Loss of Vehicle Registration Certificate (RC Book) Police Report Undertaking

Before the Ld. Concerned Authority / Notary Public At Ghatal, Dist.- Paschim Medinipur, West Bengal AFFIDAVIT (On Non-Judicial Stamp Paper of ₹50 Non-Judicial Stamp Paper) In the matter of: Loss of Vehicle Registration Certificate (RC Book) Police Report Undertaking I, [Deponent Name], [S/O / D/O / W/O] [Father / Husband Name], aged about [Age] years, by faith [Religion], by occupation [Occupation], residing at Vill.- [Village / Ward No.], P.O.- [Post Office], P.S.- [Police Station], Sub-Division- Ghatal, Dist.- Paschim Medinipur, Pin- [Pin Code], West Bengal, do hereby solemnly declare, affirm and state on oath as under:- 1. That I am the registered owner of motor vehicle bearing Registration No. [Vehicle Reg No]. 2. That the original smart card Registration Certificate (RC) was lost / misplaced during transit on [Date]. 3. That a formal Police GDE was lodged at the local police station, being GDE No. [GDE No] dated [GDE Date]. 4. That the original RC has not been seized by police or mortgaged with any financier; I apply to the Concerned Authority for a duplicate RC. Verification:- I, the above-named deponent, do hereby verify and declare that the statements made in paragraphs 1 to 4 above are true and correct to the best of my personal knowledge, belief and derived from authentic records. No material facts have been suppressed, concealed or misstated herein. If any statement is subsequently found to be false or incorrect, I shall be liable to face statutory legal prosecution under the Indian Penal Code / Bharatiya Nyaya Sanhita and relevant provisions of Central Motor Vehicles Rules 1989 & Notaries Act 1952. Solemnly affirmed and signed on this [Date] day of [Month], [Year] at Ghatal. ___________________________ Deponent Signature / LTI Identified by me and signed in my presence: ___________________________ Advocate, Ghatal Dewani Court Dist.- Paschim Medinipur, West Bengal