Table ID: 4
Government Of Kerala
Motor Vehicles Department KL2022V32016488
Transaction
Form TR5(c) (See Rule 90(a) of Pay Date: 10-08-2022
Office Name SRTO,MATTANCHERRY
Applicant Name JIYA JOSEPH
Application No 3204893822
Transaction Name Class of Vehicles Fee Amount Addn Fee Total
DL EXTRACT 50.00 0.00 50.00
SER/USR CHARGE 30.00 0.00 30.00
TOTAL Amount : 80.00
TOTAL Amount (In Words) Eighty Rupees only
Bank Reference No T22222104125JQ937
Bank / Gateway FPG
* 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
(Office Copy. Please attach with the application)
.....................................................................................................................................................................................
Government Of Kerala Table ID: 4
Motor Vehicles Department 10-08-2022
Transaction KL2022V32016488
Form TR5(c) (See Rule 90(a) of Pay Date:
Office Name SRTO,MATTANCHERRY
Applicant Name JIYA JOSEPH
Application No 3204893822
Class of Vehicles Fee Amount
Transaction Name Addn Fee Total
DL EXTRACT 50.00 0.00 50.00
SER/USR CHARGE 30.00 0.00 30.00
TOTAL Amount : 80.00
TOTAL Amount (In Words) Eighty Rupees only
Bank Reference No T22222104125JQ937
Bank / Gateway FPG
* 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
(Acknowledgement and applicant’s copy)
IT-Services NIC Hyderabad
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