Page 549 - The Central Motor Vehicles Rules, 1989

FORM 22E THE CENTRAL MOTOR VEHICLES RULES, 1989 521

Sr. No. Item Details
(1) (2) (3)

1. Motor Vehicle Details
1.1 Motor Vehicle Make & Model
1.2 Registration Number
1.3 Chassis number (Optional)
1.4 Engine number/Motor number (in case of battery operated
vehicles) (Optional)
2. Adaptation Details
2.1 Nature of Adaptation (Body Structure/ Fuel Source/ Chassis
replacement / Engine replacement)

2.2 Brief Details
3 Details of the user (person with disability) for vehicle being
adapted, if any.
3.1 Name of the prospective user of the adapted vehicle
3.2 Address of the prospective user of the adapted vehicle

3.3 Mobile Number of the prospective user of the adapted vehicle
3.4 Details of disabilities of the prospective user
4 Compliance of Adaptation with the Applicable Rules.
4.1 Compliance Details of Adaptation
(a) Details (Name, Telephone Number and address) of the
Company who has carried out Adaptation
(b) Compliance details in the formats (Form No. 22G)
provided under rule 112A of CMVR 1989 as applicable.
(Applicable in case carried out by the OE manufacturer or his dealer
or Authorized Workshop as allowed under Rue 112A of the
CMVR 1989)
This is to certify that the adaptation mentioned above is correct.
Place: ............................ (Signature of the Owner)
Date: ............................ Name: .........................................................
Mobile Number : .....................................
PART II
(To be filled by Registering Authority)
The Motor Vehicle duly adapted has been verified and cleared for endorsement
entry in to Registration Certificate subject to the condition that the user (person with
disability) shall use this vehicle after obtaining the driving license for such vehicle.
Place: ............................... (Signature of the authorised person)
Date:- ............................... Name: ....................................................