S2520190417125500.Pdf

BEFORE THE N01ARY

TEN RUPEES

f ". Rs.10

9f~'Sf qf~:q-q Gtrn~ WEST BE g~~ ,I "' I (See rule 4A) ~!" "I ,t~"" ~~\\~

AFtJIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION BEFORE THE RETURNING OFFICER FOR E~ECTION TO 15-BARRACKPORE PA~ RLIAMENTARY CONSTITUENCY (NAME OF THE HOUSE) FROM" 105- "BH TPARAASSEMBLY CONSTITUENCY (NAME OF THE CONSTITUENCY)

PART-A

I, GOPAL RAUT, Son of Late Ramjas Raut Aged 50 years, resident of H.No.3/1/1I1 , kankinara:jute mill line qu er chaimath P.O. Kankinara, P.S. Jagatdal, Dist. 24 Pgs. (N) Pin. 743126 (W.B) (mention full Postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under:-

(1) am a candidate set up by NOT APPLICABLE (**lllulle of the political p~r) /** amContesting as an Independent candidate.(**strike out whichever is not applicable)

(2) y name is enrolled in 105, Bhatpara Assembly Constituency, (West Bengal) (Name of the Constituency and the state), at SERIAL NO.10, in PART NO. 65.

is/are 9830863830 and my email-id (if any) is

"' 2 APR 2019 ,.

• (4)Details of Permanent Account Number (PAN) and status of filing ofIncome Tax return:

Sl. Names PAN The financial year Total income shown No. for which the last in Income -Tax Income- tax return Return (in Rupees) has been filed for the last five financial years completed (as on 31st March) FY-2013-2014 (i) Rs.22,56,660.00 1. FY-2014-2015 (ii) Rs.l 0,13,230.00 Self - GOPALRAUT AJOPR5338M FY-2015-2016 (iii) Rs.ll,67,070.00 FY-2016-2017 (iv) Rs.8,83,030.00 FY-2017-2018 (v) Rs.4,87,770.00 2. FY-2013-2014 (i) Nil (ii) Spouse - ASHADEBI BRRPD7729Q FY-2014-2015 Nil FY-2015-2016 (iii) Rs.3,03110.00 (iv) Rs.3,S2,940.00 FY-2016-2017 (v) FY-2017-2018 Rs.5,71,040.00 3. (i) Nil HUF (If Candidate is Karta / (ii) Nil Coparcener Nil Nil (iii) Nil (iv) Nil (v) Nil 4. (i) Nil (ii) Nil Dependent-I Nil Nil (iii) Nil (iv) Nil (v) Nil 5. (i) Nil (ii) Nil Dependent-2 Nil Nil (iii) Nil (iv) Nil (v) Nil 6. (i) Nil (ii) Nil Dependent-3 Nil Nil (iii) Nil (iv) Nil (v) Nil

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

OR followingcriminal Cases are pending against me: there are pending criminal cases against the candidate, then tick this alternative and re off alternative (i) above, and give details of all pending cases in the Table below) Table

I?ffi No. with name and address Case No.1. of the police station concerned Jagatdal P.S. Case No.263/2019, dated 24/03/2019 U/s-341/323/325/354B/506/34 of I.P.C. Case No.2. Jagatdal P.S. Case No.264/2019, dated 24/03/2019 U/s- 143/147/323/506/34 ofI.P.C. Case No.3. Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 I.P.C. And G.R. NO- 2782/2011. Case No.4. Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO- 3464/2009.

Case No.5. Jagatdal P.S. Case No.442/2009 dated 08/09/2009under Section:-325/ 341 I.P.C. And G.R. NO-2774/2009. Case No-6 Jagatdal P.S. Case No.168/2008 dated 29/05/2008 under Section: - 341/323/34 I.P.C. And G.R. NO- 1321/2008 Case No.7. Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section:-143 /447 /506/34 I.P.C. and G.R. NO- 2920/2010. Case NO-8 Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: - 341/323/506/34 I.P.C. G.R. NO- 3612/2008 Case No-9 Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. - 187/2012 & S.T.-4(7)2017 Case No-l0 Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008 and S.C. - 193/2012 & S.T.-7(5)2017. CASE NO-II Jagatdal P.S. case No-399/94 dated 23/09/1994, under section 323/341 I.P.C. AND9(b) 2E Act.

(b) Case No. with name of the court CASE NO.1. Name of the court: Ld. ACJM Barrackpore, Jagatdal P.S. Case No.263/2019, dated 24/03/2019 U/s- 341/323/325/354B/506/34 of I.P.C. CASE NO. 2. Name of the court: Ld. ACJM Jagatdal P.S. Case No.264/2019, dated 24/03/2019 U/~ 143/147/323/506/34 of I.P.C.CASE NO.3. Name of the court: Ld. 2NdJM at Barrackpore, Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 I.P.C. And G.R. NO- 2782/2011. CASE NO.4. NAMEOF Court: - Learned 2nd J.M. At Barrackpore, Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO-3464/2009 CASE NO-S Name of Court: - Learned 2nd J.M. at Barrackpore, Jagatdal P.S. Case No.442/2009 dated ~I2 APk 2619 ---~-~~---~~~ -~

