\\ FORM 26 $oil?4 (See rule 4A)

JIt ct resident of. 25, ft. GI Late. Aged 58 yeafs, I' Kirti Azad son of at the CE K. G' Mu'g, liew Dettti-l10001' a candidate Ravishankar Shukla Lane (Canning Lane), CL; and state on oath as under:- 4 above election, Oo tt"t.Uy solemnl! affirm ctt CONGRESS' GF (1) I am a candidate set up by INDIAN NATIONAL

FS (2)Mynameisenrolledin40,NewDelhi,DelhiatSerialNogginPartNoT9. fJl (3) My contact telephone numbers are: Mobile No.- 98 1 05 327 S0 1943 1219001' J 0 1 | -237 82645 12307 3234 GlG' Residence No. Mv spcial Media accou,nt are : tt I *l Email ID :- Lrrl t Facebook Page: www'taceDooK'com/Nu I Mv zc) ***. fu..U ook' com/Ki rtiazadmP I ct, My Facebook Account: b{Pgl [wlll My ;'i[,.;;;;i.*;-1,11o;/ffi itt'""''/Ki'tiAzadMP?refsrc:emai1 1 14v Website: www'kirtiazad'in -_-

return: (PAN) and status of filing of Income Tax (4) Details of Permanent Account Number Total lncome Permanent The financial Year S. Name in income No. for which the last shown No. Account income tax return tax return (in has been filed. rupee) for the last five financial Years completed (as on March 31't) 2017-20tt 37.46,9301- Self epnpegsszD _ l. )016-2017 44.'l/,65Ut -ADRPA8552D noRpessszo - 2015-2016 ffiJq,st6/- TDnpetsszo 2014-2015 ffi&?,ztol- ADRPA8552D 2013-2014 $34,Zttt- 17 96-888/- r r*: aoHpRo0qqN4 2017-201 8", ' 6,65;26v1 $Y Aazad AnnpeooqgM, .-.- zot,o'&s't'z !{ npupe0oqgM'q*- Ebrs'2016 \ 31,25,98h \$\# ,.,.",i ,ADHPA6699M ,2014-2Q.it5 ;\ ili9J86d"" - *(* ,,/t 6 '* :*r4 ;.* :' .ffi,*- S'#*t.ii &'' l"': dW*1 'i ,ii{i,)i' , 11, 'r' ab,BAB-. i{,1 ' i. ;1q,,: ti,, Y,'f\- I, \

ADI{PA6699M 2013-2014 8.s721- J. HUF (If Candidate NOT NOT NOT is APPLICABLE APPLICABLE APPLICABLE Karta/Coparcener) 4. Dependent 1 NOT NOT NOT APPLICABLE APPLICABLE APPLICABLE

5. Dependent 2: NOT NOT NOT APPLICABLE APPLICABLE 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".

(5) Pending criminal cases (ij t Oectare that there is no pending criminal case against me. (Tick this alternative if there is no criminal case pending against the Candidate and write NOT APPLICABLE against altemative (ii) below) OR (ii) The following criminal cases are pending against me: (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 FIR No. FIRNo. FIRNo. FIRNo. and 260/2015, P. S. 2012014,P.s. 53/2009, P.S. 50/2009, P.s. address of Laheriasarai, Sakatpur, Town, Town, Police Station , T.R. Darbhanga, Darbhanga, TR Dpqbhanga, concerned No.77912019 T.R. No. No.77812019 T.R. No. 78012019 776/2019

(b) Case No. with T.R. No. T.R. No. TR No. T.R. No. Name of "the 779n019 780n0t9 77812019 77612019 Court In the court of In the court of In the court of In the court of Addl. Chief Addl. Chief Addl. Chief Addl. Chief Judicial Judicial Judicial Judicial Magistrate No.- Magistrate No.- Magistrate Magistrate 1, (A.C.J.M. 1, (A.C.J.M. No.-1, No.-1, No.-1), No.-1), (A.C.J.M. No.- (A.C.J.M. No.- Darbhanga. Darbhanga. 1), 1), Darbhanga.

