Axis Colleges, Kanpur: Details of Vehicle For Campus Parking

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Form No: G-5E

w.e.f: 15th Nov2019

AXIS COLLEGES, KANPUR


Details of Vehicle for Campus Parking

Personal Details:

Name: ………………………………………………………. Employee Code: ………………..

College & Department: ………………………………… Designation: …………………......


Photograph
Gender: Female [ ] Male [ ] Mobile No.: ………………………..

Residing in College Campus: YES [ ] NO [ ]

Details of Vehicle:

Registration No. : ……………………………………………………….


Color : ……………………………………………………….
Type of Vehicle : Car /Motor Cycle/Scooter
Make : ……………………………………………………….

Vehicle Owner: YES [ ] NO [ ] (If No, Power of Attorney by the owner for use of vehicle in the name of applicant to
be submitted with application)

Supporting Document: Copy of RC/Vehicle Insurance/FIR/Repair Invoice/POA with copy of license

Undertaking: I ………………………………… hereby take complete responsibility for use of parking sticker for the
purpose it is intended and will be solely responsible in case of misuse arising out of theft, neglect or other reasons.

Employee Name: ------------------------ Applicant Signature: -------------------


Mobile No.: ---------------------------------- Date: ------------------------------------

For Office User only (Accounts Department/ Head HR)


st nd rd
Type of Issue: (Initial/1 /2 /3 ) ………….. Parking Lot: …………………………………….

Remarks: Issue ……………………………. Colour Sticker

Signature & Date

For Use of Accounts Office


Received Rs. ………………………… From Mr/Mrs ……………….. For Issue of Campus Parking Sticker

Signature & Date

For Use by Head HR

Sticker No.: …………….. Colour: …………………. Issued on: ……………………..

Collected By: …………………. Issued By: ……………………

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