COVID-19 Deceleration for Private Vehicles in Kerala- Format

DECLARATION

I, .........................................................................................................................................   (Name)   Address:  ...........................................................................................................................................

....................................................................................................................................................................................................................................................................................................................... have been  travelling in vehicle number...........................................................................................

(Scooter/ Motor Cycle/Car/ SUV)...............................................................................) I am going alone/ along with/ Sri/ Smt./ Ms .......................................................................................................

...........................................................................................................................................................

............................................................................................................................................................

to ............................................................................................................................................(place)

for the purpose of .............................................................................................................................

.....................................................................................................which is unavoidable.

I will return back on .....................................................................................(Date)

Signature:

Name:

Mobile Number:

Date:

Place:

Time: