INDIA NON JUDICIAL
e-Stamp
DL0934883201oo70S -~,,~' •... :-- Certificate Issued Date 13-Jan~20~O02:35 PM
Account Reference IMPACC (IV)! dI82t}g03! DELHI/ '" -" 11 ... Unique Doc. Reference SUBIN-DLDL82690327235050117647S Purchased by RAJENDRA PAL GAUTAM Description of Document Article 4 Affidavit ',~ 7._ - ._. Property Description Not APplicablecc, Consideration Price (As.) o (Zero) First Party AAJENDRA'p~LGAUTAM Second Party Not Applicable
i Stamp Duty Paid By RAJENDRA PAL GAUTAM Stamp Duty Amount(As.) 100 (One HW:H;j[~d,oOly~,_", , ,;~ ':;: -.,::-"1 Y -i
entncs at Ir!.No.J.~."k?. Rep. No.031!2Ob6 ~OTAa.y PUBLIO
~------.Please write or type below this line -.1 I , I
.-~-~-'~ / -: ~ 0 TA F?y ~"'~ , : i ~t/ '\ 'I", \\ 1; DINES,li KUMAR GUPTA * ~ I ...... i ""','\ :'"',,19 I-u,031/2006 I I I.l'~() '"~
=tOryAlert~--- \;:::>-.,., ~~ V 1,The,authenticityof thl~StampCertificateshouldbe ve~ Q.£Nw.Slhatest~ja, , Any discrepancyin the detailson thiSCertificateand as availableon the websiterendersIt lnvalid. .~ "IV; \.I • 2, Theonusof checkingthe legitimacyIS on the usersof the ce~ ~ 3, Incaseof any discrepancypleaseinformthe CompetentAuthority, AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO LEGISLATIVE ASSEMBLY OF NCT OF DELHI (NAME OF THE HOUSE) FROM SEEMA PURI(AC-63) CONSTITUENCY (NAME OF THE CONSTITUENCY)
PART A
I RAJENDRA PAL GAUTAM **son/daughter/wife of LATE SHRI DALIP SINGH Aged 51years, resident of 8/A5, POCKET-P, DILSHAD GARDEN, DELHI-l10095 (mention full postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under:-
(1) I am a candidate set up by AAM AADMI PARTY
(**name of the political party) / **am contesting as an Independent candidate.
(**strike out whichever is not applicable)
(2) My name is enrolled in SEEMAPURI (AC-63), NCT OF DELHI (Name of the Constituency and the state), at Serial No 239 in Part No 126
(3) My contact telephone number(s) is/are 9599107955, 9871909964 and my e-mail id (ifany) is [email protected] and my social media account(s)(if any) is/are
(i) TWITTER AlC :- @AdvRajendraPal
(ii) INSTAGRAM :-@rajendrapalgautam (iii) FACEBOOK AlC :- (1) w.w.w.facebook.com/advrajendrapalgautam
(2) facebookPage/RajendraGautamMLA (3) FacebookPagelRajendraPalGautam (iV) YOU TUBE CHANNEL NAME:- Rajendra Pal Gautam Channel link :- www.youtube.com/channeIIUCjJQkgUuTzjXys-wC8VW30g
(v) WhatsApp: 9599107955 (4)Details of Permanent Account Number (PAN)* and status of filing of Income tax return:
SI. No. Name PAN The financia Total income year for shown in Income Tax Return(in which the last Rupees) for th~T ~ Income- tax Financial Y7(~ ~ ~ return has March) / been filed , .••,DINF~L'/ ".' ._ , Self 2018-2019 (i) IRs. 8908~3 /., 20~2,Q,l9~~·;.~~·r~
ii) Rs. 58506~ ,~017-2018) " RAJENDRA (iii) Rs. 46918W~~~16-2017) ./ 'v 1. PAL (iv) ~s. 4210581'--...~'~OI6_l/d v;;. GAUTAM ABTPG5945L (v) Rs. 387814/- blalf::.*$·~/ Spouse 2018-2019 (i) ~s. 568332/- (2018-2019) (ii) Rs. 366317/- (2017-2018) (iii) Rs. 362289/- (2016-2017) 2. SUSHILA iAQIPS7603M (iv) Rs. 330856/- (2015-2016) (v) ~s. 320291 /- (2014-2015) HUF (If Candidate is i) Not Applicable KartalCoparcener) (ii) Not Applicable Not Applicable Not Applicable (iii) Not Applicable 3. (iv) Not Applicable I/V) Not Applicable Dependent 1 (i) Not Applicable I/'i)II Not Applicable (iii) Not Applicable 4. SIDHARTH Not Applicable CCUPG8778D (iv) Not Applicable GAUTAM (v) Not Applicable 5, Dependent 2 (i) Not Applicable No (ii) Not Applicable YATHARTH PAN (iii) Not Applicable GAUTAM allotted Not Applicable (iv) Not Applicable (v) Not Applicable 6, Dependent 3.. , (i) Not Applicable (ii) Not Applicable Not Applicable Not Applicable Not Applicable (iii) Not Applicable I(iv) Not Applicable (v) Not Applicable
Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should be clearly stated "No PAN allotted",
2 . '" I
(5) Pending criminal cases
OR
(ii)The following criminal cases are pending against me: NOT APPLICABLE (If there are pending criminal cases against the candidate, then tick this alternative and score off alternative (i) above, and give details of all pending cases in the Table below) Table
(a) FIR No. with name and address of Police Station .Not Applicable Not Applicable Not Applicable concerned (b) Case No. with Name Not Applicable Not Applicable Not Applicable of the Court (c) Section(s) of concerned Acts/Codes involved (give no. of the Not Applicable Not Applicable Not Applicable Section, e.g. Section ...... of IPC, etc.). (d) Brief description of Not Applicable Not Applicable Not Applicable offence (e) Whether charges have been framed Not Applicable Not Applicable Not Applicable (mention YES or NO) (f) If answer against (e) above is YES, then give the date on Not Applicable Not Applicable Not Applicable which charges were framed (g) Whether any Appeal/Application for revision has been filed against the Not Applicable Not Applicable Not Applicable proceedings (Mention YES or NO)
3
------~:;;':"'4"_~ ,'''' '~ Af.t~,. , '/,/~ \~;0 T ~ ",/ "-" / I \ \ / '..iflr \ If r : ~''', \ *' ; I, lJ,(~t'.'::~;~'.IMARGUPM \ ) ',I '\ ",;;,~, :'k) O::l~/2'~ I ''71 ." '. I l'VlJ J I.~\...... (6) Cases of conviction . '....,q"-->.~ / /,:'.t;/J,t." , '\ ' /o!"\'V.!. '~~ OF-" ,':-~. v {/ ./' (i) I declare that I have not been convicted for any criminal'~ this alternative, if the candidate has not been convicted and write NOT APPLICABLE against alternative (ii) below) OR (ii) I have been convicted for the offences mentioned below: Not Applicable (If the candidate has been convicted, then tick this alternative and score off alternative (i) above, and give details in the Table below)
Table
(a) Case No. Not Applicable Not Applicable Not Applicable (b) Name of the Court Not Applicable Not Applicable Not Applicable (c) Sections of Acts/Codes involved (give no. of the Section, e.g. Not Applicable Not Applicable Not Applicable Section ...... of IPC, etc.). (d) Brief description of offence for which Not Applicable Not Applicable Not Applicable convicted (e) Dates of orders of Not Applicable Not Applicable Not Applicable conviction (0 Punishment imposed Not Applicable Not Applicable Not Applicable (g) Whether any Appeal has been filed against conviction order Not Applicable Not Applicable Not Applicable (Mention YES or NO) (h) If answer to (g) above is YES, give details and present status of Not Applicable Not Applicable Not Applicable appeal
(6A) I have given full and up-to-date information to my political party about all pending criminal cases against me and about all cases of conviction as given in paragraphs (5) and (6). NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above
[Candidates to whom this Item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) AND 6(i), ABOVE]
4 ; . " .; . Note: i I' ()j,~';~i-:iKUMAR GUP!A • ~ 1. Details should be entered clearly and legible in BOLD letters. .. :~,\ .~~.u.031/?006 ~ 2. Details to be given separately for each case under different cOlum/i.~ each 'f(".:sl item. ' O~ A _- "1" ."'~~~, IV C \. '->,.,,:/'/" 3. Details should be given in reverse chronological order, i.e., the latest cis~ mentioned first and backwards in the order of dates for the other cases. 4. Additional sheet may be added if required. 5. Candidate is responsible for supplying all information in compliance of Hon'ble Supreme Court's judgment in W. P (C) No. 536 of2011.
(7) That I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all dependents: A.r. 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 Bank/Institution and Branch are to be given.
Note: 3.Value of Bonds/Share Debenturesas per the 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' means parents, sorus), daughter(s) of the candidate or spouse and any other person related to the candidate whether by blood or marriage, who have no separate means of income and who are dependent on the candidate for their livelihood. Note: 5. Details including amount is to be given separately in respect of each investment
Note: 6. Details should include the interest in or ownership of offshore assets.
Explanation,- For the purpose of this Form, the expression "offshore assets" includes, details of all deposits or investments in Foreign banks and any other body or institution abroad, and details of all assets and liabilities in foreign countries.
5 ~ ~OlARr-~ .. .\ OINES!1 KUMAR GUPTA l \ I Reg. No. 03 i/20Cfj J G)\ /3: I S. Description Self Spouse HUF No.
(i) Cash in hand 750001- 650001- Not 10,0001- NIL Not Applicable !Applicable (ii) Details of deposit in 1.S.B.I, DILSHAD 1.SBI, Not SBI, ~IL Bank accounts (FDRs, GARDEN (JOINT DILSHAD Applicable DILSHAD GARDEN (JOINT GARDEN, Not Term Deposits and all SAVING A/C ~O.l 0201890502 saving A/C A/C NO. !Applicable other types of deposits WITH WIFE AND NO. 3692224348 including saving WIFE IS HAVING 10201890502 Rs. 22295.95/- accounts), Deposits FIRST NAME With Husband with Financial and husband is having second Institutions, Non- 2.PNB, YAMUNA name Banking Financial VIHAR, A/C NO. RS.266742/- Companies and 2256000101256466 Rs. 502522.98/- Cooperative societies ~.PPF, SBI, and the amount in each 3.PPF, SBI, DILSHAD such deposit iDILSHAD GARDEN GARDEN, A/C ~/C NO. ~O.38351573719 38351616020 IRs700001- Rs. 1500001-
~.FDR, Dated 17-08- 2018, PNB, YAMUNA VIHAR, A/CNO. ~25600PU00052249 RS.724253/-
5.PNB, CIVIL LINES A/C NO.- 0115000100550840 IRs.OO.OOI- (Election account) (iii) Details of investment 984 SHARES OF Not I.AXS ALLIED NIL Applicable FINANCIAL in Bonds, RELIENCE POWER SERVICES DebentureslShares and LTD. WORTH Rs. 5,00,0001- units in Rs.2362/- 7.TWO SHARES companieslMutual NIL WITH Funds and others and AGROPHOS Not the amount. Rs.79/- Applicable 3.THREE SHARES WITH IBVENTURES Rs. 368/-
6 " " ~ I 'f- l ._..._ Description Self S. Spouse HUF Dependent, ,..l Depe Depenoe No. '~'.." -", nden n'J'_) . "<~'. , " , ; " ,~.:..... - . i-1\.I,\ .'-;/"-' .•..•:.~ ....;.,;.:;;.,...-., / .,;~-::-'.'..."' (iv) Details of investment IdC POLICY LICPOLICY in NSS, Postal Saving, No. 126025046 NO. 124786439 Insurance Policies and Rs. 500000/- Rs. 250000/- Not NIL NIL Not investment in any Applicable Applicable Financial instruments LIC POLICY in Post office or NO. 111372187 Insurance Company and the amount Rs. 100000/- (v) Personal loans/advance RS. 5,00,000/- given to any person or GIVEN TO entity including firm, Mr. NAVEEN company, Trust etc. NIL VIDE Not NIL NIL Not and other receivables CH.NO. Applicable Applicable from debtors and the ~05206 amount. (vi) Motor MARUTI WAGONR SCOOTER DOMINARD Vehicles/ Aircrafts/ REGD.NO. MAESTRO-R 400/BIKE Yachts/Ships (Details DLICL8520 DL5SBL6306 DL5SCL3942 of Make, registration YOP: 2009 YOP: 2015 YOP: 2019 NIL Not number. etc. year of Rs. 330000/- Rs.55000/- Rs. 198000/ Applicable purchase and amount) Present value - Present Value- Present Value Rs.50000/- Rs. 15000/- Rs. I80000/-
(vii) Jewellery, bullion and GOLD-67.06 OM GOLD-75.04 Not valuable thing(s) (give Applicable Rs. 2,74,678/- GM NIL NIL Not details of weight and SILVER-IKO WORTH Applicable value) Rs.51042/- Rs. 307364/-
(viii) Any other assets such as Not NIL NIL Applicable value of claims/interest NIL NIL Not Applicable (ix) Gross Total value Rs.2349858/ - Rs.1554106/- Not Rs.712743/- NIL Not Applicable Applicable
lL Details of Immovable assets: Note: I. 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 in this format.