(c) Section(s) of 171(F), 188IPC U/s Uls 447,171(F) U/s 188IPC, concemed & 9 147,149,323,42 IPC, 125 (R.P 133 (R.P. Act) Acts/Codes Control of use 7,341,504,506,1 Act) & 3(D) involved (give and Play of 71(c) (i) IPC Bihar Control no. of the Loudspeaker use of Section, e.g. Act. Loudspeaker Section...... of Act 1955. A ffie"). Violation of Violation of Violation of Violation of Model Code of Model Code of 7*L ,"ff*N"t Model Code of Model Code of l-. Conduct. Conduct. ,fr kft\+\ Conduct. Conduct. sil r4x \e ,d s )\ ($eAn. jW (e) Whether YES YES YES YES charges have been framed (mention YES orNO) (f) If answer NOT NOT NOT NOT against (e) APPLICABLE APPLICABLE APPLICABLE APPLICABLE above is YES, then give the date on which charges were framed (e) Whether any NO NO NO NO Appeal/Applic ation for revision has been filed against the proceedings (Mention YES orNO)

(6) Cases of conviction : (i) I declare that I have not been convicted for any criminal offence. (Tick 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:' (If the candidate has been convicted, then tick this alternative and score off alternaliive (i) above, and give details in the Table below)

(a) Case No. NOT NOT NOT APPLICABLE APPLICABLE APPLICABLE (b) Name of the court NOT NOT NOT APPLTCABLE APPLICABLE APPLICABLE (c) Sections of Acts/Codes NOT NOT NOT involved (give no. of the APPLICABLE APPLICABLE APPLICABLE Section, e.g. Section ...... of IPC, etc.). (d) Brief desoiption of NOT NOT NOT offence for which APPLICABLE APPLICABLE APPLICABLE convicted NOT p Dates of orders of NOT NOT ! // t 6Qtn APPLICABLE APPLICABLE APPLICABLE .!/ +"\/"!/" td&uion ('^'/ (0\ NOT NOT NOT q;f' I y.ft**imposed APPLICABLE APPLICABLE :fi{ sgrAP) APPLICABLE lQr Whethpilany Appeal has NO NO NO -*(\' s# uEerigtda asainst \c\ ( ./ \\ 'l,':,.J, l:. n, \___-z- /,,,'91r'r'C

\;'-l'6rr', ! \t\ '!,.r --7 -,,.?:f,.,.,:,. -,-;?':d!''l W^*J I (h) If answer to (g) above is NOT NOT NOT YES, give details and APPLICABLE APPLICABLE APPLICABLE oresent status of anpeal

(64) 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).

[candidates to whom this ltem is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), abovel

Note:

l. Details should be entered clearly and legibly in BOLD letters. 2. Details to be given separately for each case under different columns against each item. 3. Details should be given in reverse chronological order, i.e.,.the latest case to be 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 of 201l.

(7) That I give herein below the details of the assets (movable and immovable etc.) of myself my spouse and all dependents:

A. Details of movable assets:

Note: 1. Assets in joint name indicating the extent ofjoint ownership will also have to be given. 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 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. 4. 'Dependent' means parents, son(s), 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. 5. Details including amount is to be given separately in respect of each Investments 6. Details should include the interest in or ownership of offshore assets.

