PART- A. return: s1. Name PAN the financial total income No year for which shown in the last income income tax tax return has return( in

Size: px

Start display at page:

Download "PART- A. return: s1. Name PAN the financial total income No year for which shown in the last income income tax tax return has return( in"

Jeffery Bell
5 years ago
Views:

$AFFDA VT A S 8 4 1 02 8 Affidavit is filled by the candidate alongwith nomination paper before the Returning officr for election to J&K Legislative Assembly from cl \$ $>ba \\V\A ged 3& resident of Y>oJ[ 1\1'lhQ'h a candi(l; e at the above election do hereby sjolelhnly affirm and sate on oath as under:- () am candidate set up by$ $le number is''\\':$d2$bl:'' i:l my e mail N) L ; and my social media account are \ L ' Art (4) Details of permanent Account Number (PAN) and status of filing of$ $\6-t f S " OS;-?$ offence(s) punishable with imprisonment for two years or more in a pending case(s)in which a charge(s) has/have been framed by the court(s) of competent jurisdiction

offence(s) punishable with imprisonment for two years or more in a pending case(s)in which a charge(s) has/have been framed by the court(s) of competent jurisdiction

1 AFFDA VT A S Affidavit is filled by the candidate alongwith nomination paper before the Returning officr for election to J&K Legislative Assembly from cl \ _ <embly constituency PART- A m W 8k-Jo\1S ftbm1 s\-\\ S/o!>ba \\V\A ged 3& resident of Y>oJ[ 1\1'lhQ'h a candi(l; e at the above election do hereby sjolelhnly affirm and sate on oath as under:- () am candidate set up by 2"'d(' (2) Myname is enroled in \"'M= constituency of J&K State at Serial No::lJp m part No \ "\ 01\-0<6 (3) My contact tlepho!le number is''\\':$d2$bl:'' i:l my e mail N) L ; and my social media account are \ L ' Art (4) Details of permanent Account Number (PAN) and status of filing of income tax a h return: s1 Name PAN the financial total income No year for which shown in the last income income tax tax return has return( in 1 Self been filed rupees \6-t f S " OS;-?>3 \:) N\L NLL 2 Spouse '\1 i L At'J L 1\1 LJ J Dependent -1 \ L At' t N 1 J 4 Dependent - 2 l\tl 1\11' J Atll 5 Dependent - 3 V" L N/\L N'L (5) am not accused of any offence(s) punishable with imprisonment for two years or more in a pending case(s)in which a charge(s) has/have been framed by the court(s) of competent jurisdiction f the deponent is accused of any such offence(s) he shall furnish the following information:- ' (i) The following case(s) is/are pending gainst m in whih charges have bm _-:1 '/-'Cl twt: ::: ';' :a:eby the court for an offence punshable wth 11llpnsonment for jy \' Cas/first information eport olns ogether with complete \ \ :';P( 'i detals of concerned pollee staton/dstrict/state N L _ Sectionr s) Of the concerned Act(s) and short description of the 1\1 " i- "<2i::;t1;

$i offence(s) for which charged AS 4J-i/ c Name of the court case No' and date of order taking cognizance d Court(s) which framed the charge(s) " f' L 1\;1 L- e Date(s) on which the charge(s) was/were$ taken by the court other than the cases mentioned in (i) above (a) Name of the court case No and date of order taking cognizance N'L (b) The details of case where the court has taken cognizance

taken by the court other than the cases mentioned in (i) above (a) Name of the court case No and date of order taking cognizance N'L (b) The details of case where the court has taken cognizance

(6) have been / have not been convicted of an offence(s) ( other than any offence(s) referred to in sub section (1) or sub-section (2) or covered in sub-section (3) of section 24 of the Jammu and

2 i offence(s) for which charged AS 4J-i/ c Name of the court case No' and date of order taking cognizance d Court(s) which framed the charge(s) " f' L 1\;1 L- e Date(s) on which the charge(s) was/were framed N'L f Whether all or any of the proceeding(s) have been stayed by any court(s) of competent jurisdiction NiL (ii) The following case(s) is/are pending against me in which cognizance has been taken by the court other than the cases mentioned in (i) above (a) Name of the court case No and date of order taking cognizance N'L (b) The details of case where the court has taken cognizance section(s) of the Act(s) and description of the offence(s) for which cognizance taken yi L (c) Details of appeal(s) strike application(s) for revision ( if any) filed against the above order( s) NjL; (6) have been / have not been convicted of an offence(s) ( other than any offence(s) referred to in sub section (1) or sub-section (2) or covered in sub-section (3) of section 24 of the Jammu and Kashmir Representation of the People Act 1957 ( V of 1957) and sentenced to imprisonment for one year or more f the deponent is convicted and punished as aforesaid he shall furnish the following information: - n the following cases have been convicted and sentenced to imprisonment by court of-law (a) The details of cases section(s) of the concerned Act(s) and description of the offence(s) for which Nl'L convicted (b) Name of court(s) case No and date(s) of order(s) Nt L (c) Punishment imposed /\/' L (d) Whether any appeal was/has been filed against the conviction order f so details and the present status V" / of the appeal -! (7) That give here in below the details Of't';{e and imrno'veable ete) myself my spouse and all dependents - '-( ->':-'' "l': : '- ' ; A Details of moveable assets of

