Authorization Letter - Certificate of administrative status

*: Required information - make sure to enter a value in each field marked with an asterisk (*)

Date

Vehicle's make *

Vehicle's registration mark *

Who's authorizing whom? *

I: Individual(s)
C: Company
D: Company Director
R: Company Representative
1: Vendor
2: Purchaser

Who's authorizing whom? *

Authorizer(s) *

#1

Title *

Name *

Nationality *

NID / Passport number *

Authorized *

Title *

Name *

Nationality *

NID / Passport number *

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Date: 12/12/2025

To

The Officer-in-Charge

National Land Transport Authority

Road Transport Division

Port-Louis

Dear Sir/Madam,

I, Mr. , I.D No. , owner of vehicle bearing No. Make hereby authorize Mr. , I.D No. , to proceed with all relative documents concerning the said vehicle such as certificate of "gage sans déplacement".

Thanking you in anticipation.