08/09/2009under Section:-325/ 341 I.P.C. And G.R. NO-2774/2009 CASE NO-6 Name of the court: Ld. 5th J.M. at Barrackpore, Jagatdal P.S. Case No.168/2008 dated 29/05/2008 under Section: - 341/323/34 I.P.C. And G.R. NO-1321/2008. CASE NO. 7. Name of the Court: - Leamed 4th J.M. At Barrackpore, Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section:-143 /447 /506/34 I.P.C. and G.R. NO-2920/2010. CASE NO-8 Name of the Court :- Learned 5th J.M. at Barrackpore, Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: - 341/323/506/34 I.P.C. G.R. NO-3612/2008 CASE NO-9 Name of Court: - Learned Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. - 187/2012 & S.T.-4(7)2017 Case No-IO Name of Court: - Learned F.T.C. 3RD AT Barrackpore, Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017. CASE NO-II Name of the Court:-Learned 2nd J.M. at Barrackpore, Jagatdal P.S. case No- 399/94 dated 23/09/1994, under section 323/341 I.P.C. AND 9(b) 2E Act. (c) Section(s) of concerned acts / CASE NO. 1. codes involved (Give No. of the Ld. ACJM Barrackpore, Jagatdal P.S. section, e.g, section Of Case No.263/2019, dated IPC)Etc. 24/03/2019 U/s- 341J323/325/354B/506/34 of I.P.C. CASE NO. 2. Ld. ACJM Jagatdal P.S. Case No.264/2019, dated 24/03/2019 U /s- 143/147/323/506/34 of I.P.C. CASE NO. 3. Ld. 2NdJM at Barrackpore, Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 I.P.C. And G.R. NO- 2782/2011. CASE NO.4. Learned 2nd J.M. At Barrackpore, Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO- 3464/2009 CASE NO-5 Learned 2nd J.M. at Barrackpore, Jagatdal P.S. Case No.442/2009 dated 08/09/2009under Section:-325/ 341 I.P.C. And G.R. NO-2774/2009 ~., CASE NO-6 Ld. 5th J.M. at Barrackpore, Jagatdal 'I,G1* ..N' ,SIL *&...' P.S. Case No.168/2008 dated R No -2262 29/05/2008 under Section: - 11a 0 341/323/34 I.P.C. And G.R. NO- \\ 2...._ Barrack pm < 1321/2008. I~~ 24 Pgs (N) " CASE NO. 7. Learned 4th J.M. At Barrackpore, ~E"N"'O~ Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section:-143 /447 '~~.'---- /506/34 I.P.C. and G.R. NO- 4- 11 2 APh 2019 2920/2010. CASE NO-8 Learned 5th. J.M. at Barrackpore, Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: 341/323/506/34 I.P.C. G.R. NO- 3612/2008 CASE NO-9 Learned Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: - 326/307/34' I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. -187/2012 & S.T.-4(7)2017 Case No-10 Learned F.T.C. 3RD AT Barrackpore, Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017. CASE NO-II Learned 2nd J.M. at Barrackpore, Jagatdal P.S. case No-399/94 dated 23/09/1994, under section 323/341 I.P.C. AND9 b 2E Act (d) Brief description of offence CASE NOt. Section Stated on Wrongful Restrain, Voluntarily causing Hurt, voluntarily causing grievous Hurt, Assault or use of criminal force to woman with intend to disrobe, Criminal Intimation, and Common intention.

CASE NO 2. Sections stated on unlawful assembly, rioting, Voluntarily causing Hurt Criminal Intimation, and Common intention.

CASE NO 3. Sections stated on Unlawful assembly, Criminal Trespass, voluntary grievous hurt, threating and common intention.

CASE NO 4. Section stated on Criminal Trespass, wrongful restraining, Voluntarily causing hurt, with common intention.

CASE NO-5 Section Stated on Voluntarily causing Hurt, wrongful restraining with common intention. CASE NO-6 Sections stated on wrongful assembly, Voluntarily Causing hurt with common intention. CASE NO 7. Sections stated on Unlawful assembly, Criminal trespass, threating with common intention. CASE NO 8. Sections stated on wrongful confinement, Voluntarily causing hurt, threatening with common intention. CASE NO 9. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition.

CASE NO 10. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition.

~I2 APR 2019 ; CASE NO 11. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition. (e) Whether charges have been YES framed (mention YES or NO) (f) If answer against (e) above is 1) Jagatdal P.S. Case No.516/2008 YES, then give the date on which dated 22/12/2008 under Section: - charges were framed 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. - 187/2012 & S.T.-4(7)2017

2) Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017

Date of charge not known to deponent (g) Whether any Appeal/Application for revision has been filed against NOT APPLICABLE the proceeding (Mention YES or NO)

(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: (Ifthe candidate has been convicted, then tick this alternative and score off alternative (i) above, and give details in the Table below) Table

(a) :CaseNoi NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (b) Name ofithe Court NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (c) Sections of acts/Codes involved NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (give no. of the section, e.g. section ... IPC, etc. (d) Brief descriptlon of offence for NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE which convicted (e) Dates of orders of conviction NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (f) Punishment imposed NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (g) Whether any Appeal has been NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE filed against conviction order (Mention YES or No) (h) If answer to (g) above is YES, NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE give details and present status of appeal (6A) 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 & 6. [Candidates to whom this Item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i) above] Note: 1. 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 mention first and backward in the order of dates for the other cases. 4. Additional sheet may be added if required . ....-:: .' 'andldate is responsible for supplying all information in compliance of Hon'ble Supreme '~~!'s *.'. judgment in W.P. (C) No. 536 of2011. /* B. N. SIL &,;. G) R No-2262 o Barrackpt.\{ Z ~~ 24 Pgs (N) ..... ~ 0« II 2 APR 20Ja /1IMEN~ (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.

Note: 2. In case of deposit / Investment, the details including Serial Number, Amount, date of deposit, the Scheme, Name of Bank / Institution and Branch are to be given. Note: 3. Value of Bond / share / Debentures as per the current market value in stock Exchange in respect of listed companies and as per books in case of non-listed companies should be given. Note: 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. Note: 5. Details including amount is to be given separately in respect of each investment. Note: 6. Details should be include the interest in or ownership of offshore assets.

