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Vutsrqponmlkjihgfedcbazyxwvutsrqponmlkjihgfedcbaof Bihar ~,::;Ir~~~., H~Zyxwvutsrqponmlkjihgfedcbazyxwvutsrqponmlkjihgfedcbai! ?Tg .';;...1I ~O\rTzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAOF BiHAR ~,::;iR~~~.,_ h~zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAi! ?tG .';;...1i",.;;. ~zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 0.7 jg;-zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Ht ."",WU)ALd / =---- 'zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ' ....." »..,,11'- ~ ". .zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAI ... !::>. ~ idavit to be filed by the candidate alongwith nomination paper before the returning lection to COUNCIL OF STATES (RAJYA SABDA) (name of the House) from ARLEGISLATIVE ASSEMBLY constituency (Name of the constituency) ~\~ PART-A ~ \, Ahmad Ashfaque Karim, **sonieattgftt8r/vAfe of Ahmad Karim Rahmani, aged 56 years, resident of Katihar Medical College Campus, Bari Digola, Dalan, Post Office- Dalan, Police ufassil Thana, District-Katihar-854106, Bihar (mention full postal address), a candidate -/'7 t the above election, do hereby solemnly affirm and state on oath as under:- .. ~_-/'(Y v I t1 - (1) I am a candidate set up by RASHTRIYA JANATA DAL (**name of the political party)/**&llf 8~mt88tiftgas !m Ifte8}'l8fte8Iit8!meieat8. (**strike out whichever is not applicable) (2) My name is enrolled in 63, KATIHAR-GENERAL, BIHAR (Name of the constituency and the State), at Serial No. 758..in Part No. 44 (3) My contact telephone number(s) is/are 9473324400, 9852777777 and my email id (if any) is ~~~!!!i~:!@lilli£ID5!m~at~·!:.l.£!co~mnand my social media account(s) (if any) is/&f@(i)Onfacebook https:/ /www.facebook.com/Ashfaquekarim (ii) Nil ermanent Account Number (PAN) and status of filing of Income Tax return: PAN The financial year Total Income for which the last shown in Income Income-tax return Tax return (in has been filed rupees) Self AHBPK0392H 2016-17 1,03,12,893/- 02 Spouse (i) Nuzhat Nasreen AANPN0485H 2016-17 8,48,320/- (ii) Dr. Seeba Hussain AIGPH7571M 2016-17 9,19,214/- 03 Dependent 1. Shefa Karim EXUPK3519K 2016-17 7,06,037/- 04 De endent 2. Nil Nil Nil 05 Dependent 3. Nil Nil Nil (5) I am/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) haslhave 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) The following case (s) is/are pending against me in which charges have been framed by the court for an offence punishable with imprisonment for two years or more:-zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANot Applicable (a) Case/First Information ReportzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANo.INQs. together with . Not Applicable complete details of concerned Police StationlDistrictiState. (b) Section( s) of the concerned Act( s) and short description Not Applicable of the offence(s) for which charged (c) Name of the Court, Case No. and date of order taking Not Applicable cognizance: (d) Court(s) which framed the charge(s) Not Applicable (e) Date(s) on which the charge(s) was/were framed Not Applicable (f) Whether all or any of the proceedings(s) have been Not Applicable stayed by any Court(s) of competent jurisdiction (ii)The following case(s) is/are pending against me in which cognizance has been taken by the court [0 er than the cases mentioned in item (i) above]:- 1) Court of Special Judge, Vigilance, 1st, Patna; Spl Case no. 32/2013 arising out of Shastri Nagar PS, Patna case no. 213/13, date of cognizance-l 1.09.2013 2) Court of Chief Judicial Magistrate, Katihar; GR no. 1762- 13 arising out of Mufassil PS, Katihar case no. 92/13, date of cognizance-Nil (b) The details of cases where the 1) Section 384,353,406,420,467,468,469zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& 471 read court has taken cogmzance, with 120B IPC, Section 25 (I-B)A, 26 & 30 of Arms Act section(s) of the Act(s) and and section 10 Bihar Conduct of Examination Control Act description of the offence(s) for and section 7, 13(l)(d) and 13 (2) of PC Act which cognizance taken 2) Section 25(l-B)A, 26 & 30 of Arms Act (c) Details of Appeal(s)/ 1) The above order of cognizance has been quashed by Application(s) for revision (if Hon'ble Division Bench of the Patna High Court vide order any) filed against the above dated 05.03.2014 passed in Cr.W.J.C no. 1126 of2013. order(s) 2) The Mufassil PS, Katihar has submitted Final Report no.