FORM 27A

CERTIFICATE OF OWNERSHIP

See Rule 35 (13)

1. Full name and address of the person who owns the goods.

(If he is a registered dealer, the registration certificate No,and

the name of the officer in which he is registered should also be

given)

2. Details of the goods transported

(a) No.of packages/cases/bundles/bags etc.

(b) weight

(c) Value of goods estimated

3. Extent of a agricultural holdings of the person mentioned in

Item I

4. The name of the place to which the goods are transported

5. The name and the number of the vehicle or vessel through

which the goods are transported

6. The place from which the goods are transported

7. The purpose for which goods are transported (i.e. Whether

for sales or manufacture etc., given details)

8. If for the name and address of the person to whom he (the

owners of the goods) usually sell goods (if the purchaser is a

registered dealer, the registration certificate number and the

office in which he is registered should also be given)

DECLARATION

I/We ........................................................declare that to the best of my/ our knowledge that the information furnished above is true and correct.