Explanation,- For the purpose of this form, the expression "offshore assets" includes, details '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. Description Self Spouse HU Depend Depend Depende No. F ent ent nt

1 2 3

(i) Cash in hand 1,45,560.00 Rs.50,000 NIL Nil NIL Nil

(ii) Details of deposit in ICICI BANK AXISBANK NIL Nil Nil Nil Bank accounts (FDRs, Savingaccount: Current Account 271401500649 No· Term Deposit and all 9130100354628 Rs. 10,63.818.29 other types of Deposits 75: including saving AXIS BANK: Rs.2,95,600.21. accounts), deposits with SavingAccount: HDFC 436010100249720 Financial Institutions" Account No- Rs.8019.01 Non-Banking, Financial 2422187000046 Companies and AXIS BANK: 8: Rs.64,718.99. Cooperative societies and Current account: the amount in each such 914020019128128 deposit Rs. 1,02,478.35 BHATPARA- NAIHATIco- OPERATIVE BANK LTD. Savingaccount :- 107000702884, Rs. 5,03,525.00 BHATPARA- NAIHATIco- OPERATIVE BANK LTD. Current account No- 13504030 l105, Rs.I070.00. , H.D.F.C. Bank Current account No- 50200004251200 Rs.I0,777.87. HDFC Account No- 24221000003451 Rs.14,272.27. . H D F C in the name ~ ~~'"?~...» ofPawansut (; Enterprise, account i, 1;;;, No- It'~.. ,".)XL *A-.\ . '-; 1'- 2 __... 50200004251200: ic: r~o-...,..\.I 0 ~R Rs. 10,895.87. ('0 ""tl'itfrackpur 2 ICICI, in the name ~\ 2' Pgs (N) " ofPawansut Ol( Enterprise, current ~ account No- ~ fEN' 271405500026: -"".,."",- Rs.42,144.09. 7 12 APR 2019. . (iii) Details of investment in Rs.849075.90 Nil NIL Nil Nil Nil Bonds, Debentures 1 investment in shares and units in Shares: . L companies /Mutual Rs.1,23,028.00 Funds and others Investment in And the amount. Mutual Fund Rs.1,32,079.00 Investment in Share in B.N.C.B. LTD. Rs.29,120.00 Investment in ICICI Securities. (iv) Details of investment in Rs.7,80,210.00 Rs.4900.00 NIL Nil Nil Nil NSS, Postal Saving, Investment in investment in Insurance Policies and Insurance Policies LICI policy Investment in any financial instruments in Post office or Insurance company and the amount. (v) ,Personal Loans 1 Rs.25,16,575/' NIL Nil Nil Nil advance given to any person or entity including firm, company , Trust etc. and other receivables from debtors and the amount. (vi) Motor Vehicles 1 XUV 500 VIDE Nil NIL Nil Nil Nil Aircrafts/ Yachts 1 Ships Registration No- (Details of Make, WB-24C-3339: registration number etc. Achiever: year of purchase and Rs.15,96,370.00 amount).

(vii) Jewellary, bullion and 60 Grams Gold, Rs.55620.00 NIL Nil Nil Nil valuable thing(s) (given Rs.1,97,580.00 for Jewellary details of weight and value)

(viii) Any other assets such as Rs.10065.00 for Rs.l,20,500.oofor N Nil Nil Nil value of claims 1 interest Bank Interest. Furniture. I Rs.1,80,000.00 for Commission L Income.

Rs.7,85,614.00 for ~ .D- advance payment 0 for the purchase of c5 flat. (ix) Gross Total Value 65,85,702.65/- 66,80,541.68 NIL Nil Nil Nil ,,,""~~r;-:_... -" ..,c-: '...-~R ~'".- ., ~ ,A • ',' ,

B!~t ....·,~;IL. ~~.,..,.. R r·h)W.l)~tails lff'l] nmovable Assets: o Ba.I"{'<'Ickpcl 2 \L 1.4 Pgs (~E!J Properties in joint ownership indicating the extent of joint ownership will also have to I~\~ ~J' beindi ~EN" .. e: 2. Each land or building or apartment should be mentioned separately in this format,

Note: 3. Details should include the interest in or ownership of offshore assets.

S. Description Self Spouse HUF Depende Depende Depende No. nt nt nt3 1 2 (i) A2;ricultural Land Nil Nil Nil Nil Nil Nil Location(s) Survey number(s)

.I·'_ ,A,P,k lli1~ ------;------

. Area (total measurement in acres) Nil Nil Nil Nil Nil Nil Whether inherited NIL Nil Nil Nil Nil Nil . Property (Yes or No) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of Land(in case of purchase) at Nil Nil Nil Nil Nil Nil the time of purchase Any investment on the land by way Nil Nil Nil Nil Nil Nil of development, construction etc. Approximate current market value Nil Nil Nil Nil Nil Nil (ii) Non-Az:;riculturalland Nil Nil Nil Nil Nil Nil Location(s) Survey numbers(s) Area (total measurement in sq. ft.) Nil Nil Nil Nil Nil Nil Whether inherited property (Yes or Nil Nil Nil Nil Nil Nil No) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of Land (in case of purchase) Nil Nil Nil Nil Nil Nil at the time of purchase Any Investment on the land by way Nil Nil Nil Nil Nil Nil of development, construction etc. Approximate current market value Nil Nil Nil Nil Nil Nil (iii) Commercial Buildinz:;s Nil Nil Nil Nil Nil (including apartments)- NIL -Location(s) -Survey(s) Area (total measurement in sq. ft) NIL Nil Nil Nil Nil Nil Built-up Area (total measurement in NIL Nil Nil Nil Nil Nil sq. ft) Whether inherited property (YES or Nil Nil Nil Nil Nil Nil NO) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of property (in case of NIL Nil Nil Nil Nil Nil purchase) at the time of purchase Any Investment on the property by Nil Nil Nil Nil Nil Nil way of development, construction etc. Approximate current market value NIL Nil Nil Nil Nil Nil (iv) Residential BuUdinz:;s NIL Nil Nil Nil Nil Nil 1 (including apartments): -Location(s) -Survey number(s) ~ Area (total measurement in sq. ft) NIL Nil Nil Nil Nil Nil ~ Builtup Area (Total measurement in NIL Nil Nil Nil Nil Nil 0 sq. ft) C5 Whether inherited property (Yes or NIL Nil Nil Nil Nil Nil No) Date of purchase in case of self- NIL Nil Nil Nil Nil Nil acquired property Cost of property (in case of NIL Nil Nil Nil Nil Nil purchase) at the time of purchase _.~ __ Any Investment on the land by way NIL Nil Nil Nil Nil Nil ,,;;r' .-;-;~evelopment, constructionetc. ~~ "~i'i'" ~ "'", ,(Pfto~mate currentmarket value NIL Nil Nil Nil Nil Nil ;>', ~ .1 ~I &. G) • ,"" .-~:}~ . o ~r ~)t~tli4)theffi ~h as interest in property). Nil Nil Nil Nil Nil Nil c:::::. "-~()tI.~Pt rrot~ ,_urrentmarket value of (1) NIL Nil Nil Nil Nil Nil ~ 24 fgs (r~lo (~ ve