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 15115 dated 03-02-2015 before CJM, Katihar as mistake of facts. ." In the following cases, I have been convicted and sentenced to imprisonment by a court oflaw: (a) The details of cases, Section(s) of the concerned Act(s) Not Applicable and description of the offence(s) for which convicted. (b) Name of the Court(s), Case No. and date(s) of order(s): Not Applicable (c) Punishment imposed Not Applicable (d) Whether any appeal waslhas been filed against the Not Applicable conviction order. If so, details and the present status of the appeal: (7) That I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all dependents:zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA A. Details of movable assets: Note: 1. Assets in joint name indicating the extent of joint ownership will also have to be given. Note: 2. In case of deposit/Investment, the details including Serial Number, Amount, date of deposit, the scheme, Name of the Bank/Institution and Branch are to be given. Note:3. 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. Note:4. Dependent here has the same meaning as assigned in Explanation (v) under section 75A of the Representation ofthe People Act, 1951. Note: 5. Details including amount is to be given separately in respect of each investment. S1. Description Self (Ahmad Spouse Dependent- Dependent- Dependent No. AshfaquezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA1 (Shefa 2 -3 Karim) Karim) Cash in hand Rs. 96 Lacs 1. Nuzhat Rs. 35000/- Nil Nil (Approx) Nasreen- Rs. 36 (Approx) Lacs (Appro x) 2. Dr. Seeba Hussain- Rs. 2.6 Lacs (Approx) (ii) Details of deposit in As per para As per para (ii) As per para Nil Nil Bank accounts(FDRs, (ii) of of Annexure (ii) of Term Deposits and all AnnexurezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA"A" attached Annexure other types of deposits "A" attached herewith "A" attached including saving herewith herewith accounts), Deposits with Financial Institutions, Non- Banking Financial Companies and Cooperative societies and the amount in each such deposit (iii) Details of investment As per para As per parazyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAs per para Nil NilzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA III Bonds, (iii) of (iii) of (iii) of debentures/shares and Annexure Annexure"A" Annexure units III "A" attached attached "A" companies/Mutual herewith herewith attached funds and others and herewith the amount. (iv) Details of investment As per para Asperpara (iv) Asperpara Nil Nil in NSS, Postal Saving, (iv) of of Annexure (iv)of Insurance policies and Annexure "A" attached Annexure investment III any "A" attached herewith "A" Financial instruments herewithzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAattached III Post office or herewith Insurance Company and the amount. (v) Personal loans/ As per para Asperpara(v) Asperpara Nil Nil advancegiven to any (v) of of. Annexure (v)of person or entity Annexure "A" attached Annexure including firm, "A" attached herewith "A" company, Trust etc., herewith attached and other receivables herewith from debtors and the amount. (vi) Motor Vehicles/ As per para Asperpara (vi) Asperpara Nil Nil Aircrafts/Y achts/Ships (vi) of of Annexure (vi)of (Details of Make, Annexure "A" attached Annexure ~stration numberzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA"A" attached herewith "A" V etc. Year of purchase herewith attached -,-1\ and amount) herewithzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA _";j ('A) Jewellery, bullion and As per para As per para Asperpara Nil Nil ~V~\ '6 valuable thing(s) (give (vii) of (vii) of (vii)of ~rJ\ \ details of weight and Annexure Annexure "A" Annexure .\ value) "A" attached attached "A" herewith herewith attached herewith (viii) Any other assets such As per para As per para Asperpara Nil Nil as value of (viii) of (viii) of (viii)of Claims/interest Annexure Annexure "A" Annexure "A" attached attached "A" herewith herewith attached herewith (ix) Gross Total Value 597.38Lacs 342.60Lacs 10.79 Lacs Nil Nil B. Details of Immovable Assets: IzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Note: 1. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated. Note: 2 Each land or building or apartment should be mentioned separately IIIthis format.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Sl. Description Self (Ahmad Spouse Dependent-l Dependent Dependent No. Ashfaque Karim) (ShefaKarim) -2 -3 (i) Agricultural As per para (i) of As per para (i) Asper para (i) Nil Nil Land Annexure of Annexure ofAnnexure Location(s) "B"attached "B" attached "B" attached Survey herewith herewith herewith number(s) Area (total Asperpara (i) of Asperpara (i) As per para (i) Nil Nil measurement in Annexure ofAnnexure of Annexure acres) "B"attached "B"attached "B"attached herewith herewith herewith Whether As per para (i) of As per para (i) As per para (i) Nil Nil inherited Annexure ofAnnexure of Annexure
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