Explanationr- For the purpose of this Form, the expression "offshore assetso' includes, deiaits 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';

S. No. Description Self Spouse Name IIUF Dependen Dependen Smt. Poonam t1: t2z Azad

(i) Rs. 90,259l- Rs.2,536/- NOT NOT NOT APPLIC APPLICA APPLICA ABLE BLE BLE wi(-mxr); '1: €:

(ii) Details of deposit in CitibankNA, CitibankNA, NOT NOT NOT Bank accounts New A/c New Delhi APPLIC APPLICA APPLICA (FDRs, No.05699818005 A/c No. ABLE BLE BLE Term Deposits and Frs.2,07,523.101- s708150225 all Rs. other types of SBI, PHA, NEW 4,48,000.04/- Delhi A/c No. deposits 10023808460. including saving Rs. 3,3 8,841.30/- accounts), Deposits with HDFC Bank, Financial Boring Canal Institutions, Road, Patna Non-Banking A/c No. Financial 0235 l 5300s897 Companies and Rs. 124041.531-l- Cooperative societies and the amount in each such deposit

(iii) Details of Bank of Baroda Escorts Ltd. NOT NOT NOT investment in Bonds, Eq. Rs. 21,978/- Eq. Rs. APPLIC APPLICA APPLICA debentures/shares Gati Ltd. Eq. - 1,16,0701- ABLE BLE BLE and units in Rs.81,7001 Finolex companies/\4utual Himachal Industries Eq. funds and others and Futuristic Rs.24,350/- the amount Communications ICICI Bank Ltd. Eq. -Rs. Ltd. Eq. Rs.

22,t50/- r,38,6231-' l:1 Oriental Bank of Commerce Eq. - Poonam & Rs.7,64,460/- Sons Reliance Industries Fvt. Communication Ltd. Eq - Rs. Ltd Eq. - Rs. 4,10,000/- 10,050/- DSP Credit Sical Logistics Risk Fund - Limited Eq. -Rs. Pis.4,43,373/- 2,016/- Syndicate Bank Eq.- Rs. 86,300/- Tata Motors Ltd. Eq. -Rs. 91,800/-

Poonam & Sons lndustries Pvt. Ltd. Eq. - Rs. 22,10,0001- DSP Credit Risk * Fund Eq. -Rs. 16,45,397 PNB Mutual l-v Fund Rs. tl NC 1.30,000/- * r( tu J .-/ UTI Infrastructure Fund Rs. 4,00,053/-

PPF A/c No. 10819220581 SBI, Rs. 3s.47.93s/- (iv) Details of Birla Sun life Birla Sun life NOT NOT NOT investment in NSS, Insurance Policy Insurance APPLIC APPLICA APPLICA Postal Saving, No. U211269928 Policy No. ABLE BLE BLE Insurance policies Sum Assured 629t132 and investment in 12,00,0001- Sum Assured any Financial Amount Invested 12,00,000/- instruments in Post to Date Rs. Amount office or Insurance 6,00,000/- Invested to Company and the Date Rs. amount. Tata AIA 6,00,000/- Insurance Policy No. U211269928 Sum Assured 50,00,000/- Amount lnvested to Date Rs. 5,00,000/- (v) Personal Mrs. Poonam NOT NOT NOT NOT loans/advance Azad APPLICABL APPLIC APPLICA APPLICA given to any person Rs. 5,00,000/- E ABLE BLn,.. BLE or entity including firm, company, Trust etc., and other receivables from debtors and the amount. (vi) Motor Vehicles/ Scorpio No, DL NOT NOT NOT NOT Aircrafts/Yachts/ ucc 0247 APPLICABL APPLIC APPLICA APPLICA Ships (Details of Model2014 E ABLE BLE BLE Make, regishation Market Value : number etc. 7,50,000/- year ofpurchase and amount). Scorpio No, BR 07PA9900 Model2015 Market Value : 7,65,000

Maruti Eco, DL2CAVS2IO Model2016 Market Value : # 3,30,000 llhl4 e) U,^-,-J WW'+{Ady I