~ . ~~ , ~~~t4~i.G:?"jn belo.wthe details ofl.iabilities/dues to pu~lic ~n~ncial i~stituti.on~~ndgovernment:- ~e: please grve separate details of name of bank, mstitutton, entity or individual and amount -~eachitem )

S. Description Self Spouse HU Dependent- Depend Depe No. F 1 ent-2 ndent -3 (i) Loan or dues to Bank / NIL Nil Nil Nil Nil Nil Financial Institution( s) Rs.23, 11 2 APR 20t9 Name of Bank or financial 42973.81 for Institution, Amount outstanding, Secured Nature of Loan Loan. Loan or dues to any other Rs.7,29,654.00 Nil Nil Nil Nil Nil individuals/entity other than for Unsecured Loan mentioned above Name(s), Amount outstanding, nature of loan Any other liability Rs.5,OO,OOO.OORs.5,56,620.00 Nil Nil Nil Nil short terms Rs.20,OO,OOO.OO loan and Advances Grand total of liabilities 35,72,627.81 Rs.25,56,620.00 Nil Nil Nil Nil (ii) Government Dues: (A) Has the Deponent been in occupation of YES accommodation provided by the Government at any INO Dues to departments dealing time during the last ten years before the date of (PI. tick with Government notification of the current election? the accommodation approp (B) If answer to (A) above is YES, the following riate declaration may be furnished namely:- altern a tive) (i) The address of the Government accommodation: NOT APPLICABLE NIL (ii) There is no dues payable in respect of above Government accommodation, towards-

(a) rent; (b) electricity charges; t (c) water Charges; and NIL (d)' Telephone charges as on ... (date) 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 thereafter]. 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 department dealing with Nil Nil Nil Nil Nil Nil Government transport(including Aircrafts and helicopters) Q Self Spouse HUF Dependent- Depend Depen ~~~-+~ =-~ +- ~ ~ ~-+ ~ 1 ~e_n_t_-2~~de~~_t~- (iv) Income Tax dues NIL Nil Nil Nil Nil Nil (v) GST dues NIL Nil Nil Nil Nil Nil (vi) Municipal/property tax dues NIL Nil Nil Nil Nil Nil (vii) Any other dues NIL Nil Nil Nil Nil Ni I (viii) Grand total of all Government NIL Nil Nil Nil Nil Ni I .< - __ dues :;:. ,Ox}.;ll ~~?er a~y other lia?ilities are NIL Nil Nil Nil Nil Nil IA lII"9/pute, If so, mention the ~. '';;b~mou~' volved an? th.e . Z•~ , ~. . 'I. Juth 1.\ before WhIChIt IS ~ .Nv -_l. pend' . Bi.U:al,.;;:P' pm ~ Pgs(~N>etait8-2' profession or occupation:

(at S0«' : Business ~'41E~)\S se Business ~ (9A) Details ofsource(s) of income:

(a) Self Business (b) Spouse Business (c) Source of income, if any,of dependents, NOT APPLICABLE

, () . II 2 APR 20'V (9B) Contracts with appropriate Government and any public company or companies (a) Detailsof contracts entered by the candidateNOT APPLICABLE (b) Details of contracts entered into by spouseNOT APPLICABLE (c) Details of contracts entered into by dependentsNOT 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 contracts.entered into by Partnership Firms in which candidate or spouse or dependents are partnersNOT APPLICABLE (f) Details of contracts, entered into by Private companies in which candidate or spouse or dependents have shareNOT APPLICABLE

(10) My educational qualification is as under: - VIII PASSED (Give details of highest SchoollUniversity 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 DETAILS GIVEN IN (1) TO (10) OF PART -A: 1. Name of the candidate GOPALRAUT 2. Full postal address 3/1/1/1,KankinaraJute Mill CoolieLine,Quarter, Chhaimath,P.O.- Kankinara,P.S. Jagatdal,Dist. North 24 Parganas,Pin No. 743126(W.B.) 3. Number and name of the constituency and 105- Jagatdal Assembly Constituency and State West Bengal 4. Name of the political party which set up the Independent candidate (otherwise write 'Independent') 5. Total number of pending criminal cases 11 (ELEVAN ) Cases

6. Total Number of cases in which convicted Not Applicable 7. PAN of Year for which last Total Income shown Income Tax Return filed (a) Candidate AJOPRS3338M FY-2017-2018 Rs.4,87,770.00

(b) Spouse BRRPD7729Q FY-2017-2018 Rs.S,71,040.00

8. Details of Assets and Liabilities (including offshore assets) in rupees Description Self Spouse HUF Dependent Dependent Dependent 1 2 3 A. Movable Nil Nil Nil Nil Nil Nil Assets(Total a-: value) 0 B. Immovable Nil Nil Nil Nil Nil Assets I. Purchase Price NIL Nil Nil Nil Nil Nil of self-acquired immovable property II. Developmentlc Nil Nil Nil Nil Nil Nil onstruction cost of immovable property.after purchase (if applicable) III. Approximate Nil Nil Nil Nil Nil Current market .~~~,,p~rice - ~ ~) Self- SI'~ 4 uired assets •J1-~'1 * -'22 2 tal Value) l'~'J ~nherited NIL ck.~4't arro ets (Total p ~s (1~)...~ lue)

All ~ ~ ~_.....v'""-s I , L_I 2 AP R 201t 9. Liabilities (i) Government Nil Nil Nil Nil Nil , dues (Total) (ii) Loans from NIL Nil Nil Nil Nil Bank, Financial Institutions and others (Total) 10 Liabilities that are under dispute (i) Government Nil Nil Nil Nil Nil dues (Total) (ii) Loans from Nil Nil Nil Nil Nil Bank, Financial Institutions and others (Total)

11 Highest education qualification:- VIII PASSED (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.)

VERIFICATION

I, the deponent, above named, do hereby verify 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 therefrom. 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 assets 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 atBarrackpore this the 10TH day of April '2019.

