0sc1 FORM 2A (See rule 4) NOMINATION PAPER Election to ihe House of the PeoPle
p-- 1n-rn.i-- *{r J lit *
STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE PART I (To be used by candidate set up by recognised political party)
I nominate as a candidate for election to the House of the People from the..1:.2AMAN. ....k. ..).t.U.M. CN)..Parliamentary constituency. PATEL Candidate' n"m".BlTE!"..-L/1.LU.B.HAl...RABUDlrFaher's/motherslMs name. . |KU.TIRz)g'dAaal .RAB.UBliAl..... His postal address tl:l'19:29.k.h,f'A'D.Rl fl uA./.R*s.$t.AAM,NANl bAMANAI62lo His name is entered at s.No..l2.?...... in Part No...10...... of the electoral roll in) Parliamentary for.L. 1 * U*rt..& I t U.l! -Constituencv. il;; is.T..+rl.).EL).E-E.P.E]!/...T.H2!9.5W# ,t is entered at S.No. 1.3.0""i n Part No..f ?...... or the electoral roll for ..1.-..D.&nN-'t....A..j.!.1)"(6gf')'.t""tt'uy-"tttstl enmlrised withil) ...... Parliamentary constitue n I
D"t" ?.q.l.q-g-l?o 19 roposer
PART II (To be used bY candidate NOT up by recogrrised political panY)
We herebY nominate as candi for election to the House of the People from +L^ P iamentary ConstituencY Candidate's name ...Father's/mothcr's/husband's n4me...... His postal address
1 His name is entered at S.No ...... in Part No..... of the electoral roll for 1(Assembly constituency comprised within) Parliamentary constituency
We declare that we are electors of the above Parliamen stituency and our names are entered in the electoral roll for that Parliamentary Consti bncy as indicated below and we append our signarures below in token of subscribing to thi omtnatlon:-
Particulars of the proposers d their signatures S[.no. Name of Elector Roll No. Full Name Signature Date component Proposer Assembly Part No. of )No. in Constituency Electoral Roll fhatoan 2 4 5 6 7 l. ) 3. 4. 5. 6. 7. 8. 9. l0 N.B.- There shoul ten electors of the constituency as proposers
PART III I, the candidate mentioned in Part I/Part-ll (Stdke out which is not applicable) assent to this nomination and hereby declare- (a) that I am a citizen of India and have not acquired the citizenship of any foreign State/country. (b) that I have completed...... 6.9. .years of age; ISTRIKE OUT c(i) or c(ii) BELOW WHICHEVER IS NOT APPLICABLEI (c) (i) rhat I am set up at this election by the...BHA.RA.Il yA. .. JA/.{A.IA.. pany, which is a recognised National Party/Sgre+arty in this State and that the symbol resen'ed for the abovc party bc allotted to me. OR ) rJO0l-
(c) (ii) that I am set up at this election by t party, which is a registered-un ognised political party/that I am contesting this election as an independent idate. (Strike out which is not applicable) and that the sr..rnbols I have chose in order ofpreference, are:- (r...... ,. (jr. (,,,) (d) that my name and my father's/mother's/husband's name have been correctly spelt out auore in...€N.6 .L!.|H.. ... (name of the language); (e) that to ihe best of my knowledge and l-,cliel I am qualified and not also disqualified for being chosen to fill the seat in the House of the People.
+I further declare that I am a of the...... , +*Caste/tribe which is a scheduled **caste/tri the State of. ,....in relation to in that State I also declare that I have not been, and shall not be nominated as a candidate at the present general election/the bye-elections being held simultaneously, to the House of the People from more than two Parliamentary Constituencies.
Date-?.c4.0-3.1.:. o I 9 Signature of andidate rScore out the words "assembly constituency comprised within" in the case of Jammu and Kashmir, Andaman and Nicobar Islands, Chandigarh, Dadra and Nagar Haveli, Daman and Diu and Lakshadweep *Score out this paragraph, ifnot applicable. t+Score out the words not applicable. N.B.-A "recognised political party" means a political party recognised by the Election Commission under the Election Symbols (Resewation and Allotment) Order, 1968 in the State concemed.
PART IIIA (To be filled by the candidate) (l) whether the candidate- (i) has been convicted- (a) of any offence(s) under sub-section ( I ); or (b) for contravention of any larv specified in sub-section (2), of section 8 of the Representation of the People Act, 195 I (43 of I 95 I ); or Y^' (ii) has been convicted for any other offence(s) for which he has been sentenced to imprisonment for two years or more, 3
t If the answer is "Yes", the candidate shall fumish the following information: (i) p.p.Ll.CAp.!=e Case/first information repo( No.Atos.. N 0.T . .. A .... (i!) Police station(s)... .. AI0 :f . .. . A.p.p.L.l 9 *.D.LE .. Distric(s).f{07..n?.P.1-.1C4.ht .A.Statels;...N0.?...Afl.pt1CARIF...... (irr) section(s) of the concerned Act(s) and bnef description of the offence(s) for which he has been conv i cted...... N. 0.7. .. b.P.p.L l.e.A.h L e.. ...
