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1 INDIA NON JUDICIAL Government of National Capital Territory of Delhi e-stamp vli44 Certificate No. Certificate Issued Date Account Reference Unique Doc. Reference Purchased by Description of Document Property Description Consideration Price (Rs.) First Party Second Party Stamp Duty Paid By Stamp Duty Amount(Rs.) IN-DL P 01-Apr :46 PM IMPACC (IV)/ di845803/ DELHI/ DL-DLH SUBIN-DLDL P DEEPANJALI Article 4 Affidavit Not Applicable 0 (Zero) DEEPANJALI Not Applicable DEEPANJALI 10 (Ten only) Please write or type below this line Statutory Alert: 1. The authenticity of this Stamp Certificate should be verified at " Any discrepancy in the details on this Certificate and as available on the website renders it invalid. 2. The onus of checking the legitimacy is on the users of the certificate. 3. In case of any discrepancy please inform the Competent Authority.
2 FORM 22 (SEE RULE 18 (2) AFFIDAVIT TO BE FURNISHED BY THE CANDIDATE ALONGWITH NOMINATION PAPER BEFORE THE RETURNING OFFICER For Election to the North Delhi Municipal Corporation of Delhi. From 33, Begumpur (No. and name of the Ward) I, Deepanjali Daughter of Sh. Ram Ji Lal aged about 30 years, R/o House No.5/6, Kailash Vihar Panshali, Block-A, Prahladpur Bangar Village, Delhi , a candidate of the above election, do hereby solemnly affirm and state on oath as under:- I am a candidate set up by Independent. I am contesting as an independent candidate. Detail of PAN and status of filling on Income tax return: S. No. Name Permanent Account Number (PAN) The financial year for which the last income tax return has been filed Total income shown in income tax return (in rupees) 41.).. ' r. RadheY Shy 3: 1 1; AdVOCat.e 0 Req. NO.-9( V.8 TV,: f V." 1. Self - ASLPD3230A Deepanjali 2. Spouse 3. Dependent Gayatri (younger sister) A RZPG1575E 4. Dependent 2 4. Dependent 2 (3) The following case(s) is/are pending against me in which cognizance has been taken by the court:- N/A S. No. Offence (a) The details of case where the court has taken cognizance, sections of the Act and description of Description a tai)oict
3 (b) (c) the offence for which cognizance taken: Name of the court, case No. and date of order taking cognizance: Detail of appeal(s)/ Application(s) for revision (if any) filed against the above order(s) (4) Cases in which I have been convicted be a court of law(other than those referred to in Form 'A') (a) The details of cases, sections of the act and description of the offence for which convicted: (b) Name of the Court(s), case- No. and date(s) of order(s): (c) Punishment imposed: (5) That I give herein below the details of the assets (moveable and immovable etc.) of myself, my spouse and all dependents. (A) Details of movable assets: (Note : 1. Assets in joint name indicating the extent of joint ownership will also have to be GARY given. '?.. ecg. - \\In case of deposit/investment, the details including serial number, account, date of 3 1,41') ;1; i'pleposit, the scheme, name of bank/institution and branch are to be given. 9.:zto,,: :7.' _b 0 \ y Value of Bonds/Share Debentures as per Current market value in stock exchange in ----%. Respect of listed and companies and as per books in case of non-listed companies should be given. 4. Dependent hare has the same meaning assigned in Explanation (v) under Section 75A of the Representation of the people act, Details including amount is to be given separately in respect of each investment. SI No. Description Self Spouse Dependent-1 Dependent- 2 (i) Cash in hand Rs.20000/- Rs.15000/- Depend ent-3
4 (iv) (v) Details of deposit in Bank accounts (FDRs, Term Deposits and all other types of deposits including saving accounts), Deposits with financial Institutions, Non-Banking Financial Companies and Cooperative societies and the amount in each such deposit. Details of investment in Bonds, debentures/ shares and units in companies /Mutual funds and other and the amount. Details of investment in NSS, Postal Saving insurance policies and investment in any Financial instruments in Post office or insurance Company and the amount. Personal loans/ advance given to any person or entity including firm, company, One saving account No at Punjab National Bank, Shastri Nagar Branch, Delhi with his uncle Sh. Krishan Kumar and balance amount of Rs N.A joint LIC policy No for SA and quarterly installment of Rs.772/- One saving account No Punjab National Bank, Shastri Nagar Branch, Delhi with his uncle Sh. Krishan Kumar and balance amount of Rs LIC policy No for SA and quarterly installment of Rs.772/-