Note: 1. Affidavit should be filed latest by 3.00PM on the last day filing nominations. Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public. Note: 3. All columns should be filled up and no Column to be left blank. If there is no information to furnish in respect of any item, either "Nil" or "Not applicable", as the case may be, should be mentioned. Note: 4. The Affidavit should be either typed or written legibly and neatly. Note: 5. Each page of the affidavit should be signed by the deponent and the affidavit should bear on each page the stamp of the Notary or Oath Commissioner or Magistrate before whom the Affidavit is sworn.

SOLEMNLY AFFIRMED & DECLARED BEF RE Mi ON "·l'··2···~· 2DlJ,~

tfJ.·t."! N HSIL N - H! NO - 2262 OF INDIA

) 2 APR 201 -- ---_--- ._-- l:' ..' \i APR 10\9 8EFORE THE NOTARY . , OVERNMENT OF INDIA

TEN RUPEES Rs.1m

~1=1 iSiJllc1 WEST BENGAL Form 26 (See rule 4A)

IAFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMI~ATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO 15 - BARRACKPORE PAR IAMENTARY CONSTITUENCY (NAME OF THE HOUSE) FROM 105 - BHATPARA ASSEMBLY CONSTITUENCY (NAME OF THE CONSTITUENCY) , U~~ .

I, Gopal Raut, Son of Late Ramjas Raut Aged 50 years, resident of H.No.3/1/1/1, KANKlNARA JUTE MILL LINE QUQRTER .CHHAIMA..THP.O. Kankinara, P.S. Jagatdal, Dist. 24 Pgs. (N) Pin. 743126 (W.B) (men ion full Postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as un er:-

(1) I am a candidate set up by NOT APPLICABLE (**Rame gfti:le pglitkal party) 1** am Contesting as an .Independent candidate. (**strike out whichever is not applicable)

" (2) M~ name is enrolled in 105, Bhatpara Assembly Constituency, (West Bengal) (Name of the

. , 6 ~PR 10\9 ...... ~. .~ . ~'"

'i, ..

,.-

'.. .. ,-

...... (4) Details of Permanent Account Number (PAN) and status of filing ofIncome Tax return:

Sl. Names PAN The financial year Total income shown in No. for which the last Income - Tax Return Income - tax return (in Rupees) for the has been filed last five financial years completed (as on 31'1 March) FY-2013-2014 (i) Rs.22,56,660.00 1. FY-2014-2015 (ii) Rs.l0,13,230.00 Self - GOPALRAUT AJOPR5338M FY-2015-2016 (iii) Rs.ll,67,070.00 FY-2016-2017 (iv) Rs.8,83,030.00 FY-2017-2018 (v) Rs.4,87,770.00 2. FY-2013-2014 (i) Nil (ii) Nil Spouse - ASHA DEBI BRRPD7729Q FY-2014-2015 FY-2015-2016 (iii) Rs.3,03110.00 (iv) Rs.3,52,940.00 FY-20l6-20l7 (v) FY-2017-2018 Rs.5,71,040.00 3. (i) Nil HUF (If Candidate is Karta I (ii) Nil Coparcener Nil Nil (iii) Nil (iv) Nil (v) Nil 4. (i) Nil (ii) Nil Dependent-l Nil Nil (iii) Nil (iv) Nil (v) Nil 5. (i) Nil (ii) Nil Dependent-2 Nil Nil (iii) Nil (iv) Nil (v) Nil 6. (i) Nil (ii) Nil Dependent-3 Nil Nil (iii) Nil (iv) Nil (v) Nil

Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should be clearly stated "No PAN allotted".

(a) FIR No. with name and address Case No. 1. of the police station concerned Jagatdal P.S. Case No.263/2019, dated 24/03/2019 U/s- 341/323/325/354B/506/34 of I.P.C.

I Case No.2. Jagatdal P.S. Case No.264/2019, dated 24/03/2019 U/s- 143/147/323/506/34 ofI.P.C.

Case No.3. Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 l.P.C. And G.R. NO- 2782/2011.

Case No.4. Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO- 3464/2009.

Case No.5. Jagatdal P.S. Case No.442/2009 dated 08/09/2009 under Section:-325/ 341 l.P.C. And G.R. NO-2774/2009. Case No-6 Jagatdal P.S. Case No.168/2008 dated 29/05/2008 under Section: 341/323/34 I.P.C. And G.R. NO- 1321/2008 Case No.7. Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section:-143 /447 /506/34 I.P.C. and G.R. NO- 2920/2010. Case NO-8 Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: 341/323/506/34 l.P.C. G.R. NO- 3612/2008 Case No-9 Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. 187/2012 & S.T.-4(7)2017 Case No-I0 Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008 and S.C. 193/2012 & S.T.-7(5)2017.

CASE NO-II Jagatdal P.S. case No-399/94 dated 23/09/1994, under section 323/341 I.P.C. AND9(b) 2E Act. (b) Case No. with name of the court CASE NO.1. Name of the court: Ld. ACJM Barrackpore, Jagatdal P.S. Case No.263/2019, dated 24/03/2019 U/s- 341/323/325/354B/506/34 of I.P.C.

CASE NO.2. Name of the court: Ld. ACJM Jagatdal P.S. Case No.264/2019, dated 24/03/2019 U/s- 143/147/323/506/34 of I.P.C.

CASE NO.3. Name of the court: Ld. 2Nd JM at Barrackpore, Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 I.P.C. And G.R. NO- 2782/2011. CASE NO.4. NAMEOF Court: - Learned 2nd J.M. At Barrackpore, Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO-3464/2009

CASE NO-5 Name of Court: - Learned 2nd J.M. at Barrackpore, Jagatdal P.S. Case No.442/2009 dated 08/09/2009 under Section:-325/ 341 I.P.C. And G.R. NO-2774/2009

CASE NO-6 Name of the court: Ld. 5th J.M. at Barrackpore, Jagatdal P.S. Case No.168/2008 dated 29/05/2008 under Section: - 341/323/34 I.P.C. And G.R. NO-1321/2008. CASE NO. 7. Name of the Court: - Learned 4th J.M. At Barrackpore, Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section: -143 /447 /506/34 I.P.C. and G.R. NO-2920/2010.