Note: 1 Note 2 Note' 3 Note: 4 AS 841026 Assets injoint name indicating the extent of joint ownership will also have to given n case of deposit/investment the details including serial Number Amount

per books in case of non-listed companies should be given Dependent here has the same meaning as assigned in Explanation (v) under Section 75 A of the Representation of the people Act 1951 Note 5

$account (FDRs term deposits and all other types of deposits including saving account) A- )o\o 4s-\-o deposits with Financial \ cro-o'jk Financial Companies and \ebg9 7 cooperative societies and the$

3 Note: 1 Note 2 Note' 3 Note: 4 AS Assets injoint name indicating the extent of joint ownership will also have to given n case of deposit/investment the details including serial Number Amount date of Deposit the scheme Name of the Bank/nstitution and branch are to be given Value of Bonds/share Debentures as per current market value in stock Exchange in respect of listed companies and as per books in case of non-listed companies should be given Dependent here has the same meaning as assigned in Explanation (v) under Section 75 A of the Representation of the people Act 1951 Note 5 Details includinzto amount is to be given separately in respect of each investment S Description Self Spouse Dependent Dependent Dependent 3 No / 2 i fii Cash in Hand Details of deposit in Bank 4l account (FDRs term deposits and all other types of deposits including saving account) A- )o\o 4s-\-o deposits with Financial \ cro-o'jk Financial Companies and \ebg9 7 cooperative societies and the amount in each such deposit Details of investment in bonds debentures/shares and units in yoererd o) /V''L ) N'L NiL institutions Non-Banking NJ 1- N'L companies/mutual funds and Nt'L N' L N'L others and the amount V Details Of investment in NSS Postal Saving nsurance Policies and investment in any financial instrument in Post office o isurance company and the amount v Personal loans/advance given to any person or entity vi Nr'L NiL 11/ /' L--- Nt'L NrL including firm company trust A r' L 't L NL N L etc and other receivables from debtors and the amount Motor Vehicles/ AircraftslY achts/ships ( details of make Registration j/l- f'lt'l!v'l V) L N'L number etc yer of purchase -'\TE and amount oil CO' - _ ' L Vii Jewellery bullion and valukl f\:'-4 \ 1 i' 'v r> \l\") " thing(s) give( details of we it li ' t V ':;-\ 0- \'o N'fl- NL fit

apartment should be mention separately in this format '------------------------------------------------ S Description Self Spouse Dependent 1 Dependent 2 Dependem No 3 i Agriculture land ' /

4 and value AS 4 i LJL Viii Any other assets such as value ) 1 of claims/interest H-- vl i N/ L NL NL /Arr 1 J x Gross Total value lf ( tn::rd :L 1f?S815D JV1') );} ' Details of mmoveable assets -' Note ':t Properties in j oint ownership indicating the extent of j oint ownership will also have to be indicated Note 2 Each land or building or apartment should be mention separately in this format ' S Description Self Spouse Dependent 1 Dependent 2 Dependem No 3 i Agriculture land ' / Locations) N 1 L N / L v t' L S_u_r_veyN u_m_b_er Area (total measurement in Kanals) t Whether inherited property( yes or No) Date of purchase in case of self acquired property Any investment on the land by way of development construction etc Approximate current market value 11 Non-agricultural land location(s) Survey number(s) Area (total measurement in SqFt) Ni L v/l _r _ N;'L! ly'l Nt L Nr'L N;' L N! L N( L N" L NiL lvi L NiL /y/ L 1'// L Nil

! Weather inherited property ( Yes or No) Date of purchase in case of self acquired property Cost of land ( in case of

market value 111 Commercial Buildings( including apartments) Location (s) Survey Number(s) Area (total measurement in sq

$L Ni L JV" L NfL N'L v/l NiL H L N(l v/'l Nt l NiL NJ L A('L NL Any investment NL /V/ l '>;; x\ - ' \ ' V /' --- ''\"; '$