(iv)Date(s) of conviction(s) . NQ f ... *.?.?. L!.c AR L€ (v) Court(s) which convicted the candidate.NiT..ADt)!..tc.F.BL€...... (vi)Punishment(s) imposed Iindicate period of imprisonment(s) and./or quantum of fi ne(s)1... N 07.. a 0pLt.cAnt€... (vrr) Date(s) of release from prison.....N.0.T.. A.l.Q.L-t.efrfrL-e (viii)Was/were any appeal(s)/revision(s) filed against above conviction(s)...... YcVr.Io (,-r) Date and particulars of appeal(s/application(s) for revision filed..f(.gz..Appl=l.cARt-E
(;r) Name of the court(s) before which the appeal(s)/apptication(s) for revision filed...N0.Z ....A.P.P.1-t.CA.B !-8...... (,rr) whether the said appeal(s)/applicalion(s) for revision has/have been disposed of or is/are pending...l,l 07 h ll L t gAr5LE (xil) If the said appeal(s)/application(s) for revision has,4rave been disposed of_ p0.Ll.(.A.BLC (a) Dare(s) of disposat. .. . N 0 1.. A (D) Nature of order(s) passed. .l!.? L . A.P. P.f J. C,a BC -E . (2) whether the candidate is holding any office ofprofit under the Govemment of lndia or State Government?...... ()e6alo; yes, -If detai ts of theoffi ce held...r)l 9_7:.. .. Al P !.t gn l3ue (3) Whether the candidate has been declared insolvent by any Court?...... ()e6nVo) -lf Yes, has he been discharged fiom insolven cy..N0.7. Ap? Ll cAbLE (4) whether the candidate is under allegiance or adherence ro any foreign country?...... ()eSNo)
-lf Yes, give detaits...... N9.f .. A ?.l? !.1.q4 B.LE .... (5) whether the candidate has been disqualified under section gA ofthe said Act by an order of the President?...... (pstNol -lf Yes, the period for which disqualified.,.fl.Q.I..4. PPf.!.q.4.R. !.8_.. (6) whether the candidate was dismissed for comrption or for disloyalry while holding office under the Government of India or the Covemment of any StateZ ...... (!X?I,lo) -If Yes, the date of such dismissal ...|:,lCT..A.P.PLIcARLe (7) whether the candidate has any subsisting contmct(s) with the Governmenl either in individual capacity or by trust or pa(nership in which the candidate has a share for supply 4 .i001
of any goods to that Govemment or for execution of works undertaken by that Government?-...... ()efmo; -lf Yes, with which Govemment and details of subsisting contract(s).. Nc).T...4.1D. !,!.c.8 ttLE
(8) Whether the candidate is a managing agent, or manager or Secretary ofany company or Corporation (other than a cooperative society) in the capital of which the Central Govemment or State Govemment has not less than twenty-five percenr share?...... (Y7,clno) -[f Yes, with *hich Gorernment and rhe details thereof ... N?.T... *! !..9.1.34 n l€ ....
(9) Whether the candidate has been disqualified by the Commission under section l0A of the said Act...... gefl{o)
-lf yes, the date of d isqualifi cation... lt{QT.. . 4.?P .L l.< a B,L..
Ptt(.;e: .?.A.n.4.N.. Signature of Candidate oate: .tgt.otlzo lg
PABT IV (To be Slled !y the Rqturning Officer) Serial No. of nomination pup", ..Ql.l..k.P./..H.l1lRO b4' This nomination was delivered to me at my office at.t2-4 ....(hour) on....T/Oflmf .(date) by the *candidate/prepos€r. (name of proposer ...... )
,*" 3jqdttr R mrng flicer
PART V Decision of Returning Officer Accepting or Rejecting the Nomination Paper I have examined this nomination paper in accordance with section 36 of the Representation of the People Act, I 95 I (43 of I 95 I ) and decide as follows:-
Date Retuming Oflicer (Perforation) 5
i eo*. ptg. fi'ess, Daman.- 03/2019 - 15O-
.- ;+.'.. I
\
AFFIDAVIT
of
PATEL LALUBHAI BABUBHAI H. No. 2O6-G, Sabri Kutir, Dungri Falia, Kachigam, Nani Daman, Dist-Daman, Rs. 100 ). 'k6TiltrqilI :. I ONE )- 100 HUNDRED HUPEES |.' F{iqqqt ,:\ l o(r TTVil INDIA .}a)1c)c!!! I 1 ()C) -. ) ,? ()c)c)(. , ( N ,-,!()O1 )( ) \, I .,.