CASE NO-8 Name of the Court :- Learned 5th J.M. at Barrackpore, Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: - 341/323/506/34 I.P.C. G.R. NO-3612/2008

CASE NO-9 Name of Court: - Learned Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. N0-4105/2008 and S.C. 187/2012 & S.T.-4(7)2017

Case No-I0 Name of Court: - Learned F.T.C. 3RD AT Barrackpore, Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017.

CASE NO-II Name of the Court:-Learned 2nd J.M. at Barrackpore, Jagatdal P.S. case No- 399/94 dated 23/09/ 1994, under section 323/341 I.P.C. AND 9(b) 2E Act. (c) Section(s) of concerned acts / CASE NO.1. codes involved (Give No. of the Ld. ACJM Barrackpore, Jagatdal P.S. section, e.g. section OfIPC) Case No.263/2019, dated Etc. 24/03/2019 V/s- 341/323/325/354B/506/34 of I.P.C.

CASE NO.2. Ld. ACJM Jagatdal P.S. Case No.264/2019, dated 24/03/2019 V/s- 143/147/323/506/34 ofI.P.C.

CASE NO.3. Ld. 2Nd JM at Barrackpore, Jagatdal P.S. Case No.578/2011 dated 17/10/2011 under Section:-143 /447 /325/ 506/34 I.P.C. And G.R. NO- 2782/201l.

CASE NO.4. Learned 2nd J.M. At Barrackpore, Jagatdal P.S. Case No.586/2009 dated 20/11/2009 under Section:-447 /341/323/34 I.P.C. And G.R. NO- 3464 2009 J i AP 2019 CASE NO-5 Learned 2nd J.M. at Barrackpore, Jagatdal P.S. Case No.442/2009 dated 08/09/2009 under Section:-325/ 341 I.P.C. And G.R. NO-2774/2009 CASE NO-6 Ld. 5th J.M. at Barrackpore, Jagatdal P.S. Case No.168/2008 dated 29/05/2008 under Section: 341/323/34 I.P.C. And G.R. NO- 1321/2008.

CASE NO.7. Learned 4th J.M. At Barrackpore, Jagatdal P.S. Case No.455/2010 dated 19/08/2010 under Section:-143 /447 /506/34 I.P.C. and G.R. NO- 2920/2010.

CASE NO-8 Learned 5th J.M. at Barrackpore, Jagatdal P.S. Case No.464/2008 dated 23/11/2008 under Section: 341/323/506/34 I.P.C. G.R. NO- 3612/2008 CASE NO-9 Learned Jagatdal P.S. Case No.516/2008 dated 22/12/2008 under Section: - 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. -187/2012 & S.T.-4(7)2017 Case No-I0 Learned F.T.C. 3RD AT Barrackpore, Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017. CASE NO-II Learned 2nd J.M. at Barrackpore, Jagatdal P.S. case No-399/94 dated 23/09/1994, under section 323/341 I.P.C. AND9 b 2E Act (d) Brief description of offence CASE NO 1. Section Stated on Wrongful Restrain, Voluntarily causing Hurt, voluntarily causing grievous Hurt, Assault or use of criminal force to woman with intend to disrobe, Criminal Intimation, and Common intention. CASE NO 2. Sections stated on unlawful assembly, rioting, Voluntarily causing Hurt Criminal Intimation, and Common intention. CASE NO 3. Sections stated on Unlawful assembly, Criminal Trespass, voluntary grievous hurt, threating and common intention. CASE NO 4. Section stated on Criminal Trespass, wrongful restrammg, Voluntarily causing hurt, with common intention. CASE NO-5 Section Stated on Voluntarily causing Hurt, wrongful restraining with common intention. CASE NO-6 Sections stated on wrongful assembly, Voluntarily Causing hurt with common intention. CASE NO 7. Sections stated on Unlawful assembly, Criminal trespass, threating with common intention. .1 APR 2019 CASE NO 8. Sections stated on wrongful confinement, Voluntarily causing hurt, threatening with common intention. CASE NO 9. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition.

CASE NO 10. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition.

CASE NO 11. Sections stated on Voluntarily causing grievous hurt by dangerous weapons or means, attempt to murder, common intention and Explosive and Ammunition. (e) Whether charges have been YES framed (mention YES or NO) (f) If answer against (e) above is 1) Jagatdal P.S. Case No.516/2008 YES, then give the date on which dated 22/12/2008 under Section: - charges were framed 326/307/34 I.P.C. & 9(b) 2E Act. And G.R. NO-4105/2008 and S.C. - 187/2012 & S.T.-4(7)2017

2) Jagatdal P.S. Case No.522/2008 dated 24/12/2008 under Section: - 326/307/34I.P.C. & 9(b) 2E Act. And G.R. NO-3987/2008. And S.C. -193/2012 & S.T.-7(5)2017

Date of charge not known to deponent (g) Whether any Appeal!Application for revision has been filed against NOTAPPLICABLE the proceeding (Mention YES or NO)

OR (ii) I have been convicted for the offences mentioned below: (If the candidate has been convicted, then tick this alternative and score off alternative (i) above, and give details in the Table below) Table

Case No. NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE Name of the Court NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE Sections of acts / Codes involved NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE (give no. of the section, e.g. section... IPC, etc. (d) Brief description of offence for NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE which convicted NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE

NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE

1.' ~Pt\ 1Q\9 (6A) 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 & 6. [Candidates to whom this Item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i) above] Note: 1. Details should be entered clearly and legiblyin 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 mention first and backward 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 2011.

(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.

