High Court of Karnataka Bengaluru, Dated: C I R C U L A R

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No. HVM.100/2017 High Court of Karnataka Bengaluru, Dated: 23.11.2017 C I R C U L A R Sub: Annual Assets and Liabilities statement for the Year ending 2017 - reg. * * * * All the Judicial Officers, Software Technicians and Chief Administrative Officers/Assistant Registrars, working in subordinate courts are requested to submit their annual statement of Assets and Liabilities in the prescribed form for the year ending 31 st December 2017. Further, if there is no variation or change in the return furnished for the previous year and current year in respect of movable and immovable properties in the prescribed form need not be used, but they are required to declare in writing to the effect that the return furnished for the previous year holds good for the current year, alongwith the following particulars:- 1. Name (in block letters) 2. Designation 3. Date of entry into service 4. Present pay: Gross Salary Net Salary 5. Insurance policy numbers i.e., KGID, LIC, PLI etc: a) Sum assured b) Amount of annual premium 6. Provident Fund: a) Account number b) Amount of annual subscription c) Closing balance of General Provident Fund as on 31.12.2017.

- 2-7. Savings/Current Bank Account number/s: a) Name of the Bank/s and place b) Bank balance in various account numbers as on 31.12.2017. 8. Bank/Financial Institutions: Deposits, Fixed Deposit/recurring deposits/cash certificates particulars of: Number/s Date of deposit Amount of deposit maturity value. 9. Post office deposits, Fixed Deposit/ Recurring Deposits particulars viz., Account number/s Date of deposit Amount of deposit maturity value. 10. National Savings Certificate/ Kissan vikas patra particulars of: Account number/s Date of investment Face value maturity value. 11. Fixed Deposit/Provident Fund in the Judicial Officers Credit Co-operative Society Ltd./Judicial Department Multipurpose Co-operative Society particulars of: Number/s Date of deposit Amount of deposit maturity value

- 3-12. Shares/Debentures etc., Number Date of purchase Face value Name of the company/bank 13. Particulars of Bank/post office/accounts of SB/FD/RD and also cash certificates/ shares/ NSC/KVP made in the name/s of any member of his/her family with particulars of: Number/s Date of deposit Amount of deposit maturity value 14. Agricultural income, if he/she owns/inherited lands received by him/her other than salary. 15. Income from House rent, if so furnish details. 16. Details of the movable/immovable properties acquired during the year 2017 along with source and proof. 17. Whether his/her wife/ husband is employed/ avocation of his/her wife/husband, furnish details. 18. Salary/income of his/her wife/husband. 19. Cash on hand as on 31.12.2017. 20. Liabilities (Debts): i) Loans availed by the Officer or in the name of his/her family members from Banks, Financial Institutions, Co-operative Societies, etc. a) Name of the Bank/ Institutions/Societies b) Date of availment c) Amount availed with EMI d) Purpose of availment

- 4 - ii) Loans availed from Karnataka Judicial Officers Credit Cooperative Society (a) Date of availment (b) Amount availed with EMI (c) Purpose of availment iii) Loan sanction letter/s for the above. iv) Amount repaid during the year towards such loans. v) Outstanding loan as on 31.12.2017. vi) Take home salary after deduction of EMIs in view of O.M.No.FD 141 PPF 69 dated 25.03.1970 modified dated 30.05.1970 21. List of family members of the Officer. 21(a) Photo of the Officer to be affixed in the list of family members. 22. Mobile number/s 23. Other purchases/investments if any, along with source and proof. The above information shall be forwarded to the Registrar (Vigilance), High Court of Karnataka, Bengaluru, before 31 st January 2018 without fail. Any lapse in this regard will be viewed seriously. BY ORDER OF HON BLE THE Ag. CHIEF JUSTICE, NOTE: Sd/- (SHIVASHANKAR AMARANNAVAR) REGISTRAR (VIGILANCE) The newly appointed Judicial Officers have to furnish the first Assets and Liabilities statements in the format 1 and 2 as prescribed by the Government of Karnataka (C üpàèvà eáõ À À ÀASÉå : ¹D ÀÄE 11 ÉÃ ¹ 92, ÁAPÀ 26.04.1994) along with above statement (Copy enclosed).