5 ! Weather inherited property ( Yes or No) Date of purchase in case of self acquired property Cost of land ( in case of purchase) at the time of purchase Any investment on the land by way of development construction etc Approximate current market value 111 Commercial Buildings( including apartments) Location (s) Survey Number(s) Area (total measurement in sq Ft) Guilt up area ( total measurement in sq Ft) Whether inherited property( yes or No) Date of purchase in case of self acquired nropertv Cost of property( in case of purchase) at the time of purchase Nt L NL NL- / A s tsltrtrza NL Nt L Ni L Ni L JV" L NfL N'L v/l NiL H L N(l v/'l Nt l NiL NJ L A('L NL Any investment NL /V/ l '>;; x\ - ' \ ' V /' --- ''\"; ' ;;/

$otg- \c)! N'L \l t L- apartment(s) ULL NL Location(s)Survey \ Number(s) 4 Area (total t -!f)rj measurement in N{l 1'?b h z sq ft) )\\W Built up area ( r)o!$ $' Nt L Nt\- NL total NL ST measurement in Nt i N L N L sq Ft "- Whether inherited property ( yes or Nl L N-o ' no) Date of f'l A n o '0' purchase in case NL NtL )"m of self acquired lv! L e?$

6 way of ; on the property by A tl41ul 15 1 development N'L NfL construction etc t Approximate t current market /'J/fL Nt'L Nt L value V Residential t5w2- ""01r- NiL N; L- NL " buildings( / t including otg- \c)! N'L \l t L- apartment(s) ULL NL Location(s)Survey \ Number(s) 4 Area (total t -!f)rj measurement in N{l 1'?b h z sq ft) )\\W Built up area ( r)o! ' Nt L Nt\- NL total NL ST measurement in Nt i N L N L sq Ft "- Whether inherited property ( yes or Nl L N-o ' no) Date of f'l A n o '0' purchase in case NL NtL )"m of self acquired lv! L e?-o\ v Ni L y;:-sz: ' /V1' 1- N L N( L property Cost ofpr )-k( property ( in --- : case of )V/ L fyll purchase) at the NL time of purchase Any investment! on the land by fv7l NL Nlk way of NfL NfL NL development construction etc Approximate o'l-w AWh7\ current market N! 'i'" = NL- NL ' tf 0- \- value V Others( such as \ :t-t interest in 'NfL / ' 1 l-v;' NltJ:' / '' f\;l N;L

property) A Vi Total of current market value of N-l L (i) to v) above fi - (8) give herein below the details of liabilities/dues to public

before each item t Sl No (i) ( ii Description Self Spouse Dependent Dependent 2 Dependen i Loan or dues to o 000 err- N' f'r

$)uox' institution s ameo M 4 :l-73'" s f4 the Bank or Financial t;'- -rdc Y'1 D1-t-n-ri>; nstitutions amount V' 6Y\ _ C- outstanding$ nature of loan Any other liability N' L-- A' L N-i'L Grandtotal ofliabilities '>L11rn;""' /Y1'11-- Government dues dues to departments

nature of loan Any other liability N' L-- A' L N-i'L Grandtotal ofliabilities '>L11rn;""' /Y1'11-- Government dues dues to departments

7 property) A Vi Total of current market value of N-l L (i) to v) above fi - (8) give herein below the details of liabilities/dues to public financial institutions and Government Note: Please give separate details of name of Bank institution entity or individual and amount before each item t Sl No (i) ( ii Description Self Spouse Dependent Dependent 2 Dependen i Loan or dues to o 000 err- N' f'r bank/financial ee((0:vj-k t () N f k c1!)uox' institution s ameo M 4 :l-73'" s f4 the Bank or Financial t;'- -rdc Y'1 D1-t-n-ri>; nstitutions amount V' 6Y\ _ C- outstanding Nature of Loan _{r;-:::;; ; JJ &-rh Loan or dues to any other individuals/entity other than mentioned above name(s) amount outstanding nature of loan Any other liability N' L-- A' L N-i'L Grandtotal ofliabilities '>L11rn;""' /Y1'11-- Government dues dues to departments dealing with govt Accommodation Dues to department dealing with supply of water Dues to department dealing with electricity Dues to department dealing with supply to telephones/mobiles Dues to department dealing with Nt L- NL N'l-- /V L NL- NfL NL /v;l Nl V7 NfL Nt NJ t

$- 1\ Governmerif transport A tl41u (including aircraft and N't'L NL N;L$ $dues 'N/ /v/'l- 1\11 L Service Tax dues A/L /\1;' L N;'L NiL-$ $\t l Nt'L A// L A/ L N' i Grand Total of all Nz'L Government dues Nt L$ - N; L- - if so mention the Nr'L NiL N;L Weather any other / V