Note: 2. In case of deposit I Investment, the details including Serial Number, Amount, date of deposit, the Scheme, Name of Bank I Institution and Branch are to be given. Note: 3. Value of Bond I share I Debentures as per the current market value in stock Exchange in respect of listed companies and as per books in case of non-listed companies should be given. Note: 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. Note: 5. Details including amount is to be given separately in respect of each investment. Note: 6. Details should -.~include the interest in or ownership of offshore assets.

Explanation,- For the purpose of this form, the expression "offshore assets" includes, details 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. Description Self Spouse HUF Depe Depe Depend No. ndent ndent ent 1 2 3 (i) Cash in hand 1,45,560.00 Rs.50,000 NIL Nil NIL Nil

(ii) Details of deposit in ICICI BANK AXIS BANK NIL Nil Nil Nil Bank accounts (FDRs, Saving account: Current Account 271401500649 No- Term Deposit and all 91301003546287 Rs. 10,63.818.29 other types of Deposits 5: Rs.2, 95,600.21 including saving AXIS BANK: accounts), deposits with Saving Account: HDFC Account No- 436010100249720 Financial Institutions, 24221870000468: Rs.8019.01 Non-Banking, Financial Rs.64,718.99 Companies and AXIS BANK: Cooperative societies and Current account: the amount in each such 914020019128128 deposit Rs. 1,02,478.35 BHATPARA -NAIHATI CO-OPERATIVE BANK LTD. Saving account :- 107000702884, Rs. 5,03,525.00

BHATPARA -NAIHATI CO-OPERATIVE BANK LTD. Current account No- 135040301105, Rs.1070.00

H.D.F.C. Bank Current account No-50200004251200 Rs.I0, 777.87

HDFC Account No- 24221000003451 Rs.14, 272.27 J 6 - H D F C in the name ofPawansut , Enterprise, account No-50200004251200: Rs. 10,895.87

ICICI, in the name of Pawansut Enterprise, current account No- 271405500026: Rs.42, 144.09

(iii) Details of investment in Rs.8,49,075.90 Nil NIL Nil Nil Nil Bonds, Debentures j investment in shares and units in Shares: companies jMutual Rs.l,23,028.00 Funds and others And the amount. Investment in Mutual Fund Rs.l,32,079.00 Investment in Share in B.N.C.B. LTD. Rs.29, 120.00 Investment in ICICI Securities.

(iv) Details of investment in Rs.7,80,210.00 RsA,900.00 NIL Nil Nil Nil NSS, Postal Saving, Investment in investment in Insurance Policies and Insurance Policies LICI policy Investment in any financial instruments in Post office or Insurance company and the amount. l (v) Personal Loans j Rs.25,16,575/- NIL Nil Nil Nil ~ advance given to any NIL ~ person or entity ~ including firm, company c:..!) , Trust etc. and other receivables from debtors and the amount. (vi) Motor Vehicles j XUV 500 VIDE Nil NIL Nil Nil Nil Aircraftsj Yachts j Ships Registration No-WB- (Details of Make, 24C-3339: Achiever: registration number etc. Rs.15,96,370.00 year of purchase and amount).

(vii) Jewellery, bullion and 60 Grams Gold , Rs.55620.00 NIL Nil Nil Nil valuable thing(s) (given Rs.l,97,580.00 for Jewellery details of weight and value)

(viii) Any other assets such as Rs.10065.00 for Rs.l,20,500.00 NIL Nil Nil Nil value of claims j interest Bank Interest. for Furniture.

_,.-~~~ ~ ~ Rs.l, 80,000.00 for Commission Income. Ic~ or~~/~~~__~~~~\ Rs.7, 85,614.00 for 2 ..~I:)' ~~~, U- ~ ~r>,~ ~ o. advance payment for * IO~~po J.....~ the purchase of flat. ~ At>< .s.. 'J 65,85,702.65 66,80,541.68 NIL Nil Nil Nil 'bld-~l'!~dtal Value ~-~.~ B. Details ofImmovable Assets:

Note: 1. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated

Note: 2. Each land or building or apartment should be mentioned separately in this format.

Note: 3. Details should include the interest in or ownership of offshore assets. 1 6 APR 2019 ------

- S. Description Self Spouse HUF Depende Depende Depende - No. nt nt nt3 1 2 (i) A2ricultural Land Nil Nil Nil Nil Nil Nil Location(s) Survey number(s) Area (total measurement in acres) Nil Nil Nil Nil Nil Nil Whether inherited NIL Nil Nil Nil Nil Nil Property (Yes or No) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of Land (in case of purchase) Nil Nil Nil Nil Nil Nil at the time of purchase Any investment on the land by way Nil Nil Nil Nil Nil Nil of development, construction etc. Approximate current market value Nil Nil Nil Nil Nil Nil (ii) Non-Agricultural land Nil Nil Nil Nil Nil Nil Location( s) Survey numbers(s) Area (total measurement in sq. ft.) Nil Nil Nil Nil Nil Nil Whether inherited property (Yes or Nil Nil Nil Nil Nil Nil No) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of Land (in case of purchase) Nil Nil Nil Nil Nil Nil at the time of purchase Any Investment on the land by way Nil Nil Nil Nil Nil Nil of development, construction etc. Approximate current market value Nil Nil Nil Nil Nil Nil (iii) Commercial Buildings Nil Nil Nil Nil Nil Nil (including apartments)- ~ -Location(s) -Survey(s) ~ Area (total measurement in sq. ft) NIL Nil Nil Nil Nil Nil ~ Built-up Area (total measurement in Nil Nil Nil Nil Nil Nil a sq. ft) C5 Whether inherited property (YES or Nil Nil Nil Nil Nil Nil NO) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil a~quired property Cost of property (in case of Nil Nil Nil Nil Nil Nil purchase) at the time of purchase Any Investment on the property by Nil Nil Nil Nil Nil Nil way of development, construction etc. Approximate current market value Nil Nil Nil Nil Nil Nil (iv) Residential Buildings Nil Nil Nil Nil Nil Nil (including apartments): -Location(s) -Survey number(s) Area (total measurement in sq. ft. ) Nil Nil Nil Nil Nil Nil Built up Area (Total measurement Nil Nil Nil Nil Nil Nil in sq. ft.) Whether inherited property (Yes or Nil Nil Nil Nil Nil Nil No) Date of purchase in case of self- Nil Nil Nil Nil Nil Nil acquired property Cost of property (in case of Nil Nil Nil Nil Nil Nil purchase) at the time of purchase Any Investment on the land by way Nil Nil Nil Nil Nil Nil .,I' \~elopment, construction etc. ~... ~l4t'lJl.~ate currentmarketvalue Nil Nil Nil Nil Nil Nil 'c A\.\),c{)th~~ as interest in property) Nil Nil Nil Nil Nil Nil < ~.~~(y!9}.<);J\.~tal)~ rent market value of (i) Nil Nil Nil Nil Nil Nil .. ~(). ~\l~~(\{) ~ \~'u ,Y' LJ... o ~'\~~ 0 o rp~~ ~ ~RNN\~~ -. J & APR 2019 _ M..L (8) I give herein below the details of liabilities/dues to public financial institutions and government (Note: please give separate details of name of bank, institution, entity or individual and amount Before each item)