Note: 3. Details should include the interest in or ownership of offshore assets.
7
------i\\ (,J \ ""09"'Ill," 031/20C6' 11 \\(),, ~ \\ )::- JJ S.No Description Self Spouse HUF Depend~ ~pende ~~!~,'~C.\~ t-3 (i) A2ri~uI1!!ral Land "'~~- NIL NIL Not NIL NIL Not Location(s) Applicable Applicable Survey number(s) Area (total measurement Not Applicable Not Applicable Not Not Not Not in acres) Applicable Applicable Applicable Applicable Whether inherited Not Applicable Not Applicable Not Not Not property Applicable Applicable ~pplicable Not (Yes or No) Applicable
Date of purchase in case Not Not Applicable Not Applicable Applicable Not Not Not of self - acquired property Applicable Applicable Applicable Cost of Land (in case of Not purchase) at the time of Not Applicable Not Applicable Applicable Not Not Not purchase Applicable Applicable Applicable Any Investment on the Not land by way of Applicable Not Not Not Not Applicable Not Applicable Applicable Applicable Applicable development, construction etc. Approximate Current Not market value Not Applicable Not Applicable Applicable Not Not Not Applicable Applicable Applicable (ii) NQD-A2ri~uI1!!ral Land Not Applicable Location(s) NIL NIL NIL NIL Not Survey number(s) Applicable Area (total measurement Not Applicable Not Applicable Not Applicable Not Not Not in sq. ft.) Applicable Applicable Applicable Whether inherited lNot Applicable Not Applicable Not Not Not property Applicable Applicable Applicable Not Applicable (Yes or No) Date of purchase in case Not Applicable Not Applicable Not Applicable Not Not Not of self - acquired property Applicable Applicable Applicable Cost of Land (in case Not Applicable Not Applicable Not of purchase) at the time Applicable Not Not Not Applicable Applicable Applicable of purchase Any Investment on the Not Applicable Not Applicable Not land by way of ~pplicable Not Not Not development, construction Applicable ~pplicable Applicable etc. Approximate current lNot Applicable Not Applicable Not Not Not Not market value Applicable Applicable Applicable Applicable 8 , ~ ;/ lYlt ~ ff D/ldfSH" " K'Ut>fAR. GUPTA ..'\ ,.1\ 1':-, Rna>J, No. 03!,12000 ') (iii) Commercial Buildings ...... J. \'\O~\\ L. (including apartments) ~ NIL NIL Not .~ ~I' Not -Location(s) Applicable ~ry_.~~~ Applicable -Survey number(s) Area (total measurement Not Applicable Not Applicable ~ot Not lNot Not in sq. ft.) ~pplicable Applicable [Applicable Applicable
Built-up Area (total Not Applicable Not Applicable ~ot Not lNot Not measurement in sq.ft.) ~pplicable Applicable ~pplicable ~pplicable Whether inherited Not ~ot Applicable Not Not ~ot Not property Applicable Applicable Applicable ~pplicable ~pplicable (Yes or No) Date of purchase in case Not Applicable Not Applicable Not Not Not Not Applicable Applicable of self - acquired property Applicable [Applicable
Cost of property (in case Not Applicable Not Applicable Not Not ~ot Not of purchase) at the time of Applicable Applicable [Applicable Applicable purchase Any Investment on the Not Applicable Not Applicable Not Not Not Not property by way of Applicable Applicable Applicable Applicable development, construction etc. Approximate current Not Applicable Not Applicable Not Not Not Not market value Applicable Applicable Applicable Applicable (iv) R~~id~ntii!1Buildings 1. v-s. 1. 8fA5, Not (including apartments): KHAJOOR POCKET-P, Applicable GALl, DILSHAD -Location (s) GHONDA, GARDEN, -Surveynumber(s) DELHI- 110053 DELHI- 25% SHARE) 110095