- N; L- - if so mention the Nr'L NiL N;L Weather any other / V

before which it is pending (9) Details of profession or occupation; (a)

8 - 1\ Governmerif transport A tl41u (including aircraft and N't'L NL N;L NL helicopters) ncome tax dues /\/' 'l N;'L rv i l'\f " J Wealth tax dues 'N/ /v/'l- 1\11 L Service Tax dues A/L /\1;' L N;'L NiL- Municipal/property tax dues NL Nt 2- NL tv/l Sales Tax dues Nt'L NL /V'L t Any other dues!\t l Nt'L A// L A/ L N' i Grand Total of all Nz'L Government dues Nt L - N; L- - if so mention the Nr'L NiL N;L Weather any other / V liability are in dispute N L Nt'L amount involved and N L the authority before which it is pending (9) Details of profession or occupation; (a) Self:- h1r!j loje-e:t (b) Spouse :- NA- (10) My Educational qualification is as under: t BCoyy]>/ST {J(A$S km()'1 cr---rart B J (11)

/ (ii)total number of pending cases where the A 4 lulu court(s) have taken cognizance ( other than the cases mentioned in item (i) above) Nt'L 6 Total number of cases in which convicted and sentenced

$tT(j) rs 3S-3j rcit: /Y'fL (b) Spouse N/) N7\L /V'/L ( C ) Dependents Nt'L Nt'L Description Self Spouse Dependent Dependent Dependent 1 2 3 A Moveable Assets( total \ \ 385"C?$ $od \ttl P\j\L L value) " B mmoveable Asset - 3voo-o of \ f'fll NtL M'L "'L 1 Purchase price of self cquired immoveable 3'- C-5 t{';/ f'[cl Nt L property 2 Development/construction cost of immoveable$

9 / (ii)total number of pending cases where the A 4 lulu court(s) have taken cognizance ( other than the cases mentioned in item (i) above) Nt'L 6 Total number of cases in which convicted and sentenced to imprisonment for one year or more( except for offences referred to in sub section (1) N;L (2) or (3) of section 8 of Representation of the people act Pan of Year for Total income / which last shown income Tax return filed (a) Candidate!tT(j) rs 3S-3j rcit: /Y'fL (b) Spouse N/) N7\L /V'/L ( C ) Dependents Nt'L Nt'L Description Self Spouse Dependent Dependent Dependent A Moveable Assets( total \ \ 385"C?od \ttl P\j\L L value) " B mmoveable Asset - 3voo-o of \ f'fll NtL M'L "'L 1 Purchase price of self cquired immoveable 3'- C-5 t{';/ f'[cl Nt L property 2 Development/construction cost of immoveable property after purchase ( if applicable 3 Approximate current iy/l N(L NiL NfL N'L- 3 \ Market price of V/- Nt L a lf acquired assets ( 31loC3 total value) b nherited assets( total value) NfL Nt' fv'l NfL NiL 9 Liabilities )1( [0/'" S W(L< vrl- 1Yt'i- v/l Government dues(total) Loans from bank Financial institution and other ( total) Nt'/;- ANtL Nrr Nt'L NiL'?' t \ )4107/ g- Ne'L( '()/M : - \L i' r ':) ; : '' '"[r" "- -r ; """"'1 "7- ;y! :i NL

10 Liabilities that are under A 14'1 U '1 dispute tv/l Nt'L f'rtl NfL-

$Financial nstitutions and Str/o73 other ( total) \ \ NL Nr'L Nt L NL$ above named do hereby verify and declare that the contents of this

and no part of it is false and nothing material has been concealed

pending case against me other than those mentioned in item 5 and 6 of

assets or liability other than those mentioned in item 7 and 8 of part

10 10 Liabilities that are under A 14'1 U '1 dispute tv/l Nt'L f'rtl NfL- NL- Government dues ( total) A/';L v'-f ') N'L Nt'L Loans from Bank Financial nstitutions and Str/o73 other ( total) \ \ NL Nr'L Nt L NL 111 Highest educational qualification :- Verification: - ' the deponent above named do hereby verify and declare that the contents of this affidavit are true and correct to the bet of my knowledge and belief and no part of it is false and nothing material has been concealed there from further declare that:- (a) There is no case of conviction or pending case against me other than those mentioned in item 5 and 6 of part A and B above (b) my spouse or my dependents do not have any assets or liability other than those mentioned in item 7 and 8 of part A and item 8 9 and 10 of part B above Verified at Srinagar this the <: day of ovember 2014 Deponent

FORM 26 (See rule 4A)

FORM 26 (See rule 4A) Please affix your recent passport size photograph here Affidavit to be filed by the candidate alongwith nomination paper before the returning officer for election to... (name of the