Maruti Ciaz, DL2CAWO29O Model2016 Maruti Value : 7.00.000 (vii) Jewellery, bullion 200 gm Gold 750 gm. Gold NOT NOT NOT and Market Value Market Vale APPLIC APPLICA APPLICA valuable thing(s) Rs. 6,56,800/- Rs. ABLE BLE BLE (give (Approx.) 24,60,0001- details of weight and (Approx.) value). (viii) Any other assets House Hold House Hold NOT NOT NOT such as value of Items/lvlobile Items/IVlobile APPLIC APPLICA APPLICA claims/interest. etc. 1,45,000/- etc. 1,50,000/-. ABLE BLE BLE (Approx.) (Approx.) (ix) Gross Total Value 1,47,21,303.931- 47,92,952.041 NOT NOT NOT APPLIC APPLICA APPLICA ABLE BLE BLE

B. Details of Immovahle Asqets:

Note: l. Properties in joint ownership indicating the extent ofjoint ownership will also have to be indicated. 2.Eachland or building or apartment should be mentioned separately in this Format: 3. Details should include the interest in or ownership of offshore asset3."

Self Spouse TIUF Dependent Dependent s. Description t. No. Name Smt. 1: Poonam Azad (i) Asricultural Land Village- Darhar, NOT NOT NOT NOT Location Survey Mouja Bali APPLICABL APPLICA APPLICA APPLICA number(s). Bagraul, E BLE BLE BLE Bahadurpur Darbhanga NOT Area (Total r/z aCf,e NOT NOT NOT Measurement in (Approx) APPLICABL APPLICA APPLICA APPLICA acres) (8 Kattha 15 E BLE BLE BLE Dhur) Whether inherited NO NOT NOT NOT NOT property (Yes or APPLICABL APPLICA APPLICA APPLICA No) E BLE BLE BLE

NOT Date of purchase in 1. 6-l 1-2010 NOT NOT ' NOT selt (5 Kattha) APPLICABL APPLICA APPLICA APPLICA 2. 20-12- E BLE BLE BLE I 2010 ll+, F^ eoD\. (2Kattha c]I a. l e*c/^*,^--.l Rw(Snni

(ii) Non-Asricultural NOT NOT NOT NOT NOT Land Location(s) APPLICABLE APPLICABL APPLICA APPLICA APPLICA Survey number (s) E BLE BLE BLE

Area (Total NOT NOT NOT NOT NOT Measurement in APPLICABLE APPLICABL APPLICA APPLICA APPLICA acres) E BLE BLE BLE

Whether inherited NOT NOT NOT NOT NOT property (Yes or APPLICABLE APPLICABL .APPLICA APPLICA APPLICA No) E BLE BLE. BLE

Date of purchase in NOT NOT NOT NOT NOT case of self- APPLICABLE APPLICABL APPLICA APPLICA APPLICA acquired property E BLE BLE BLE

Cost of Land (in NOT NOT NOT NOT NOT case ofpurchase) at APPLICABLE APPLICABL APPLICA APPLICA APPLICA the time of E BLE BLE BLE purchase Any investments on NOT NOT NOT NOT NOT the land by way of APPLICABLE APPLICABL APPLICA APPLICA APPLICA development, E BLE BLE BLE construction etc. Approximate NOT NOT NOT NOT NOT current market APPLICABLE APPLICABL APPLICA APPLICA APPLICA value. E BLE BLE BLE

(iit Commercial Azad Bhawan, NOT NOT NOT NOT Buildines 23-B, APPLICABL APPLICA .APPLICA APPLICA (including Krishnapuri, E BLE BLE BLE /, Boring Canal /t Road, Patna- /t" * {e/ 800001 l>l2f .,s r\Yt"%:;7 Or"*r* Saer',HFi}Y Area (Total 7140 Sq ft. NOT NOT NOT NOT Measurement in sq. APPLICABL APPLICA APPLICA APPLICA ft.) E BLE BLE BLE

Built- Up Area 5712 Sq. ft. NOT NOT NOT NOT (Total APPLICABL APPLICA APPLICA APPLICA measurements in E BLE BLE BLE sq.ft.) Whether inherited YES NOT NOT NOT NOT property (Yes or APPLICABL APPLICA APPLICA APPLICA No) E BLE BLE BLE