ertrfl il.I d[q. I AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH ilOMIIYATION PAPER BEFIORT THE RETURITING OFFICER FOR ELECTIOIY TIO THE HOUSE OF THE PEOPLE (LOK SABHA} FROM 1 - DAMAN & DIU P/IRLIATf,ENTARY I COI{STITUENCY I I I I I fk i E *geJA ,)),:;!.-_ I I oTA n P &. (. lAJiir,r'tijrli!!L) i : |,,,ltt ,:, o c,.l { R€9 rro il rT lN!,A o( Serial No. 73289 Daman Treasury, dated 25-Mar-20'19 Value of Stamps Papers Rupees ONE HUNDRED Name of the Purchaser IALUBHAI B PATEL of Residing at KACHIGAM' NANI DAMAN son/wife Agent MAYUR D HALPATlPurpose Affdaldls Name of Parties to the Transaction sought - N. A"ty - Signature of Purchaser Signature of Treasurer Ve. . -*8afr PART A I, PATTL LALITBIHI BABITBIIAI, son of PATEL aABITBHAI G/TNDABIIAI Aged 63 years, resident of H. No. 206-G, Sabri Kutir, Dungri Falia, Kachigam, Nani Daman, Dist-Daman, a candidate at tl1e above election, do hereby solemnly alfr.rm and state on oath as under:- (1) I am a candidate set-up by Bharatiya Janata Party. (2) My name is enrolled in I - Daman & Diu Parliamentary constituency, u.T. of Daman & Diu at Serial No. 127 in Part No.70. (3) My contact Telephone Nos. are (Ol 0260-2230789 (M) 9825122858 and' My E-mail ID is [email protected] and My Social Media accounts are - Facebook - [email protected] (Lalubhai Patel) - TWitter - [email protected] @Lalubhai0O7) (4) Details of Permanent account Number (PAN) ald the status of filing of Income Tax Return Sr. Narne s PAN The Financial year Total Income No. for which the last shown in Income-Tax retum Income Tax has been filed Return (in Rs.) 1 Lalubhai Babubhai Patel ABRPP3684M 20t7-14 6,69,168 2016-t7 8,84,602 2015- 16 49,56,814 2014-15 I0,45,253 2073-14 to,77,469 2 Tarunaben Lalubhai Patel ABRPP36O9A 20t7-18 7,35,185 2016-77 7,36,325 20 15- 16 5,41,068 20t4-15 4,5t,203 2013-14 4,3t,741 Gaurang La-lubhai Patel AQAPPl664R 2017-18 13, 1 1,466 L3 20t6-17 9,48,865 { I 2015- 16 9,79,316 r 2074-15 13,27,a45 2013-14 13,21,540 4 Shivangini Lalubhai Patel DFPPP6409R 2077-la 3,50,127 20L6-17 2,52,651 2015- 16 Not Available 20t4-15 Not Available 2013-14 Not Available o'rA n I [k, RA,lli nl i i irllD!L I r,l.: N ! crJ o R€9 rlo 08 ci t4 o( >-il,r 44 d", i- j j o 't- Re9 IN 0ta ( it1 o ( (5) (t| I declare that there ls ao peadlag crlmloal case agalnat me. or (iif The followlag Crlmlnal casea ere pendlag agalnst me : --.- NOT /IPPLICABLE .... (6) (tf I declare that I have Dot beetr coavlcted for any crlmlnal offeace' OR (ttl I have beer cotrvlcted for the offeaces Ee[tloned below : .-.. NOT APPLICABLE .... (6A) NOT /IPPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i) above (7) That I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all dependents : A DETNLS OF MOVABLE ASSESTS: s. Deacrlptloa Self Spouse Depeldeut Depeadeut No. 1 2 Natae: NaEe: Name: Taruaaben Gauraug Shlvanglnl I Cash in hand 925,630 856,230 7 56,230 6,520 1l Deposlt la Baaks, Fluanclal Inrtltutloa and l{on-BaaLlag Flnanclal Compadea The Goa State Co-op. Bank Ltd. - 905 7 ,207 NIL NIL NIL The Goa State Co-op. Bank Ltd. - 162 NIL 31,301 NIL NIL The Goa State Co-op. Bank Ltd. - 270 NIL NIL t38,223 NIL The Goa State Co-op. Bank Ltd. - 290 73,015 NIL NIL NIL The Goa State Co-op. Bank Ltd. - 289 NIL 318,819 NIL NIL The Goa State Co-op. Bank Ltd. - 1556 NIL 3,607 NIL NIL The Goa State Co-op. Bank Ltd. - 239 NIL NIL 643,298 NIL State Bank of India - 9270 23,844 NIL NIL NIL Auto Swipe Fixed Deposit - SBI with Link 27,OOO NIL NIL NIL A/C. No. 9270 State Bank of India - 50631 NIL NIL 1t3,37 4 NIL ICICI Bank - 3279 NIL 204,646 NIL NIL The Goa State Co-op. Bank Ltd. - 288 NIL 91,234 NIL NIL The Goa State Co-op. Bank Ltd. - 2268 NIL NIL 61,534 NIL The Goa State Co-op. Bank Ltd. 1953 NIL 6,316 NIL NIL HDFC Bank - 01301000010758 NIL 2,036,709 NIL NIL HDFC Bank - 01301930003505 NIL NIL 1,204,415 NIL HDFC Bank - 50200008283233 NIL NIL 1 13,164 NIL HDFC Bank - 01308620000063 NIL NIL 495,363 NIL HDFC Bank - 01301530008210 NIL NIL NIL 5,804 t,47 4 i\ HDFC Bank - 50200021555451 NIL NIL NIL 37 ,J T.1.t i.. t'.t lr ,,, t# W \a ?lJ\ rlr r 3 iAlrt - & o J al "'rN a ! Sl DAf,rA\ L R.g No 06ic/ a: >-u. -.,,; 1,,!il r1 e Iu Details of investment in Bonds, NIL NIL NIL NIL debentures/ shares and units in companies/ Mutual Funds and others and the amount. lv Other Financial instruments NSC, Postal NIL NIL NIL NIL Saving, LIC, Policies, etc. Personal loans/advance given to any person NIL