S. Description Self Spouse HUF Depende Depende Dependen No. nt-1 nt-2 t- 3 (i) Loan or dues to Bank / Rs.23, 42973.81 Nil Nil Nil Nil Nil Financial Institution(s) for Secured Name of Bank or financial Loan. Institution, Amount outstanding, Nature of Loan Loan or dues to any other Rs. 7,29 ,654.00 Nil NIL Nil Nil Nil individuals/entitv other than for Unsecured mentioned above Loan Name(s), Amount outstanding, nature of loan Any other liability Rs.5,OO,OOO.OO Rs.5,56,620.00 NfL Nil Nil Nil short terms loan Rs.20,OO,OOO.OO and Advances Grand total of liabilities 35,72,627.81 Rs.25,56,620.00 NIL Nil Nil Nil (ii) Government Dues: Has the Deponent been in occupation of accommodation ¥mS1 provided by the Government at any time during the last ten NO Dues to departments dealing years before the date of notification of the current election? (PI. tick with Government the (A) If answer to (A) above is YES, the following declaration appropriate accommodation may be furnished namely:- alternative)

(i) The address of the Government accommodation: NOT APPLICABLE NIL (ii) There is no dues payable in respect of above Government accommodation, towards- ~ (a) rent; (b) electricity charges; d- NIL (c) water Charges; and 1 (d) Telephone charges as on ...... (date) Q c23 [The date should be the last date of the third month prior to the month in which the election is notified or any date thereafter]. 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 department dealing with Nil Nil Nil Nil Nil Nil Government transport(including Aircrafts and helicopters) Self Spo HUF Oependent- Dependent - Oependen use 1 2 t -3 (iv) Income Tax dues Nil Nil Nil Nil Nil Nil (v) GST dues Nil Nil Nil Nil Nil Nil (vi) Municipal/property tax dues Nil Nil Nil Nil Nil Nil (vii) Any other dues Nil Nil Nil Nil Nil Nil (viii) Grand total of all Government Nil Nil Nil Nil Nil Nil ~ ...... A Nil Nil ~~l~er liabilities are Nil Nil Nil Nil ~ dis u~ 0, mention the }t,I~t ~1 d and the authority "" .I~~ wh~i 'ls pending. 14 'P'~a:" ii~"\ ~~i ~ <.l!t~I\~ profl ion or occupation: J..l ~'():"\ £. LL.. ~ ~KJ. '},0I~~lf .. 0;;. Business 0- (b)Spo ~ Business ,1 i APR 10\9 (9A) Details ofsource(s) of income: (a) Self Business (b) Spouse Business (c) Source of income, if any, of dependents, NOT APPLICABLE

(9B) Contracts with appropriate Government and any public company or companies (a) Details of contracts entered by the candidate NOT APPLICABLE (b) Details of contracts entered into by spouse NOT APPLICABLE (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 contracts, entered into by Partnership Firms in which candidate or spouse or dependents are partners NOT APPLICABLE (f) Details of contracts, entered into by Private companies 111 which candidate or spouse or dependents have share ..... NOT APPLICABLE (10) My educational qualification is as under: - VIII PASSED (Give details of highest SchoollUniversity education mentioning the full form of the certificate Idiploma Idegree course, name of the SchoollCollegelUniversity and the year in which the course was completed.)

PART-B (11) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART -A: 1. Name of the candidate GOPALRAUT 2. Full postal address 3/111/1, KankinaraJute Mill CoolieLine,Quarter, Chhaimath,P.O.- Kankinara,P.S. Jagatdal,Dist. North 24 Parganas,Pin No. 743126(W.B.) 3. Number and name of the constituency and 105- Bhatpara Assembly Constituency and State West Bengal 4. Name of the political party which set up the Independent candidate (otherwise write 'Independent') 5. Total number of pending criminal cases 11 (ELEVEN) Cases

6. Total Number of cases in which convicted Not Applicable ~ 7. D_ PAN of Year for which last Total Income shown 0 Income Tax Return filed (a) Candidate AJOPR53338M FY-2017-2018 Rs.4,87,770.00

(b) Spouse BRRPD7729Q FY-2017-2018 Rs.5,71,040.00

~~~~~after~, ~ u~ e(if ;\\) ap'p~a e)

VERIFICATION

(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 assets 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 Barrackpore this the 16TH day of April '2019.

Td~~~ ~ ~ Note: I. Affidavit should be filed latest by 3.00PM on the last day filing nominations. R_o.'rn ~ Sh:uJ. Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public. M~ Note: 3. All columns should be filled up and no Column to be left blank. If there is no information to furnish in respect of any item, either "Nil" or "Not applicable", as the case may be, should be mentioned. Note: 4. The Affidavit should be either typed or written legibly and neatly. Note: 5. Each page of the affidavit should be signed by the deponent and the affidavit should bear on each page the stamp of the Notary or Oath Commissioner or Magistrate before whom the Affidavit is sworn .

IL 0.-2262 .J 6 APR 2019 INDIA 11:5183 R 2019