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\\ FORM 26 $oil?4 (See rule 4A) JIt ct resident of. 25, ft. GI Late. Bhagwat Jha Azad 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 Darbhanga, 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 Bihar 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 Delhi 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.