To: - 5-1. The Registrar General, Registrar (Recruitment), Registrar (Judicial), Registrar (Administration), Registrar (Infrastructure & Maintenance), Registrar (Review & Statistics), Registrar (Computers), Secy. to the Hon ble Ag.Chief Justice, Central Project Co-ordinator, Bengaluru. 2. The Secretary, High Court Legal Services Authority, Bengaluru. 3. The Prl. City Civil & Sessions Judge, Bengaluru City with a request to circulate the copy of the circular amongst all the Judicial Officers working in the unit and also the Officers working in the cadre of Software Technicians/Asst. Registrars in their units. 4. The Prl. District & Sessions Judge, Bengaluru (Rural) District, Bagalkot, Belagavi, Ballari, Bidar, Chamarajanagar, Chikkaballapur, Chikmagaluru, Chitradurga, Davanagere, Dharwad, D.K. Mangaluru, Gadag, Hassan, Haveri, Kalaburagi, Kodagu-Madikeri, Kolar, Koppal, Mandya, Mysuru, Raichur, Ramanagara, Shivamogga, Tumakuru, Udupi, U.K.Karwar, Vijayapura, Yadgir with a request to circulate the copy of the circular amongst all the Judicial Officers working in different capacities including OOD Officers, Software Technicians, C.A.Os/ Assistant Registrars of the concerned District Court and the Judicial Officers, C.A.Os and Assistant Registrars under suspension in their unit. 5. The Presiding Officers, Industrial Tribunals, Bengaluru, Hubballi, Mysuru and the Presiding Officers, Labour Court, Bengaluru, Chikkamagaluru, Hubballi, Kalaburagi, Madikeri, Mangaluru, Mysuru and Vijayapura with a request to circulate the copy of the circular amongst the other Judicial Officers working in different capacities in the District. 6. The Chief Judge, Court of Small Causes, Bengaluru with a request to circulate the copy of the circular amongst the other Judicial Officers working in the unit. 7. The Prl. Judge, Family Court, Bengaluru with a request to circulate the copy of the circular amongst the other Judicial Officers working in the unit, the Judge, Family Court, Ballari, Belagavi, Chikkamagaluru, Davanagere, Dharwad, D.K. Mangaluru, Gadag, Hassan, Hubballi, Kalaburagi, Kolar, Mysuru, Raichur, Shivamogga, Tumakuru, Vijayapura. 8. The Secretary, Department of Law with a request to circulate the copy of the circular amongst all the Judicial Officers working in the Government in different capacities. 9. The Director, Karnataka Judicial Academy, the Director, Mediation Centre, Nyaya Degula, the Registrar, Karnataka Appellate Tribunal/Karnataka Lokayuktha, with a request to circulate the copy of the circular amongst all the Judicial Officers working in their unit. 10. The Member-Secretary & Deputy Secretary, Karnataka State Legal Services Authority, Nyaya Degula, Siddaiah Road, Bengaluru.

- 6-11. The Presiding Officer, Karnataka State Transport Appellate Tribunal, M.S.Buidling, Bengaluru. 12. The Principal, Training Institute, City Civil Court Complex, Bengaluru. 13. The Registrar, Karnataka Administrative Tribunal, Kandaya Bhavan, Bengaluru. 14. The Addl. Registrar General, Dharwad Bench. 15. The Addl. Registrar General, Kalaburagi Bench. 16. The Presiding Officer, Karnataka Wakf Tribunal, Bengaluru, Belagavi, Kalaburagi and Mysuru. 17. The Under Secretary to Government of Karnataka, Legal Cell, Karnataka Bhavan, New Delhi. 18. The Registrar-Cum-Administrative Officer, Karnataka State Consumers Dispute Redressal Commission, Bengaluru. 19. The Professor, Faculty of Law, Administrative Training Institute, Mysuru. 20. The CPC, High Court of Karnataka, Bengaluru, to publish the same in the Web Site accessible to the Judicial Officers only. 21. The Registrar, Karnataka Land Grabbing Prohibition Special Courts, Bengaluru. 22. The Registrar, Debt Recovery Tribunal, Bengaluru. 23. OOD, Leave Reserve, High Court of Karnataka, Bengaluru. 24. The Section Officer, LCA- I, four copies for circular file.

- 7 - PROFORMA Affix Passport Size Photo of the Officer DETAILS OF FAMILY MEMBERS AND THEIR RESIDENTIAL ADRESSES: (VIDE CIRCULAR NO.FD(SPL) 17 CPF 77, DATED 14.4.1974 NAME OF THE JUDICIAL OFFICER: Sl. No. Members of Family Name 1. Wife or Husband 2. Sons (including step and adopted sons) 3. Daughters (unmarried including widow or divorced) 4. Brothers (below 18 years) 5. Sisters (unmarried widow or divorced) 6. Parents: Father Mother (including adopted) 7. Married daughters 8. Children of predeceased son Relationship with the Officer Date of Birth Residential Address Place: Date: Signature & Designation Of the Officer.