Date of purchase in Inherited Property NOT NOT NOT NOT case of self APPLICABL APPLICA APPLICA APPLICA acquired property E BLE BLE BLE

Cost of property (in Inherited Property NOT NOT NOT NOT case ofpurchase) at APPLICABL APPLICA APPLICA APPLICA the time of E BLE BLE BLE purchase Any investments on NIL NOT NOT NOT NOT the land by way of APPLICABL APPLICA APPLICA APPLICA development, E BLE BLE BLE construction etc. Approximate Rs. 5,00,00,000,/- NOT NOT NOT NOT current market APPLICABL APPLICA APPLTCA APPLICA value E . BLE BLE BLE

(iv) Residential Katahalwari, NOT NOT NOT NOT buildinqs Ward No. 10, APPLICABL APPLICA APPLICA APPLICA (Including Diwani Takiya, E BLE BLE BLE apartments): Darbhanga. Location(s) Survey number(s). Area (Total 4000 sq. ft. NOT NOT NOT NOT Measurement in sq. APPLICABL APPLICA APPLICA APPLICA ft.) E BLE BLE BLE

Built- Up Area 3200 sq. ft. NOT NOT NOT NOT (Total APPLICABL APPLICA APPLICA APPLTCA measurements in E BLE BLE BLE sq.ft.) Whether inherited NO NOT NOT NOT NOT property (Yes or APPLICABL APPLICA APPLICA APPLICA .a"Ff Wb" E BLE BLE BLE ,/' .r,,3 (\.? Ffp\rchase in 22-tt-2013 NOT NOT NOT NOT crj {_") -a \;vot self APPLICABL APPLICA APPLICA APPLICA \> U Cy' ,i{-rn'ilnertv -;.' i? & -.i, ;..5. \ .^^J '*itj.rir;; S \

E BLE BLE BLE

NOT NOT Cost of proPertY (in 75407501- NOT NOT APPLICA case ofpurchase) at APPLICABL APPLICA APPLTCA the time of E BLE BLE BLE purchase NOT NOT Any investments on 8,00,000/- NOT NOT the land by waY of APPLICABL APPLICA APPLICA APPLICA development, E BLE BLE BLE construction etc. NOT NOT Approximate 1,04,00,000/- NOT NOT current market APPLICABL APPLICA APPLICA APPLICA value E BLE BLE BLE

. NOT NOT (v) Other (such as NO NOT NOT APPLICA APPLICA interest in ProPertY) APPLICABL APPLICA E BLE BLE BLE

NOT NOT NOT (vi) Total current 6,45,12,500/- NOT market value (i) to APPLICABL APPLICA APPLICA APPLICA (v) above E BLE BLE BLE l institutions and govemment:- or individual and (Note: please give separate details of name of bank, institution, entity amount before each item).

IITIF Dependen( 1: Dependent 2: S. No. Description Self Spouse Name Smt. Poonam Azad NOT NOT (i) Loan or dues to NIL NIL NOT Bank/financial APPLIC APPLICABLE APPLICABLE institution(s) ABLE Name of Bank or financial institution, Amount outstanding, Nature of Loan NOT Loan or dues to NIL 5,00,000/- NOT NOT APPLICABLE any other (Kirti Azad) APPLIC APPLICABLE individuals/entitY ABLE other than mentioned above. Name(s), Amount outstanding, nature of loan

liabilitY Rental Rental SecuritY Any other NOT NOT Security 17,20,1001- NOT APPLICABLE 29,27,0001- APPLIC APPLICABLE K#% ABLE fr >t IT ol .b ,3V-'tU* &rqj Grand total of 29,27,200/- 22,20,100 NOT NOT NOT liabilities APPLIC APPLICABLE APPLICABLE ABLE

(i0 Qovernment {ues: (A) Has the Deponent been in occupation. of YES Dues to accommodation provided by the Government at any time departments during the last ten years before the date of notification of with dealing the current election? Govemment accommodation (B) If answer to (A) above is YES, the following declaration may be furnished namely:-

(i) The address of the Govemment accommodation:

25, Pt. Ravishankar Shukla Lane (Canning lane), K. G. Marg, New Delhi-110001

(ii) There -is no dues payable in respect of above Govemment accommodation, towards-

(a) rent: NIL

(b) electricity charges: NIL

(c) water charges : NIL

(d) telephone charges as on l5-03-2019 : NIL

[the date should be the last date of the third month prior,to the month in which the election is notified or any date thereafterl.

