Moveable, Immovable and Valuable Property The Schedule {Rule-18(11)} Return of assets and liabilities on the First appointment on 31 st Dec.

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1 Moveable, Immovable and Valuable Property The Schedule {Rule-18(11)} Return of assets and liabilities on the First appointment on 31 st Dec Name of the Govt. Servant in full(in block letters VIJAY KUMAR 2 Service to which he belongs Himachal Pradesh Fisheries Department 3 Total length of service up to date ( 1) In non Gazetted rank EIGHT YEARS ( 11) in Gazetted rank - 4 Present Post held and place of posting SUB INSPECTOR FISHERIES, HOLI 5 Total annual income from all sources during The calendar year immediately preceding the 1 st Rs /- January 2011 to 31 st Dec Declaration:- I hereby declare that the return enclosed namely, Forms I to V are completed true and correct as on to the best of my knowledge and belief in respect of information due to be furnished by me under the provisions of sub Rule 18 of the central services (conduct rule 1964)

2 FORM-1 STATEMENT OF IMMOVABLE PROPERTY ON 1 ST APPOINTMENT/ AS ON 31 ST DEC (Lands, houses, shops, other buildings etc.) Description of Precise location name of Distt., Div., town and village in which the is situated and also its distinctive etc. 1 HOUSE VILL. SANCHUIN H.P. 2 LAND VILL. SANCHUIN H.P 3 ORCHARD VILL. SANCHUIN H.P 5 SHEEPS AND GOATS FOCK 290 NO. VILL. SANCHUIN H.P Area of land in case of land 0.3 BISWA Nature of land(in case of landed BIGHA AGRICULTURE 5 BIGHA HORLTICULTURE Extent of interest

3 Form -I (ii) If not in own name state in whose name it is held and his/her relationship if any to Govt. servant JOINT ENCESTOR PEROPERTIES Date of acquisition NOT KNOWN How acquired(whether by purchase, mortagage, lease, inheritance, gift or person/persons from whom acquired address and connection of the govt. servant if any with the person (concerned ) SELF 2010 GIFTED BY FATHER Value of Particular of sanction of prescribed authority, if any BY TEHSILDAAR Total annual income from the

4 STATEMENT OF LIQUID ASSETS ON FIRST APPOINTMENT AS ON 31/12/2011 CASH AND BANK BALANCE EXCCEEDING THREE MONTHS EMOLUMENTS DEPOSITS, LOAN ADVANCED AND INVESTMENTS i.e. shares, securities, debentures etc. FORM-II Description Name and address of company, banks etc. amount If not on own name and address of person in whose name held and his/her relationship with the govt. servant Annual income derived SAVING PNB BANK 87385/- SELF HOLI 2 R.D. PO 2000/- P.M. SELF

5 STATEMENT OF movable ON FIRST APPOINTMENT AS ON 31/12/2011 Description of items Price or value at the time of acquisition and/or the total payments made up to the date of return as the case may be in case of articles purchased on hire, purchase or on installments basis If not on own name and address of person in whose name held and his/her relationship with the govt. servant Annual income derived GOLD 170GM. NOT KNOWN remarks FORM-III WIFE - GIFTED AT THE TIME OF MARRIAGE AND OTHER CERMONEY 2 SILVER 180 GM. NOT DO KNOWN 3 REFERIZERATOR - WIFE FROM SAVING 4 CTV 2 NO. WIFE DO 5 WASHING MACHINE 6 SEWING MACHINE AND OTHER HOUSE HOLD GOODS WIFE OWN NAME DO FROM SAVING

6 STATEMENT OF provident fund and life insurance policy ON FIRST APPOINTMENT AS ON 31/12/2011 FORM-IV Insurance policies Provident Fund Policy and date of policy / Name of insurance company Sum insured date of maturity LIC 1.00 LAKH Amount of annual premium 7000/ PER YEAR Type of funds/g.p.f./c.p.f. CPS NO. Closing balance as last reported by A.G. along with date of such balance Contribution made subsequently if there is dispute regarding closing balance the figure according to the govt. servant should also _ once in the column

7 Statement of Debts & other liabilities on First Appointment as on 31/12/2010 FORM-V No. Amount Name & Address of creditor Date of incurring liability Detail of transaction SUB INSPECTOR FISHERIES

FORM - I STATEMENT OF IMMOVABLE PROPERTY HELD BY BOARD EMPLOYEES AS ON. (e.g Lands, House, Shops, Other Buildings etc) Date of acquisi tion

FORM - I STATEMENT OF IMMOVABLE PROPERTY HELD BY BOARD EMPLOYEES AS ON (e.g Lands, House, Shops, Other Buildings etc) Sl. Description N Property o Precise location (Name District, Division, Taluk, Village