5 (vi) Trust etc., and other receivable from debtors and the amount Motor Vehicle / Aircrafts/ Yachts/ships (Details Make, registration number year purchase amount) of etc. of and One second hand Maruti Car bearing No. DL2FFZ0003 swift Model For Rs.1,40,000/- One Scooty Honda Activa bearing No. DL7SAZ0050 Model for Rs.45500/- (vii) Jewellery, bullion and valuable thing (s) (give details of weight and value) (viii) Any other assets such as value of claims/investm ent 3 gm gold Worth Rs.6000/- Nil :. (ix) Gross Total Rs Rs Value Details of mmova le Assets:- ote: Properties in joint ownership including the extent of joint ownership will have to be I indicated G) Res. Ofr, 24- Each land or building of apartment should be mentioned separately in this format. 0 1No. Description Self Spouse Dependent Dependent Dependent (i) Agricultural Land Location (s) Survey number (s) Area (Total measurement in acres) Whether inherited property (Yes/No)
6 (ii) Date of purchase in case of self acquired property Cost of Land (In case of purchase) at the time of purchase Any investment of the land by way of development, construction etc. Approximate current market value. Non agricultural Land Location(s) Survey number(s) Kailash Vihar Pansali Khasra No.18/14 and 18/1 0 Kailash Vihar Pansali Khasra No.18/14 * Ra _ -frey Rh AdvOcaA 0 "eg Alcs, Area (Total measurement in sq.ft) Wheather inherited property (Yes/No) Date of purchase In case of self acquired property Cost of Land (In case of purchase) at the time of purchase 250 sq. ft. 750 sq. ft Rs.12 lacs Rs.7.5 lacs Rs.4.20 lacs Any investment on, the land by way of development, I'Qrt)* ) construction etc. le l Approximant Rs.17 Rs.7.5 lacs S".,',/ Current market value lacs 1 T4 ) Commercial 'i Building, (Including apartments) -Location (s) -Survey number (s) Built up area (Total Measurement in sq.ft.) Whether inherited property (Yes/No)
7 (iv) \.401-AR N.:\ \ * Witihey Shy hl * AtivOcak: C) Reg. No Iv 0 Date of purchase in case of self acquired property Cost of property (in Case of purchase) at the time of purchase Any investment on the property by way of development. construction etc. Approximate Current market value Residential Building (Including apartments.) -Location (s) - Survey number (s) Area (Total measurement in sq.ft) Built up area (Total Measurement in sq.ft.) Whether inherited property (Yes/No) Date of purchase in case of self acquired property Cost of property (in Case of purchase) at the time of purchase Any investment on the property by way of development construction etc. Approximate Current market value Other (such as / interest in property) (vi) Total of Current market Value of (i) to (v) (6) I give herein below the details of liabilities/dues to public financial institutions and government:-
8 (Note: Please give separate details of name of Bank, institution, entity or individual and amount for each item) CRY Si No. Description Self Spouse Dependent- 1 Dependent- 2 Dependent- 3 (i) Loan or dues to NIL Bank/Financial Institution (s) Name of Bank or Fl Amount outstanding Nature of Loan Loan or dues to any Nil individual/ Entity other than mentioned in (i) above Name (s) Amount Outstanding Nature of loan Any other liability NIL Grand total of liabilities NIL (ii) Government Dues NIL Dues to departments dealing with government accommodation Dues to departments NIL dealing with supply of water Dues to departments NIL dealing with supply of electricity Dues to departments NIL dealing with supply of telephones/ mobiles Dues to departments NIL dealing with government transport (including aircrafts and helicopters) Income Tax Dues NIL Wealth Tax Dues NIL Service Tax Dues NIL Municipal/property Tax NIL Dues Sales Tax Dues NIL Any other Dues NIL Grand Total of all Govt. Dues NIL (7) Details of profession or occupation : a. SELF Setting pension from Delhi Govt. for his late father 0.4e,c41
9 b. Spouse. (8) My educational qualification is as under: 8th Pass from Sarvodya Kanya Vidyalya, Delhi on (Give details of highest school/university educational with full form of the certificate/diploma/degree course) (Name of the School/College/ University and the year in with the course was completed.) (9) ABSTARCT OF THE DETAILS GIVEN IN (1) TO (8) ABOVE: 1. Name of the Candidate Smt. Deepanjali 2. Full postal address 5/6, Kailash Vihar, Panshali, Delhi Number and Name of the MCD Ward 33- Begum Pur North Delhi 4 Name of the Political party which set up the candidate (otherwise write independent) 5. (a) Number of cases in which conviction order passed (other than those referred to in Form 'A' Independent Not Applicable 0 ON 4 a (b) Total Numbers of Pending cases where the court (s) have taken Not applicable congnizance PAN Of Year for which last income Tax Return filed OF Candidate: ASLPD3320A Nil Nil Spouse: Dependents: ARZPG1575E. Details of Assets and Liabilities in rupee Description Self Spouse Dependent I Depende Depende A. nt II nt III Moveable Asset Rs (Total Value) Rs B. Immovable As above As above Asset (i) Purchase Price As above and As above Development cost of Immovable