NIL NIL NIL or entity including frrm, company, Trust etc. and other receivables from debtors and the amount. vl Motor Vehlcles (detalls of aake, etc.l Honda Brio DD-03-AA0027 NIL 425,303 NIL NIL (Held in Sabri polypack) Maruti Swift DD 03 AC 0027 708,997 NIL NIL NIL (Held in Sabri polypack) Honda Civic DD 03L 0007 336, 104 NIL NIL NIL (Held in Sabri polypack) Honda CRV DD-03-Z-0001 1,353, r02 NIL NIL NIL ( Held in Sabri polypack) Honda Civic -DD-03M-0007 NIL 578,208 NIL NIL Innova Crysta - DD-03-AJ-0007 NIL 2,087,430 NIL NIL Maruti Alto-DD-03-M-0034 NIL NIL 89,003 NIL Maruti 800 - DD -03-3132 NIL NIL 83, 16I NIL Fortuner - DD-03-AK-000 I NIL NIL 4,25t,543 NIL Fortuner - DD-03-AD-0007 NIL NIL t,223,453 NIL Gypsy - DD-03-AK-0027 NIL NIL 57 6,7 t3 NIL Tata Tenker -DD-03-J-9439 NIL NIL 90,61 1 NIL (Sai Water Suppliar) Tata Tenker -DD-03-J-9619 NIL NIL 306,739 NIL (Sabri Petroleum) Ninja bike NIL NIL 31,355 NIL vlt Jewellery (give Details of weight and value) 135 grns 451 gms Nil 148 Gms 372,600 1,333,945 NiI 439 ,O7 5 vrl Other assets, such as values of claims/ interests Bijal Bar & Restaurant r27 ,229 Nil 634,799 Nil Pragati 835,01 I Nil 46,185 Nil Sabri Builders 956,160 1,353,042 Nit Nil Sabri Poly Pack 3,470,481 790,722 Nil Nil Fancy Wine Nil 3,807,470 2,O17,764 Nil Chandan Complex (Land & building) Nil I,77 5,634 Nil Nit Arms: Rifa.l & Gun 22,7 t7 Nil Nil Nil Revolver 16,227 12,500 18,400 NiI l.-ix GROSS TOTAI VALUE 9,255,324 15,713,160 t2,495,327 422,473 C I.i l i W RAJIl(lrrT 0 iAlDEl. --lF L rr.llN I 0 Ll o Reg No oB o/ I iNOIA ( EN1 o $d, I DcrcdpUoE aGlf spoulc{r} DcpGrdGDtl Dcp.rilclt 2 N.E.l.l, IIrec! N.E.! Trrur.ber al Lrad I -t cation(s) - kachiaam - Survey numberls) - lol2&Al2 Area (Total hcasurementl - 5500 sq. Mtrs. ' whether mh€rited prop€rw - No - Date of Purchas€ - 15.06.2006 - Cost of hnd at t}]e tim€ of purclEse 7,I I,945 'Any rnvestment on land by way of D€velopment,construction Etc -No - ADporoximate Current market value 5,775,OOO a Location(s) kachisam - Sufley numb€r(s) - 32ll - Arca (Total measurementl - l200sq Mtrs ' Whether inherited DroDertv - No - date ol Purchase - 22.05.2006 - Cost of Land at the time ot purchas€ - 2,4O,0O0 -Any inv€stment on land by way of Development,construction Etc -No - Apporo,'cimat€ Cuftent market value I,260,OOO t - Lcationlsl - kachigam - Survey numberlsl - 8/1 Area (Total measurementl ' l500sq Mtrs - whether inherited prop€rty - No - date of Purchas€ - 25-12-1992 ' Cost of Land at the time ofpurchase 3,00,000 -Any investment on land by way of Development,construction Etc. - No - Apporoximate Current market value t,575.000 - tocalion(sl kachisam - surv€y numb€r(sl - Al3 Area (Total measurementl l300sq Mtrs - Whether inherired prop€rty - No - date of Purchase 25.12-1992 - Cost of tand at the time ofpurchase - 2,60,000 -Any investment on land by way of Development,construction Etc. - No - ApporoxitDate Cu.renl market value 1,365,000 - [ocatron(sl - k€chicam - survey number(s) - I00 B - Arca flotal measurement) - 467so Mtrs - whetler inherited properw No - date o[ Purchase - 22.05.2006 - cost of tand at rhe rime oI purchase - 93,400 -Any investment on land by way of Development,constructlon Etc -No - ApDoroximate Current market value 245,t75 245,t75 - tcation{s) - kachisam - Survey numberls) - 78 - AIra l'total measuremen0 ' 6600sq Mtrs - Yhcther inherited property - No -dat of Purchase - 17.11.2005 - CGt of Land at the time of purchas€ 13,20,000 {ay investment on liand by way o[ Development,consEuction Etc, - No - ApDoroximate Current market valu€ 3,465,000 3,465,000 - laationls) - kachigam - Sl'vey number{s) - 7912 - AtEa tTotal measurement) - l300sq Mtrs -Ihcther inherited properw - No -a.t of Purchas€ - 22.05.2006 - Go.t of land at the time of purchas€ ' 3,00,000 &t investment on land by way of Development,conatructron Etc. - No - boroximate Current market value 682,500 6a2,500 - f.@uon(sl - kachiAam - slrvey numb€r(s| - 99128 -,kra fTotal measurement) - I050sq Mtrt - lhrher inherited properw ' No -t of Purchas€ - 22-05-2006 Ood of tand at rhe time of purchase - 2,10,000 investment on land by way of Development,construction Etc. - No boroximate Cunent market value 55r,250 551,250 Ietion(sl - kachisam 3Ercv numb€r(sl - 3212 tra fTotal measurementl 4000sq MEs !t tler inherited prop€rty - No -tG of Purchas€ - 22.05.2006 o[ Land at the time ofpurchase - 8,00,000 t on land by way of D€velopment,construction Etc. - No ate Current market value 2,r00.000 2, r00,000 ,\ W {. RAJN (TI:i B IAiIDEL lr /.N!