~. FRONT SIDE I? FRONT PORTION OF SIDE NIL NIL Not Ind FLOOR, PORTION OF Applicable JROAD lInd FLOOR, FACING, PLOT ROAD iNo, 6, MALKA FACING, joANJ, DELHI- PLOTNO,6, 110007 (JOINT MALKA IPROPERTY GANJ, lAND HAVING DELHI- 50% SHARE) 110007 (JOINT PROPERTY AND HAVING 50% SHARE)
9 \ \\ "!/* '"llr'r~ 1rl I, 1, V... ~"'-II Whether inherited 1. PROPERTY 1. PROPERTYNot Not property No.- 01, YES No.- 01, NO Applicable Applicable (Yes or No) 2. PROPERTY 2. PROPERTY Not Not NO.-02, NO No.- 02, NO Applicable Applicable Date of purchase in case 1. NA I. July 2004 Not Not Not Not of self - acquired property ~. 07.05.2019 ~. 07.05.2019 Applicable Applicable Applicable Applicable Cost of property (in case I.NA I.Rs 100000/- Not of purchase) at the time of ~.Rs.51 00000 ~.Rs.51 00000 Applicable 50% share of r--50%share of Not purchase Not Not oint Property ~oint Property Applicable Applicable Applicable worth Rs worth Rs 10200000/- ) 10200000/-) Any Investment on the Not Applicable land by way of Not Applicable Not Applicable Not Applicable Not Applicable Not development, construction Applicable etc. Approximate current I.Rs.1500000/- 1.Rs. !Not 1I4thshare of ~pplicable market value ~500000/- ~s.60 lacs ). 2.Rs.5100000 Not Applicable Not Applicable Not ~.Rs.5100000 50% share of Applicable 50% share of ~ointProperty Joint Property value of value of Rs 10200000/-) Rs 10200000/-) 10 ,/"'~OTAf?L'" /~\ , ~~ "f ~( I /'11'V' .,," * \ ! Ld ~:,:;H!\U,"lARG' 'P"'A) ": \ o U , I \ ~'''', ;-":19 Nt" U31/200f ","' __, '\ J..... 1~ Not <\:JI:~ (v) Others (such as interest in \\ "-"). .J:j;' property) Not Applicable Not Applicable \Applicable '\ ' ::-..' 1-- NotAppN~€l ~4~" ",-_, ~N}_~'::~Xpplicable ....~,-~ (vi) Total of current market Not value of (i) to (v) above Rs.6600000/- Rs.7600000/- Applicable Not Applicable Not Applicable Not Applicable (8) I 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) S. Description Self Spouse HUF Depen Depen Depend No. dent-l dent-2 ent-3 (i) Loan or dues Rs. 2500000/- Rs. 2500000/- to (50% share ofjoint (50% share ofjoint BanklFinancial loan of loan of ~s.5000000/-) Rs.5000000/-) Not NIL NIL Not Ins!ilu!illn(s) Applicable PNB, CIVIL PNB, CIVIL Applicable Name of Bank or Financial LINES. LINES. HOME LOAN Institution, HOME LOAN WITH Amount WITH OUTSTANDING outstandin OUTSTANDING LIABILITYOF LIABILITYOF g, Nature of loan RS.2347010.00/- RS.2347010.00/- i.e.50% of the total i.e.50% of the total outstanding liability outstanding liability of Rs.4694021.00/- of Rs.4694021.00/- Loan or dues to any Rs. 1350000/- Rs.1350000/- Not other individuals/ (50% share of total (50% share of total \Applicable entity other than loan of Rs. 27 lacs) loan of Rs. 27 lacs) mentioned above. 1.MunishKumar 1.MunishKumar 2. Nagender Pal 2. Nagender Pal Name(s), Singh Singh NIL NIL Not Amou 3.Nishant 3.Nishant Applicable nt outstanding, nature ~. Aakansha ~. Aakansha ofloan 5. Bhagwat Prasad 5. Bhagwat Prasad ~igam lNigam Any other liability Not Not Applicable Not Applicable Applicable NIL NIL Not Applicable Grand total of liabilities Rs.36970l0/- Rs.36970l0/- Not NIL NIL Not Applicable Applicable 11 / ------(ii) Government Dues; (A) Has the Deponent been in ·oc~ll:.~QD..