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 dealing NIL with government transport (including aircrafts and heliconters) (iv) Income Tax Dues NIL

Self \ Spouse HUF Dependent-1 Dependent-2

(v) GST dues NIL NIL NOT NOT NOT APPLICA APPLICABLE APPLICABLE BLE *M ML NIL NOT NOT NOT APPLICA APPLICABLE APPLICABLE BLE UI Y d*r ,^r--/ VrX"\ tu \3r1fus' * ;1 [ny other dues

Crana total of all Govemment dues

NOT NOT NOT anY other NOT NOT Whether APPLICABLE APPLICABLE liabilities are in APPLICAB APPLICABLE APPLICA BLE dispute, if so, LE mention the amount involved and the authority before

(9) Details of profession or occupation: (), Darbhanga, and match (a) Self : Member of parliament, commentator' (b) SPouse : House wife

(9A) Details of source(s) of incom -i;;rion Income from commercial Building & (a) self , from BCCI, Rental Cricket Match Commentary Fees Building (b) Spouse : Rental Income from Commercial : NOT APPLICABLE (c) Source of in'ornt, if any' of dependents

and any public company or comparies (9B) Contracts with appropriate Government t'"'"i;;;;;iit entered bv the candidate : - "r-Jtitt"Lts

Bhawan, 10-08-2016 Azad 23-8, Sri Krishna Puri, West Boring Canal Road, Patna-800001 Bhawan, 2l-12-2018 Azad 23-B, Sri Krishna Puri, West Boring Canal Road' Patna-800001

detnils of cotrtracts entered into Name of Rental PropertY Detail Validity S.No. Nature of Date of Amount Agreement Agreement Second Partv Bhawan, 9-08- 10-08-2016 D.B.CorP. 2,53,3501- -Azad I Rental Krishna 2025 G Ltd. Per 23-8, Sri 5* Month Puri, West Boring ) Canal Road, g.g W Patna-800001 (-- a ft [4 c G^-*t^ Wrl%) (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 contractso entered into by Partnership Firms in which candidate spouse or dependents are partners : NOT APPLICABLE (f) details of contracts, entered into by private companies in which candidate spouse or dependents have share : NOT APPLICABLE

10. My educational qualification is as under:-

Course comnleted School/Universitv Year of comoletion All Higher Secondary Modem High School, 1977 (CBSE) B.A. (H) History St. Stephens College, 1981 (University of Delhi)

(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.)

PART-B

(11) ABSTRACT OF THE DETATLS GrVEN rN (1) TO (10) OF PART-A:

1 Name of Candidate KIRTI AZAD 2 Full Postal Address 25,Pt. Ravishankar Shukla Lane (Canning lane), K. G. Marg, New Delhi-110001 J Number and name of 40, New Delhi, Delhi constituency and state. 4 Name of Political Party II\DIAI\ NATIONAL CONGRESS. which set up the candidate .(otherwise write 'indeoendent') 5 Total number of Four Cases are pending, pending criminal cases

6 Total number of cases NOT APPLICABLE in which convicted 7 PAN of Year for which Total income last income Tax shown return filed (a) Candidate ADRPA8552D F.Y.2017-2018 37,46,930/- (b) Spouse ADHPA6699M F.Y.2017-2018 17,96,888/- HUF NOT APPLICABLE