/\N a 0 LJ j: o ! sT DA',,',rlt R€_o No !3r,1/ DIA ( N1 o z---4.: I v{' ' -', i 1r;1,: 1,,\,': r\CLt ,) lo Lcationls) kachigam - Suwey numb€rls) - 79ll Area (Total measuremeno - 560osq Mtrs - Whetler mherited property , No - dat€ of Purchase - 22.05.2006 - Cost of Land at the time of purchase I I.2O,OOO Any inv€stment on land by way of Dev€lopment,construction Etc. - No - Apporoximate Current market value 2,940,000 2,940,000 II -t cation(s) - kachkam - Strrvey numberld - 9 ' Ar€a [rotal m€asurementl - 7900€q Mtrs ' Whether inherited property - No - date of Purchas€ - 17.11.2005 - Cost of Land at the time of purchas€ - I5,80,OOO -Any investment on land bv way of Developmenr,conslruction Etc. - No - ApDoroximate Current market value a.295.OOO - t crtion(s) kachi*aE - Survey numb€r(s) - 30 - Area (Total measurement) - 700sq Mtrs - Whether inhented prop€rtv , No ' dat€ of Purchas€ 09.O2.2O1O - Cost of Land at the riDe of purchase - I,05,OOO -Any investment on land bv way of Development,coflstruction Etc, -No - Apporoximate Current market value 735,000 - Location(sl - kachisam - Survey number(s) - 4llll - Area {Total m€asuremenr) - 1566.66 sq Mtr€ lll6t} Share of94OO Sq. mtrs.l - Wh€ther inhe t€d property, Ye€ - date of Purchas€ - Nil - Cost of Land at the trme of purchase , Nil -Any investrnent on land by way of D€velopment,construction Etc. , No - Apporoxlmate Current market value 1,645,000 - Lcation(sl - kachigam - Survey number(sl - 49)./2A - Arca {Tot l measurem€nt) 258.33 sq Mrrs ll/6th Share of 1550 &. mrrs.t - Whether inhented DroDertv Yes - date of Purchase - Nil - CoBt ofLand at the tifte o[ purchase - Nil -Any investment on land by way of Development,construction Erc. - No - Apporoximate Current market value 271,250 - Locatronls) kachuam - Survey numberls) - 372 - Arta (Total measurementl - 20sq Mtrs (1/5th Share of t00 Sq. mr!s.) - Whether inherited properf - Yes - dat€ ofPurchase - N - Cost of Land at the time ofpurchase , Nil 'Any mvestment on land by way o[ Dev€lopm€nt,construclion Etc. , No - ADporoximate Current market value 2 r,000 TqTAL - 22 531 t75 1a 78 925 Lrnd - r.Eation(s) ' kachisam - Surv€y numb€r(s) - 3421A - Arla (Total measurement) - 450sq Mtrs - VlEther inherited proDerty - No - drtE of Purchase - 23.08. t9a5 - Cct of land at the time of purchase , 1,80,000 day investm€nt on land by way of Development,construction Etc. - No - AForoximar€ Current mark€t value 630,000 - Ldtionls) kachiqam - Srrvey number{s) - 3731A -t.. frod measurement) l000sa Mtrs - Ibther inherired prop€rry - No - -E of Purchase 06.03.1996 - Gd of Land at the time of purchas€ - 4,00,000 It invcstment on land bv way of Development,construclion Etc. . No - borcximate Current market value 1,400,000 - lation(s) - kachigam turlv n'imberls) 347 -&. (Iotal measurementl - 2 500sq Mtrs lhrher mherited prop€rty - No -06.03.1996 of Land at the time of purchas€ r0,00,000 iavcstment on land by way of Dev€lopmenr,construction Erc. , No t€ Current market value 3,500.000 'il h. ,IAIrD!l (-- qAiNlri,lti 3. I T I cr r:lAN s c,U I sT oai,lAfi Reg l{o 081f: INDIA l- IT O I : 1,1"c - I I (' l,lNlr,:' o sl oa't"r'i t/ 4'{r"JD\ + - Locationls) - kachuam - Survey numberls) - 40417 - Area flotaL measurem€ntl - t700sq Mtrs - Wh€th€r inh€ritcd Droperty - No - date of Purchase - 18.05.1944 - Cost of tand at the time of purchas€ 6,80,000 -Anv investm€nt on land bv way of Developm€nt.construction Etc. _ No - Apporoximat€ Curreflt narket valu€ 2,380,000 t - facation(s) - kachigan Survey numberlsl - 39913 - Area lTotal measur€ment) - 525sq Mtrs - whetier inherited properw - No date ofPurchase - 02.06.2006 Cost of tand at the time of purchase 2, 10,000 'Any investnent on land by way of Developmefll,construction Etc. ' No - Apporoximate Current market value 367,500 367,500 a 't cation(sl ' kachiEam - Survey number(sl - 34217 &34218 . Area I'Iotal mearurementl - Isoosq Mtrg - whether inherited properw - No - date of Purchas€ L3.OA.2OO2 - Cost of Land at the time of purcha8€ - 6,00,000 'Any investment on Iand by way of Dev€lopment,construction Etc. - No - Apporoximate Current market value 2,l00.ooo ., t cationlsl kachiaam - Surv€y number(s) - 37112 AIea fiotal measurement) 535sq Mtre - Whether inherited propenv - No - date of Purchas€ - 3O.10.2OO7 ' cost of tand at th€ time of purchas€ ' 2,I4,OOO 'Any investment on land by vray o[ Devclopment,constructron Etc. _ No - Apporoximate Current market value 374,500 3?4,500 a Locatron(s) kachigam Survey number(s) - 350/A - Ar€a lTotal measurement) - TOOsq Mtrs - Whether inh€rited prop€rty - No - date of Purchase - 24.06.2004 - Cost of Land at the trme of purchase - 2,80,000 -Anv investment on land by way o[ Development,construction Etc. _ No - Apporoximale Current market value 980,000 -t cation{sl - Kachiaam - Survey numberls) - 32128 - Ares {Total measuremend - 1550s4 Mtrs whether inhented oroDerty - No ' date o[ Purchase 22-05-2006 'cost of LaEd at the time ofpurchas€ - 3,a7,500 -Anv inv€stmenr on Iand by way of Dev€lopment,construction Etc. - No - ADporoximate Current market value 1,08s,000 I,OA5,000 - Location(s) - Kachqam - Survey number(s) - 69 - ArEa Ootal measurementl - 4600 sq. Mtrs - whether inherited property - No ' date of Purchas€ 12.09.2008 - Cost ot tand at the time ofpurchase _ II,50.0OO -Any investment on land by way of Development,construction Dtc No - ADporoximate Current market value 14,490,000 - L,@tionlsl - Kachisam - Survcy numb€rls) - 23613 - Arla flotal measurem€nt) - 400 sq. Mtrs - Yh.th€r irherited DroDertv ' No - datc of Purchase - 15.09.2009 - Cct of t and at rle time of purchas€ - I,00,000 Jrv investment on land by way of Development,construction Etc - No - ApFmximate Current market value 560,000 - ldtion(s) - Kach4am - $rv€y number(s) '297/l -&ta lTotal measurement) - 1000 sq. Mtr€ - fb.ther mheriled properw - No - -r. of Purchas€ - 10,04.20t1 - Cd ot knd at the time of Durchas€ - 2,50,000 &y invcstment on land by way of Development,construction Etc. - No - brcximate Current market valu€ t,400,000 \ I .)' -.-4.| l ! W- i, r.li. ! :irit;- t' LSl 8€q .,4 $rt. i1- lt i o' ils: li" , :/ Rc! ri '! l INJiA L---- $d. I -\' Locationls) ' D€vka - Survev numbcrls) 45lr3l2) - A,ra ftolal mea8urem€nt) '5OOsq. Mtrs - whether inheriGd proEcrtY ' No - date of Purchasc 16.07 -2012 - Co3t of Land at th€ time of purchas€ - 2,00,000 -Any invcsrm€nt on land by way of Developmcnt.con8truction Etc. - No - Apporoximatc current market valu. 525,000 . Locetionls) - Devka - Survcy numb€rls) - 45/ r3(3) - Arca flotal measurement) - 500 sq. Mtrs - wheth€r inh€rit.d propcrw - No - datc of Purchase - 16.0?.2012 . Co.t of Land at lhe time of purchas€ 2,00,000 -Any invcsrment on land by way of D€velopm€nt,construction Etc. - No - Apporoxrmatc Currcnt market valu€ 525,000 - Leation(!) - Devka - Suwcv numb€r(s) - 45/13(41 - Arla (Totat me!.urem€nt) - 50O sq. Mtrs - Whelhcr inhcritcd property - No - &r€ of Purchas€ - I4.ll.2OII - Colt of Land at the time of Durchasc - 2,00,000 -Anv investment on land by way of D€v€lopment,conBtruction Erc. - No - ADDoroximate Current market value 525,000 ' Leeuonls) - Fort Area - Survcy number(sl 7414-i . Arta Ootal measurementl - 9OO sq. Mtrg - whcther mherit€d proDerty - No - dat! of Purchas€ - 17 .O4.2O13 - Colt of land Bt the trme of purchas€ - 26,62,5501- -Anv investmenr on land by way of Development,construction Etc. - No - ADDoroximatc Curr€nt market value 3,727,570 - tmtion(sl - Kachisam - Survcy numbcr(sl - 3OAl2 - Ara ftotal measuremeno 2350so. Mtrs - Yhcth.r inheflt.d propcrty ' No - &t of Purchase - 23-O4.2OIO - Cst of t,and at th€ time of purchas€ - 15,84,670/_ -ADy inyastm€nt on land by wav of Dcvclopm€nt,constructron Etc, - No - ADForoximate Current market valu€ 3,290,000 - ldtion(sl Fort Area - Suwlv number(sl - 7414-All - AItr lTotal mcasurementl -895sq MtIs - IlEaher mherited property - No - &rG of Purchase - l7.O4.2O13 - Cd of L.nd at the tim€ of purchasc - 26,62,5501 dlt invcstmcnt on land by way of Developmcnt,con6tnrction Etc. - No - ADFoxirnate Current market value 3,727,570 - Lation(.| kachiRam - srEy numb.rls) - 414/ | -,k lTotal measurcmentl - 10200 so Mtrs - thhcr mhented property - No -&ofPurchas€ 29-O4.2OO3 -Gi of land at the time of purchase - 20,40,000 urvGltment on land by way of Dev€lopment,construction E!c. - No --r bo.uirnatc Current market value 10,710,oo0 - ldabnlrl kachigam --*, numb€rls) - 297 /3 -t Gotal measurement) - 850sq Mtrs Elr inhcritcd prop€rty ' No - 29.t21992 d Lend at the time of purchas€ ,8s,000 iiatmcnt on land bv vay of Developm€nt,construction Etc. _ No Current market value TOTAL - 949 500 44 I 9,20 7 t7 570 * r- tu 8 14uD5 't "li.(r,{T'rr-aMAaaDrJ 0rsI oa^f^f! R.g iloO!