APPLICATION FOR ALLOTMENT OF ARMY SURPLUS CLASS V B - VEHICLES TO EX-SERVICEMEN AND WIDOWS Application No.--------------- MGO s Br Regn No.--------- DGR Regn No. 1519/---------------------------- Passport size photograph of an applicant to be affixed and to be attested by Secy RSB/ZSB/OC UNIT (DGR/ZSB Employment Registration No.. ) 1. Type of vehicle applied :...(Indicate nomenclature of vehicle) 2. To be taken from which Ordnance/ Vehicle depot.. (Indicate name of Depot) 3. Name of Applicant (Service Pers / ESM / Widow). 4. Age of Applicant.. 5. Details of Applicant / Widow s husband : Service No Rank.. Name...... Father s Name Date of death of Husband... (For widow applicant only) 6. Date of Birth.. Date of enrolment.. Date of discharge.... 7. Last Unit served... Record Office... 8. Address :.......... Pin code.. 9. Contact details : Tele No. (Landline). Mob No... E-mail ID (if any)...... 10. Total Income per annum........ 11. How the cost of the vehicle will be financed..... 12. Purpose for which required....... 13. Details of security deposit Viz : Name of Bank Bank Draft No. and Date... Amount Rs...... 14. Declaration of affidavit on non judicial stamp paper in triplicate, Note : Format of Affidavit: (a) For ESM Annexture -1A, (b) For Service personnel Annexture- 2A, (c) For Widow Annexture 3A). Place : (Signature of Applicant) Date :
RECOMMENDATION AND ENDORSEMENT OF SECRETARY RAJYA/ZILA SAINIK BAORD/OC UNIT Certified that the particulars given above have been verified and are correct, Endorsement of vehicle recommended has been/will be made in his discharge/retirement certificate. The applicant s affidavit and CTC of discharge certificate/retirement orders in triplicate are enclosed. The applicant is eligible for allotment of surplus vehicle and has necessary financial resources to buy the vehicle and the vehicle will be used by him personally. In case of those who apply for second time, the original allotment release order is also enclosed. Bank Draft for Rs vide Bank draft No. and Date issued by (Bank Name) is enclosed. Place : Zila Unit Date : Headquarters Secretary, Rajya/ Sainik Board/OC Service MINISTRY OF DEFENCE (Dte Gen Resettlement) 1. Certified that the applicant is eligible for allotment of surplus vehicle out of disposal stocks and the facts mentioned in the application are correct on the basis of certificate rendered by the Secretary, Rajya/Zila Sainik Board/OC Unit. 2. The applicant has deposited, Security of Rs 8000/-, Rs 3000/-, Rs 1000/- vide Bank Demand Draft / Manager s Cheque No Date Payable at New Delhi and drawn in favour of DGR Security Deposit Fund. Registration No. 1519/ Joint Director (SE) For Dir Gen Resettlement
AFFIDAVIT (INCASE OF ESM APPLICANT) (Annexure 1A) (TO BE TYPED ON APPROPRIATE NON-JUDICIAL STAMP PAGE OF RS. 10/-) I, No. Rank Name son of resident of do hereby solemnly affirm and declare as under:- 1 That I am a bonafide ex-serviceman and have retired from service on 2. That I am applying for allotment of a surplus vehicle for my personal use and for the betterment of my economic condition. 3. That I have neither applied nor been allotted a vehicle from the Defence surplus stock. 4. That I am not a member of any Ex-Servicemen Co-operative Society and that necessary financial resources are available with me to purchase the vehicle on allotment. 5. That I am neither re-employed in Armed Forces/BSF/NCC, nor serving in a civilian capacity under any State/Central Govt. or Public Sector Undertaking. I further depose that I have not availed of any such scheme by any other State/Central Govt/Public Sector Undertaking. 6. That the vehicle will be registered in my name within six months of allotment and that vehicle will NOT be mortgaged/resold within one year from the date of its purchase. In case it is decided to resell the vehicle after one year, it will not be sold without verifying the antecedents of the person to whom it is sold. In case the vehicle is sold without due diligence/verification of the buyer, I shall be held personally responsible for any consequences which may happen, like misuse of the vehicle for antinational activities by terrorists or by anti social elements. 7. In the event of non-registration of the allotted vehicle with the local/concerned RTO within six months from the date of issue, the amount of security deposit, deposited by me will be forfeited to the Government of India. 8. That I will immediately get the vehicle re-painted with other than Defence services colour and remove all military markings/tactical numbers before registration. 9. That in the event of any of above facts given in this affidavit being proved false, and for violation of any of these provisions I hold myself responsible for all the consequences, besides being debarred for allotment of a vehicle out of Army Surplus Quota. (ASQ). I also understand that I may also be liable for action under Regulations 4 and 5 of the Pension Regulations for the Army, 1961 (Part I) relating to withholding, suspension or discontinuation of the pension. VERIFICATION Verified at this day of year 20 that the above affidavit given by me is true to the best of my knowledge and belief, and nothing has been concealed therein. Three Specimen signatures 1. 2. 3. Certified that the above was declared on Oath before me, by the and who is personally known to me/identified by Sh/Smt s/d of, resident of OATH COMMISIONER/FIRST CLASS MAGISTRATE (FULL NAME & ADDRESS WITH SEAL) COURT SEAL
