q_g!{I~ MAHARASHTRA ~ < tf&lRfr.~cJf ClzUi Form 26 •• (See rule 4 A) AFFIDAVIT Affidavit to be filed by the candidate alongwith nomination paper the returning Officer For election to the COUNCIL OF STATESfrom the elected members of Maharashtra legislativeAssemblyconstituency. PART-A I, RAMDAS ATHAWALE son ofBANDU ATHAWALE aged 54 Years, resident of "37 Savindhan Bunglow", Near Gurunanak Hospltal.. 647 Gandhi Nagar, Bandra (East), Pin Code 400051., a candidate at the above Election, do hereby solemnly affirm and state on oathe as'under:- (1) I am a candidate set up by REPUBLICAN PARTY OF INDIA (A). I (2) My name is enrolled. in 176 Bandra (E) Assembly, Mumbai, Maharashtra State, at ~ serial No. 642 in Part No 221 I • m ~3)My Contact telephone Number IS 9004809627 and my E-mail Id IS I
[email protected] , (4) Details of Permanent and Account Number (PAN) & Status of filling of Income tax Return Sr. No Names Permanent The Financial Total Income Account for which the Shown in Number last Income Income Tax Tax Return has Return been filed (in Rupes 1 Ramdas Athawale AEAPA6269D 2012-13 6,33,0001- 2 Mrs Seema Athwale AHZPA3382P 2012-13 3,09,0001- ,K ,1-'. 3 Smt Housabai Athawale NUl APLICABLE NO'! APL :AH ,F. NOTAP 4 Master Jeet Athawale NOT APTICABLE NOTAP :AR .F NOT APLlCAHLE - (5) I am not accused of any offence (s) punishable with imprisonment for Two years or more in a pending cases (s) in which a charge (s) have been framed by the courts (s) competent jurisdication. If the deponent is accused of any such offience (s) he shall furnish the following information:- i) The Following case are pending against me in which cognizance has been taken by the court:- (a) Case !First information Report No./Nos.