/Ol lliDla ( l, FNT o ,..., ,l Nd. i,l.l\ {;ri l 3 l;rirr: r ! :rlAr' i' D r,5i DAl,liri Re! No !i Lr INf A o( i, F r11 9d : ." " - ,.\ . c. /: 4FnJa .\ Othc (such as interest in DroDertvl I -t cation(sl - kachiqam - Surey numb€r(sl - 366/27 PIor No.38 - Area (Total measurement) - 1250 sq Mtrs - Built of Ar€a - 634 sq mtrs -Whether Inherited - No - date o[ Purchale - 25.O9.t997 Cost of Property ar the time of Purchase - l,26,8OOt- Any inv€stment on land by way oI Development,construction Etc. - 13,73,200I - Apporoxim ate Current market value 1,968,7s0 r,968,750 lsabn Polr.pack) 2 - lrcationls) kachieam Surv€y numb€rls) - 387 -Area lTotal measurem€nt) ,3500 sq mtrs - Built of tuea - 1000 sq mrrs whether Inh€rited , No - date of Purchase , 06.03.1996 ' Cost of Property at the tlm€ of Purchas€ - S,OO,OOO/ -Any investment on land by way of Development,constructio[ Etc r0,00,000/ - Apporoximate Current market valu€ 4,900,oo0 bri TMAL . 6.a6a.7AO 1,954,750 Tot.l of crr?crt mltket vaul. of 4G.769.425 7O,3O4,595 4,2e7,57O 10,38a.1aO s ?,- sl .,. ,. 4- I qAJN',.'i- 3. i;,',Cl I a Re! Ic a:r.' IND A A,; (8) I give herein below the details of liabilities/dues to public frnancial institutions and govemment:- s. Descrlptlon Self Spouse Deperdent Dependent No. 1 2 Name: Name: Name: Taruaaben Gaurang Shlvanglnl (i) Loan or dues to Bank/ Nil Ni1 Nil frnancial institution(s) Name of Balk or Financia-l Institution, Amount outstanding Nature of loan HDFC Bank, Commercial Nil Nil 261,201 Nil Vehicle Loan HDFC Bank, Vehicle Loan Nil Nil 2,709,416 Ni1 The Goa State Co. Op. Nil 896,735 Ni1 Nil Bank, Vehicle [,oan (Innova Crysta) HDFC Bank, Shop Loan Nil Nit 3,351,081 3,351,O81 Loan or dues to any other individuals/entity otber thal mentioned above. Name(s) Amount Nil Nil Nil outstanding, nature of loan Sabri polypack, HDFC Auto Nit Nil Nil Nil Loan Any other liabilify Nit Ni1 Ni1 Nit Grand total of llabllltles 896,735 5,72L,698 3,351,O81 (ii) Government Dues: Dues to Nil Nil Nil Nil departments dealing with government accommodation (iii) Dues to department dealing Nil Nil Nil Nil with government transport (including aircraJts and helicopters) (iv) Income tax dues Nil NiI NiI Nit (v) GST Dues Nil Nil Nil Nil (vi) Municipal / Property Dues Nil Nil Nil Nit (vii) Any other dues Nil Nil Nil NiI (viii) Grand total of all Govt. dues Nil Nil Nil Nit (ix) Whether any other liabilities Ni1 Nil Nil Nil are in dispute, if so, mention the amount involved and the authority before which it is pending AJi] I,J I;i i IAND Ar,uN i 0, ! st 9af,ri I ticg No C8 07 i0ia (9) Detatls of professloa or occupafioa: (a) Self Asriculturist (b) spouse Asriculturist / Business (9A) Detatls of source(sf of Income: (a) Self Aericul re and Salarv from Parliamen t income (b) spouse Asriculturist / Business lncome (c) Son Business ulcome (d) Daugh ter Buslness lncome (9B) contract with appropriate Government and arry public company or companies: (a) Details of contracts entered by the candidate NIL (b) Details of contracts entered into by the spouse NIL (c) Details of contracts entered into by the dependents - one of the dependent, shri Gauralg patel, has entered into contract with Hindustan Petroleum corporation Ltd. For trading of petroleum products. (d) Details of contracts entered into by Hindu Undivided Family or trust in which the candidates or spouse or dependents have interest NIL (e) Details of contracts entered into by partnership firms in which candidates or spouse or dependents are partners NIL . (f) Details of contracts entered into by private company in which candidates or spouse or dependents have share NIL (10) My educatlonal qualiflcatloa ls as under: Quallflcatlon Secondary School Certificate (SSC) Exam Failed School/Universlty Shree Somnath Kelvani Mandal high School, Dabhel Damarr Year of Passlng 1974 SSC Exam failed 3 iT?-, ,/ B itu( -\ 0i x I,i:. *,, | ,,-il., W -t i AJl..'i iir I r. HTE,.', twJa !rr. i f I ( w I B,AJN -iJ, , - r_.