GOVERNMENT OF KERALA

MOTOR VEHICLES DEPARTMENT Table ID: 2

Form TR5(c) (See Rule 90(a) of KTC) Transaction No: U/68205/2017
Date : 29/11/2017
Office : SRTO, TRIPUNITHURA Payment Date : 29/11/2017
Name of Remitter : REMYAJITH.K.R. GRN : KL008343206201718E
Address : KONDHARAYIL HOUSE,
: MOSQUE ROAD
: MARADU ERNAKULAM
License No : 39/3320/2005
Purpose : Issue of duplicate DL - form 7
Fee : 500
Service Charge : 50.00
Total Amount : 550.00
Amount in words : Five Hundred and Fifty Rupees Only
Bank Reference No: IK00JPATY8 Bank : SBI
* This is a computer generated document and does not require any signature

* Any modification or misuse of this receipt is an offence which shall attract legal action and punishment

(Office Copy. Please attach with the application)

......................................................................................................................................................................................................

GOVERNMENT OF KERALA
MOTOR VEHICLES DEPARTMENT
Form TR5(c) (See Rule 90(a) of KTC) Table ID: 2
Transaction No: U/68205/2017
Date :29/11/2017
Payment Date : 29/11/2017
Office : SRTO, TRIPUNITHURA
GRN : KL008343206201718E
Name of Remitter : REMYAJITH.K.R.
Address : KONDHARAYIL HOUSE,
: MOSQUE ROAD
: MARADU ERNAKULAM
License No : 39/3320/2005
Purpose : Issue of duplicate DL - form 7
Fee : 500
Service Charge : 50.00
Total Amount : 550.00
Amount in words : Five Hundred and Fifty Rupees Only
Bank Reference No: IK00JPATY8 Bank : SBI
* You are instructed to submit the Online application with required documents at the counter of RT office/Sub RT Office within 3 days, belated applications shall not be entertained.

* Department is not responsible for the delay in service due to short remittance of fee,tax,service charge,cess,inaccurancy in application and documents submitted.

* This is a computer generated document and does not require any signature

* Any modification or misuse of this receipt is an offence which shall attract legal action and punishment

(Acknowledgement and applicant’s copy) IT Services NIC Kerala

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