~~$~ Dues to departments accommodation provided by the GO~~~~~~L tick the dealing with any time during the last ten years before the ~ appropriate Government of notification of the current election? alternative) accommodation (8) If answer to (A) above is YES, the following declaration may be furnished namely:- (i) The address of the Government accommodation: 4/8 Raj Niwas Marg, Civil Lines, Delhi - 110054 (ii)There is no dues payable in respect of above Government accommodation, towards- INa DUES CERTIFICA (a) rent; TE (b) electricity charges; ATTACHE D (c) water charges; and (d) telephone charges as on 14-01-2020 (date) [The date should be the last date of the third month prior to the month in which the election is notified or any date thereafter ]. Note- 'No Dues Certificate' from the agencies concerned in respect of rent, electricity charges, water charges and telephone charges for the above Government accommodation should be submitted. (iii) Dues to department dealing with Government transport Not Not Not (including aircrafts and Applicable Applicable Applicable Not Applicable Not Applicable Not Applicable helicopters) (iv) Income Tax dues NIL 12 ------,'I " ~. \ ~, ... . .'" I' OINESH~:UMARGun.; \ RE!9.No. 031/2006 /. ~\Gl\ -~ (v) GST dues Not Applicable Not Not Not ~ Applicable Applicable Applicable ~~~ ,..;: Ie Able (vi) Municipal/Property tax NIL NIL Not , Not ~. f-' ':;"'~t dues Applicable Applicable Applicable -~pplicable (vii) Any other dues NIL NIL Not Not Not Not Applicable Applicable Applicable Applicable (viii) Grand total of Not Applicable Not Not Not Not Not all Applicable Applicable Applicable Applicable Applicable Government dues Whether any other Not Applicable Not Not Not Not Not (ix) liabilities are in dispute, Applicable Applicable Applicable Applicable Applicable if so, mention the amount involved and the authority before which it is pending. (9) Details of profession or occupation: (a) Self Advocate (b) Spouse Teacher ,~*- (9A) Details ofsource(s) of income: (a) Self Salary, House Rent and Outstanding Professional Fee (b) Spouse Salary, House Rent (c) Source of income, if any, of dependents, Not Applicable (9B) Contracts with appropriate Government and any public company or companies (a) details of contracts entered by the candidate Not Applicable (b) details of contracts entered into by spouse Not Applicable (c) details of contracts entered into by dependents Not Applicable (d) details of contracts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have interest Not Applicable (e) details of contracts, entered into by Partnership Firms in which candidate or spouse or dependents are partners Not Applicable (t) details of contracts, entered into by private companies in which candidate or spouse or dependents have share Not Applicable (10) My educational qualification is as under: LL.B. (UNIVERSITY OF DELHI, 1993) (Give details of highest School/University education mentioning the full form of the certificate! diploma!degree course, name of the School!College/University and the year in which the course was completed.) 13 ... _-_ .•. _::.::: l' PART-B ..... '<~", .....;.. '.. "' " (11). ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PA~.;_~~:__;:;"; 1. Name of the candidate RAJENDRA PAL GAUTAM 2. Full postal address 8/A5,POCKET -P, DILSHAD GARDEN, DELHI-110095 3. Number and name of the SEEMA PURl (AC-63) constituency and State 4. Name of the political party which AAM AADMI PARTY set up the candidate (otherwise write 'Independent') 5. Total number of pending criminal cases NIL 6. Total Number of cases in which convicted NIL 7. PAN of Year for which last Total Income Shown Income Tax Return filed (a) Candidate ABTPG5945L 2018-2019 RS.890893/- (b) Spouse AQIPS7603M 2018-2019 RS. 568332/- (c) HUF Not Applicable Not