10 property (Total Value) (ii) Approximate Current Market Price of Asset (Total Value) As above As above 8. Liabilities NIL Government Dues (Total) NIL Loans from NIL Bank, Financial Institutions and others (total) 9 Highest educational qualif cation: 8th Pass from Sarvodya Kanya Vidyalya, Delhi on (Give details of School/University education with full form of the certificate /diploma /degree course) (Name of the School/College / University and the year in which the course was completed.) VERIFICATION The deponent above named, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed there from I further declare that: 1. there is no case of conviction or pending case against me other than those mentioned in item 3 and 4 above: 2. I, my spouse or my dependents do not have any asset or liability, other those mentioned in items 5 And 6 above. Verified at Delhi this the 3rd day of April, 2017 ATTESTED 4)Lcd;.1)g g-pov 11-1-L IWTAR 8LIC. telhi (JAN 1..)1A1 3 APR 2017
11 INDIA NON JUDICIAL Government of National Capital Territory of Delhi e-stamp I I Certificate No. Certificate Issued Date Account Reference Unique Doc. Reference Purchased by Description of Document Property Description Consideration Price (Rs.) First Party Second Party Stamp Duty Paid By Stamp Duty Amount(Rs.) : IN-DL P 01-Apr :46 PM 1MPACC (IV)/ di845803/ DELHI/ DL-DLH SUBIN-DLDL P DEEPANJALI Article 4 Affidavit : Not Applicable : 0 (Zero) DEEPANJALI Not Applicable DEEPANJALI 10 (Ten only) Please write or type below this line Statutory Alert: 1. The authenticity of this Stamp Certificate should be verified at "1,vww.shcilestamp.conf. Any discrepancy in the details on this Certificate and as available on the website renders it invalid. 2. The onus of checking the legitimacy is on the users of the certificate. 3. In case of any discrepancy please inform the Competent Authority.
12 FORM 21 (SEE RULE 18 (2) Affidavit to be furnished by the candidate before returning officer for election to the North Delhi/South Delhi/East Delhi Municipal Corporation from 33, Begumpur (No. and name of the Ward) I, Deepanjali Daughter of Sh. Ram Ji Lal aged about 30 years, R/o House No.5/6, Kailash Vihar Panshali, Block-A, Prahladpur Bangar Village, Delhi , candidate at the above election, do hereby solemnly affirms/state on oath as under:- 1. I am not accused of any offence(s) punishable with imprisonment for two years or more in a pending case(s) in which charge(s) has/have been framed by the court(s) of competent jurisdiction. If the deponent is accused of any such offence(s) he shall furnish the following information:- i. Case/First information report No./Nos. _N/A Police station(s) N/A State(s) N/A District(s) N/A Section(s) of the concerned Act(s) and short description of the offence(s) for which the candidate has been charged N/A Court(s) which framed the charge(s) N/A Date(s)on which the charge(s) was/were framed N/A Whether all or any of the proceedings (s) have been stayed by any court(s) of competent jurisdiction N/A 2. I have been/have 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 8 of the representation of the People Act, 1951 (43 of 1951) and sentenced imprisonment for one year or more. N/A If the deponent is convicted and punished as aforesaid, he shall furnish the following information: Case/First information report No./Nos.N/A Court(s) which punished N/A
13 (iii) Police station(s) N/A District(s) N/A State(s) N/A (iv) Section(s) of the concerned Act(s) and short description of the offence(s) for which the candidate has ever been charged. N/A (v) Date(s) on which the sentence(s) was/were pronounced N/A (vi) Whether the sentence(s) has/have stayed by any court(s) of competent jurisdiction N/A Place DELHI Dated Signature of Deponent ft; JO VERIFICATION I, the above named deponent, do hereby verify and declare that the contents of the affidavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed there in. Verified at Delhi this 3rd day of April, 2017 Signature of Deponent bfgpo,u-3a-l- r Note: The columns in this form which are not applicable to the deponent may be struclo6ff'' r'l f, _ r<adhey sh.,_ cdp -20 F \-0,1' ATTESTED NOT, BLIC A0,01All 3 APR 2017
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