SALE CUM DECLARATION

I Sri …………………….PO,PS & Dist- Tinsukia, Assam, do hereby

solemnly affirm and declare as follows :-

1. That I declare that one Vehicle bearing Registration No- AS-

0…………-88…..3, bearing Chassis No- ME4KC……………..7854,
Engine No- KC09E-0017951, Model/ Make- ……………………..
has been purchased on ___________ in order good and roadworthy
condition with my full satisfaction complete with all accessories
thereof including tools from Sri ……….., ……………., PO & PS-
Naharkatia Dist – Dibrugarh, Assam and the Registration certificate of
the said Vehicle is not transferred in my name.

2. That I further say that the aforesaid Vehicle is sold to Sri

……………., Son of Sri ……………. Mandal, Resident of Back side
of J......................, R G Road, PO, PS & Dist- Tinsukia, Assam on
19/01/2012 for a consideration of Rs 21,500/- ( Twenty one thousand
and five hundred only ) and the Sri ……………… has agreed to
transfer the vehicle and other relevant documents in favour of Sri
……………….
….Contd..P/2
 Page No- 2

3. That I also confirm and rectify that the above numbered vehicle has
neither transferred/sold out to any one nor mortgaged.

4. That I also agree that in case of any dispute and /or litigation would
have been arisen in connection to the vehicle herein, the content of
such consequences would have been borne by me.

That the statement made in above are true to my knowledge and belief
and I sign this Sale Cum Declaration on this , the _____ th Day of
January , 2012 at Tinsukia

WITNESESS :-

1.

2. --------------------------------------
(Sri ……………………)