Form of declaration to be issued by the transferee

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....ed under section 13(4)(e) Serial No. ............................ Name of the issuing State ....................................... Office of issue ......................................................... Date of issue ........................................................... Name and address of the person to whom issued alongwith his Registration Certificate No. ................. Date fr....

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....ry Station or Air Port or Post Office or Road Transport Company's office from where the goods were despatched .................................................…......... No. and date of Railway Receipt or Postal Receipt or Goods Receipt with trip sheet of lorry or any other documents indicating the means of transport .................................................….......... Date....