Dependent 1 NOT APPLICABLE NOT , NOT F, rh* APPLICABLE APPLICABLE N9: NOT APPLICABLE NOT NOT /a "o"*{t # tA APPLICABLE APPLICABLE t{. c:? ,!.% \A /t{:r -4, {D\ 1 [b\ I WJF, ---1.*f @ N fl4N-#/ # 8 Details of assets and liabilities (including offshore assets) in Rupees Description Self Spouse Smt. HUF Dependent Depende Poonam Azad 1: nt2: A Movable 1,47,21,303.931 47,92,952.04/- NOT NOT NOT Assets (Total APPLICAB APPLICAB APPLIC Value) LE LE ABLE

B Immovable Assets I Purchase 81,93,750/- NOT NOT NOT NOT price of self APPLICABLE APPLICAB APPLICAB APPLIC acquired LE LE ABLE immovable propertv il Development 8,00,000/- NOT . NOT NOT NOT construction APPLICABLE APPLICAB APPLICAB APPLIC cost of LE LE ABLE immovable Property after purchase (if apolicable) m Approximate (a) NOT NOT NOT NOT Current I,45,12,500/- APPLICABLE APPLICAB APPLICAB APPLIC Market Price LE LE ABLE (a) Self acquired assets (Total Value) (b) inherited assets (Total (b) Value) 5.00.00.000/- I Liabilities

(i) Government NIL NTL NOT NOT NOT Dues (Total) APPLICAB APPLICAB APPLIC LE LE ABLE

(iD Loans from 29,27,200/- 22,20,100/- NOT NOT NOT Bank, APPLICAB APPLICAB APPLIC Financial LE LE ABLE institute and others (Total) l0 Liabilities that are under disputes

(i) Govemment NIL NTL NOT NOT NOT Dues (Total) APPLICABL APPLICAB APPLIC E LE ABLE

(ii) Loans from Bank, i.-,fU'r$ry l'g -Financial NIL NIL NOT NOT NOT /1.*:/ Fl(Dl Nstitute and APPLICABL APPLICAB APPLIC r/ cr o) E LE ABLE t7 FAzd HK;, \z,z#/ ffi.\ rc 6,*r-"^J HIGIIEST EDUCATIO sihoor, ullersrtv education ,o,l _tristrest mentioning the tun rorm of the certificate/diploma/degree!9*^1!|,j:1* course, name of the sctrooycoti"lr/uniu"rsif and ir,. in which the course was comnleted-) v*, School/University

All India Higher Modern High Schoot, lCnSe;

St. StephensCollege,@ fuc",-.l DEPOI\ENT

X*a'rimrnRr DHANNAD u'$$ffi

AuthOrlsed l{'l\t1 uls?97 (i) (c) of the Cr. P.C. 19?O (AeI No 11 of 197a) & u/s (8) (iI of the NotariesAct 19S2 t,' ',1et No 53 0f tg5?) VERFICATION

I, the deponent, above named, do hereby veriff and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief and no part of it is false and nothing material has been concealed there from. I further declare that:-

(a) there is no case of conviction or pending case against me other than those mentioned in items 5 and 6 Part A and B above; (b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in item 7 and 8 of Part A and items 8, 9 and 10 of Part B above.

Verified at ...DHANBAD.... This the I?k Day of ...Aptil2019

' DEPONENT

l. Affidavit should be filed latest by 3.00 PM on the last day of filing Nominations. $f4 Z. Affidavit should be swom before an Oath Commissioner or Magistrate of the First dFt'-d"K Class or before a Notary Public. J. should be filled up and no column to be left blank. If there is no qlrl All column \ 31 information to furnish in respect of any item, either "Nil" or "Not applicable", as the case may be, should be mentioned. 4. The Affrdavit should be either typed or written legibly and neatly.'i 5. Each page of the Affidavit should be signed bt' the deponent and the Affidavit should bear on each page the stamp of tne Notary oi Oattr Conliirissioner or Magistrate before whom the Affidavit is sworn. \) \ ila(

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