SL NO. Name of Khasra No., Village/City, Taluk, Sub

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SL NO. Name of Khasra No., Village/City, Taluk, Sub

st STATEMENT OF IMMOVABLE PROPERTY RETURN FOR THE YEAR 2017 AS ON 01 January 2018 1. Name of Officer (in full) : Mr.DHIRAJ KR. AGARWAL 2. Service to which the Officer belongs : SSS 3. Cadre & Batch : CENTRAL SERVICES - 2011 4. Present Pay : 41100 SL Name of Name & Cost of Present value* If not in own name, How acquired Annual income from Remarks NO. Khasra No., Details construction/ state in whose whether by property Village/City, of Property Acquirement name held and his/ purchase, lease**, Taluk, Sub- (Description) (and year her relationship to mortgage Division, when the Govt. Servant inheritance, gift or District purchased) otherwise with in which including of date of property is land in case acquisition and situated (full of house name with details location & of postal address) 1 2 3 4 5 6 7 8 9 1 WEST BENGAL Land 2011 1080000 Yes Sole Purchase Shyam 0 purulia bandwan bihari Agarwal vill- bandwan balarampur purulia bandwan J/L no- west bengal - 4/2/22 18/01/2011 H.K. no-347 bandwan purulia west bengal 723129 6149 Dhiraj Kr. Agarwal Date : 16-02-2018 Signature JUNIOR STATISTICAL OFFICER NOTES: 1) * In case where it is not possible to assess the value accurately, the approximate value in relation to present conditions may be indicated. 2) ** Includes short term leases also. 3) The declaration form is required to be filled in and submitted by every member of Class I and Class II services under relevant provisions of Conduct Rules and the first appointment to the Service and thereafter, at the interval of every twelve months, giving particulars of all immovable property owned, acquired or inherited by him or held by him on lease or mortgage, either in his own name or in the name of any member of his family or in the name of any other person dependent on Government Servant. 4) The wording ‘No Change or No Addition or As in previous year’ may be avoided and all details filled up. 5) All Officers are requested to fill the form in duplicate..

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