--. *rstF U I, 0 r. L\r i D Beg ' ,'.'" PART - B (I1) ABSTRACT OF THE DEf,NLSI GTVEN IN (U TO (1OI OF PART. A: 1 Name of the candidate Patel Lalubhai Babubhar 2 Full postal address House No. 206 G, Sabri Kutir, Dungri Falia, Kachigam Nani Daman - 396 23O 3 Number and Name of the constituency l-Daman&Diu and state Parliamentary Constituency, U.T. of Daman & Diu 4 Name of the Political party which set up Bharaliya Janata Party the candidate Nil 5 Total Number of pending criminal cases 6 Total Number of cases in which convicted Nit 7 PAN of Year for which Total income last income Tax shown return filed (a) Candidate ABRPP3684M 2017-ta 6,69,168 (b) Spouse ABRPP36O9A 20t7-ta 7,35,185 (c) Dependent- 1 Gaurang Patel AQAPPI664R 2017-18 13, I 1,466 (d) Dependent-2 Shivangini Patel DFPPP6409R 20t7-ta 3,50,127 A l t i... B. M &0i i,:'ir IN j Ail! r iAli0El 'a\: ,.'4AN .009 r I DrU ! ST OA"1AN Reo No 06107 INDiA II.JT - f vt, i1.lt, {l"i : I :l ! sr 0r! ar: a1 i' N0a ,1 o 8 of assets and liabilities (including offshore assets) in Rupees Description Self Spouse Dependent- 1 Dependent-2 A Moveable Assets (Total Value) 9,255,324 15,713,160 12,a95,327 422,473 B Immovable Asset I Purchase Price of self-acquired 1,45,13,895 17,595,720 4,327,470 I,O3,88, 180 immovable property II Development/ construction cost of 4,560,350 2,t35,944 65,550 Nil immovable property aJter purchase (if applicable) III Approximate Current market price of- (a) self-acquired assets (Total (a)8,38,32,17s 70,308,595 8,207,570 1,o3,88,180 t Value) (b) inherited assets (Total Value) (b) 1e,37,2so NIL NIL NIL Llabillttes (i) Government dues Nil Nil Nil Nil (Total) (ii) Loans from Bank, Financial 496,735 5,721,698 3,351,081 Institutions and others (Total) 10 Llabllltles that are under dispute (i) Govemment dues (Tota-l) Nil Nil Nil NiI Nil Nil (ii) loans from Bank. Financial Nil Nil Institutions and others (Total) 11. Highest educational qualifrcation: Secondary School Certificate (SSC) Exam Failed from Shri Somnath Kelvani Marrdal High School, Dabhel, Daman in 1974 VERIFICATION I, LALT BHAI BABUBHAI PATEL, the deponent, above named, do hereby verify and declare that the contents of this alfrdavit are true arrd 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 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. Verified at Daman, this the 28th day of March, 2O19 So ly rmed Before me l^t t9, 8Jd DEPOI{ENT of ,v-.. whc is ident,ft:d by Hf .-\ whomlPerso.a*W ':1 l I RAJNKA T B. -'AI'lOEt AArocate & Notary D.m.n (u.T.) INDIA lwE i.g: No. DMtlog FORM OF OATH OR AFFIRMATION IARTTCLE 84(A) OF THE CONSTITUTION OF INDIAI (To be made by a candrdate for election to Parliament) I 141.1 1 .L4L.UAHn I BABu-0r4Avins been nominated as a candidatetofitl a seat in the House of the People do swear in the name of the God /Solemnly affirm that I will bear true faith and allegiance to the constrtution of lndia as by law established and that I will uphold the sovereignty and integrity of lndia. Signature Name (Block Lette4. P.^.t .1. . . l, n).u Pl/a]. . .!a- Sworn in the name of God/Sole affirmed by Shri/ S.hrimali hleu l-WAnAl, bAb)O1AX at .. N (Place) .. i5m hx tnorO tni. tne . 28lL. aay of .....M*.41h ps *oL1 before"t. me ) (Sandeep Kumar Singh) Returning Officer ' 1-Daman & Diu Parliamentary Constituency Daman check List of documents in connection with filing of Nomination Name of constituency ....1 Name of the candia.t" .....P-t'IEL IAU l)ttAr houota*t. tze? Hn. Date and time of filing nomination paper ,-slrd*lZ''''' |''-"''' ''' ' '' '' ''* sr. No or Nomination paper ....yl.l...ne..l...Z*.3. I A... Sr. No Documents Whether filed (Write Yes /No) if there is any defect /shortcoming in the documents, the same should be specified t4 a e 1 Affidavlt in Form 26 ?Y€s C, NC-o PtE )- (a)Whether all columns are filled up , 4 (s)(i) to Ub , e u)) t p*, a7 (b) lf not, which are blank column(s) (please specifo). tt G)0i) - tna B) (c)Whether the affidavit is sworn o Y6s ,SNoR.r 2 certified extract of electoral ro ll (when candidate is an elector of a d iffere nt Yes constituency ) 3 Forms A and B (applicable in the case of candidates set up by the Political Parties) NO 4 Copy of Caste Certificate (if the candidates claims to p/+ belong to sc/sT) 5 Security Deposit ( Whether made ) Y63 6 Oath affirmation ( Whether made ) YES The following documents which have not been filed should be filed as indicated below:- a* lvo t'tu ' (a) A &u' should be filed latest by wlq lat ,(b) Above mentioned columns in the Affidavit in Form 26 have been left blank. You mustsubmit a fresh affidavit with columns duly filled up before the commencement of scrutiny of nominations, failing which the nomination paper will be liable to be rejected. € (c) should be filed latest by ( Received (Sandeep Kum ingh ) ''Yfur^v^ Returning Officer 1-Daman & Diu Parliamentary Constituency Daman Placed: Daman Dated: {(/03/2019 Time: