description of vehicle