AFFIDAVIT (INCASE OF SERVICE PERSONNEL APPLICANT) Annexure 2A (TO BE TYPED ON APPROPRIATE NON-JUDICIAL STAMP PAGE OF RS. 10/-) I, No. Rank Name son of do hereby solemnly affirm and declare as under:- 1. No. Rank Name presently posted at and will retire from service on (attach copy of Discharge / Retirement Order) 2. That I am applying for allotment of a surplus vehicle for my personal use and for the betterment of my economic condition. 3. That I have neither applied nor been allotted a vehicle from the Defence surplus stock. 4. That I am neither re-employed in Armed Forces/BSF/NCC, nor serving in a civilian capacity under any State/Central Govt. or Public Sector Undertaking. I further depose that I have not availed of any such scheme by any other State/Central Govt/Public Sector Undertaking. 5. That the vehicle will be registered in my name within six months of allotment and that vehicle will NOT be mortgaged/resold within one year from the date of its purchase. In case it is decided to resell the vehicle after one year, it will not be sold without verifying the antecedents of the person to whom it is sold. In case the vehicle is sold without due diligence/verification of the buyer, I shall be held personally responsible for any consequences which may happen, like misuse of the vehicle for antinational activities by terrorists or by anti social elements. 6. In the event of non-registration of the allotted vehicle with the local/concerned RTO within six months from the date of issue, the amount of security deposit, deposited by me will be forfeited to the Government of India. 7. That I will immediately get the vehicle re-painted with other than Defence services colour and remove all military markings/tactical numbers before registration. 8. That in the event of any of above facts given in this affidavit being proved false, and for violation of any of these provisions I hold myself responsible for all the consequences, besides being debarred for allotment of a vehicle out of Army Surplus Quota. (ASQ). I also understand that I may also be liable for action under Regulations 4 and 5 of the Pension Regulations for the Army, 1961 (Part I) relating to withholding, suspension or discontinuation of the pension. VERIFICATION Verified at this day of year 20 that the above affidavit given by me is true to the best of my knowledge and belief, and nothing has been concealed therein. Three Specimen signatures 1. 2. 3. Certified that the above was declared on Oath before me, by the and who is personally known to me/identified by Sh/Smt s/d of, resident of OATH COMMISIONER/FIRST CLASS MAGISTRATE (FULL NAME & ADDRESS WITH SEAL) COURT SEAL
AFFIDAVIT (INCASE OF WIDOW APPLICANT) Annexture 3A (TO BE TYPED ON APPROPRIATE NON-JUDICIAL STAMP PAGE OF RS. 10/-) I,, Widow of Late, Age Years resident of do hereby solemnly affirm and declare as under:- 1. That I am widow of Late, who died on. 2. That I am not remarried after the death of my husband 3. That I am applying for allotment of a surplus vehicle for my personal use and for the betterment of my economic condition. 4. That I have neither applied nor been allotted a vehicle from the Defence surplus stock 5. That I am not a member of any Ex-Servicemen Co-operative Society and that necessary financial resources are available with me to purchase the vehicle on allotment. 6. That I am not employed nor serving in a civilian capacity under any State/Central Govt. or Public Sector Undertaking. I further depose that I have not availed of any such scheme by any other State/Central Govt/Public Sector Undertaking. 7. That the vehicle will be registered in my name within six months of allotment and that vehicle will NOT be mortgaged/resold within one year from the date of its purchase. In case it is decided to resell the vehicle after one year, it will not be sold without verifying the antecedents of the person to whom it is sold. In case the vehicle is sold without due diligence/verification of the buyer, I shall be held personally responsible for any consequences which may happen, like misuse of the vehicle for antinational activities by terrorists or by anti social elements. 8. In the event of non-registration of the allotted vehicle with the local/concerned RTO within six months from the date of issue, the amount of security deposit, deposited by me will be forfeited to the Government of India. 9. That I will immediately get the vehicle re-painted with other than Defence services colour and remove all military markings/tactical numbers before registration. 10. That in the event of any of above facts given in this affidavit being proved false, and for violation of any of these provisions I hold myself responsible for all the consequences, besides being debarred for allotment of a vehicle out of Army Surplus Quota. (ASQ). I also understand that I may also be liable for action under Regulations 4 and 5 of the Pension Regulations for the Army, 1961 (Part I) relating to withholding, suspension or discontinuation of the pension. VERIFICATION Verified at this day of year 20 that the above affidavit given by me is true to the best of my knowledge and belief, and nothing has been concealed therein. Three Specimen signatures 1. 2. 3. Certified that the above was declared on Oath before me, by the and who is personally known to me/identified by Sh/Smt s/d of, resident of OATH COMMISIONER/FIRST CLASS MAGISTRATE (FULL NAME & ADDRESS WITH SEAL) COURT SEAL