Applicable Not Applicable (d) Dependent-l (SIDHARTH CCUPG8778D Not Applicable Not Applicable GAUTAM) No Dependent -2 Not Applicable Not Applicable (YATHARTH PAN GAUTAM) allotted 8. Details of Assets and Liabilities (including off shore assets) in rupees Description Self Spouse IHUF Depende Depende Depende nt-l nt-2 nt-3 A. Moveable Assets RS.2349858/- RS. 1554106/- Not IRs.712743/-INIL Not (Total value) Applicable Applicable B. ~mmovable Assets I Purchase Price of Rs. 5100000/- Rs. 5200000/- Not self-acquired !Applicable Not Not Not immovable Applicable Applicable Applicable property II Development/const Not ruction cost of !Applicable immovable property Not Applicable Not Applicable Not Not Not after purchase (if Applicable Applicable Applicable applicable) 14 ------. »: 1/ ·/0. .. I' I io'ON' , .,', . \ .1 { '.' I .fff, .•p I~ I , ~ i !'/""" ¥,1'1 t GI rp'A ~ III Approximate Not . ~. I):) 7/2(1) ;' fl wo',1"}~/ Current Market Applicable :--.~ \\.:..~ /,~ 1/ Price ,\r. 0 ~:v/l \~ :.<:- ,/,/ , Rs. 5100000/- Rs.7600000/- ~~ (a) Self- ~ ...... ~ :i_C.\~ ~' acquired ~ assets (Total Not Not Not Value) Applicable Applicable Applicable ~. 1500000/- lNot Applicable (b) Inherited assets (Total Value)' 9. Liabilities (i) Government dues Not Not (Total) NIL NIL Applicable NIL NIL Applicable (ii) Loans from Bank, Rs.3697010/- Rs.3697010/- Not Not Financial Institutions Applicable NIL NIL Applicable and others (Total) 10. Liabilities that are under dispute (i) Government dues Not Not (Total) NIL NIL Applicable NIL NIL Applicable (ii) Loans from Bank, Not Not Financial NIL NIL Applicable NIL NIL Applicable Institutions and others (Total) 11. Highest educational qualification: LL.B. (UNIVERSITY OF DELHI, 1993) Give details of highest School/University education mentioning the full form of the certificate/ diploma! degree course, name of the School /College/ University and the year in which the course was completed.) 15 ,/~ VERIFICATION (/ -;.t>!~... . '\ \ . /)/NF..:;J'I" .... ' , , f f\(Hf14 . ~ I, the deponent, above named, do hereby verify and ded'~~tht{fgt~. iJlM~'ftS4 f t is affidavit are true and correct to the best of my knowledge and belier no part ofi~ f: se d nothing material has been concealed there from. I further declare th~~:,?, ~ I ()a thereere iIS no case 0 f conviconviction. or pend'109 case against. me other th'~~~~_#"an t~;rn Items 5 and 6 of Part A and B above; (b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 7 and 8 of Part A and items 8, 9 and 10 of Part B above. . 20LD Verified at. .. 0.e!h.I... .this the.!.""!.::! day of ..~~.:'.~.~:r:.J..... '\ DEPONENT Note: 1. Affidavit should be filed latest by 3.00 PM on the last day of filing nominations. Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public. Note: 3. All columns should be filled up and no column to be left blank. If there is no information to furnish in respect of any item, either "Nil" or "Not applicable", as the case may be, should be mentioned. Note: 4. The affidavit should be either typed or written legibly and neatly. Note: 5. Each page of the Affidavit should be signed by the deponent and the Affidavit should bear on each page the stamp of the Notary or Oath Commissioner or Magistrate before whom the Affidavit is sworn. (Ministry of Law & Justice Notification No. HI 1019(4)/2018-Leg.II,date to" October, 2018 and NotificationNo. H-I 1019/13/2016-Leg.1I,dated 26th February,2019) cutrtes at Irl. NO.~.~~_ Rega, No. 031/2&l6 NOTARY PUBLIO 1 . r I I .: JAN 201J 16