FORM 26 (See rule 4A)

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION I PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO STATE LEGISLATIVE ASSEMBLY FROM 241 TULJAPUR I CONSTITUENCY. 1 PART-A I ARCHANA RANAJAGJlTSlNHA PATlL wife of RANAJAGJlTSlNHA PATlL Aged 48 years, resident of TER. TALUKA & , a candidate at the above election. do hereby nly affirm and state on oath as under :-

9 I am a candidate set up by BHARTIYA JANTA PARTY.

$2* (2\ My name is enrolled in 241-TUWAPUR VIDHANSABHA CONSTITUENCY, MAHARASHTRA, at Serial No 583 in Part No 24.

I My contact telephone number(s) is 9821339390 and my e-mail id is [email protected] my social media accounts are Facebook Account : httr>s://www.facebaok.com/Archana-Ranaiaditsjnha- Pafi142846560069406@,and my whatsapp No. is 9821339390

(4). . Details of Perma nt Account llumber (PAN) and status of filing of lncome Tax return. Sr. I Names 1 PAN The financial Total income shown In Income Tax No. year For which return (in Rupees) for the last five the last lncome- Flnanclal Years (as on the 31th March) tax Return (In Rupees) F.Y. 2017-2018 14,88,380 . .. F.Y. 2016-2017 1 13,14,170 "' 1. Self - PATlL ARCHANA R. F.Y. 2015-2016 12,91,88 2018-2019 F.Y. 2014-2015 1236,320 F.Y. 2013-2014 13,94,61C F.Y. 2017-2018 3,64,04,840 Spouse - PATlL A.Y. F.Y. 2016-2017 14,19,600 2. ' RANAJAGJITSINHA 2018-2019 .F.Y. 2015-2016 6,96570 F.Y. 2014-2015 7,10,620 F.Y. 2013-2014 6,47,940 F.Y. 2017-2018 1,85,930 AY. F.Y. 2016-2017 5,46,650 2018-2019 F.Y. 2015-2016 1,70,050 ' F.Y. 2014-2015 2,23,090 F.Y. 201 3-2014 1,56,100 I 4. I Dependent -1- Not applicable Not applicable Not applicable 1 Not applicable I Not applicable I I 5. IDependent -2- Not applicable Not applicable Not applicable 1 Not applicable I Not applicable I 1 6. 1 Pependent -3 Not applicable Not applicable Not applicable I Not applicable I Not applicable I I. I -- - Note : It is mandatoly for PAN holder to me n PAN and in ca! 3 of no PAN, is should be clearly 'No' PAN allotted'.

(5) Pending criminal cases 0)

OR (ii) The following criminal cases are pending against me:

&4\\&- Table

(0 ~riefdaJcription of offem D&obedii of dmduly Pmulg- by NIL NIL servant and VWatlon- of code of Eondud r charges have been lwned (menlion I I NIL I NIL r agaiMt (8) above is YES, lhen give NA NIL . NIL date MI which chafges were framed

filed against the pmcaedings (Mention I I *IL I (6) Cases of conviction

Ideclare that I have not been convicted for any criminal offence. (i) . . Wk-iw- Wk-iw- WW OR (ii) I have been convicted for the offences mentioned below: NOT APPLICABLE

wsw)

Table

(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) and (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. Delails should be entered dearty and legibly in BOLD Is(len. 2. Details lo be given separately for finch case under dMerent columns against each tom. 3. Dalaib should be given in reverse chmnologlcal order, 1.8.. UIO ktmae lo ba menlionad fist and b.slnwsrds in the order of dstes for the other cpses. I A .4. Addltionllthaet may be added if rewired. '-+jjl\tk Candidnb is rasponiible for supplying all informalion in compliance of Hon'ble Supreme Cou~I'sjudgment - in W.P O No. 538 of2011. I qw) That I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all dependents:

&:'~etailsof movable assets: name indicaUng the extent of jolnt ownership will alpo have to be given. depqsiinvestment. the details including Serial Number. Amount date of deposit. the scheme. Name of BanWlnsMution and , Branch areto be given. Note: 3. Value of BondslShare Debentures as per the current market value in Stock Exchange in respect of listed companies and as per books in case of non-lii companies should be given. Note: 4. 'Dependent' means parents, son(s), daugMer(s) of the candkiate or spouse and any other person related to the candidate whether by blood or rnaniage, who have no separate means of income and who am dependent on Ule candidate for their livelihood. Note: 5. Details induding amount is to be given separately in of each investment. Note: 6. Details should indude the interest in or armership of offshore assets. Explanation- For Ule purpose of this Fonn, the ewression 'offshore assets' includes detab of all depcsb or invssbnents in foreign Banks and any other body or institution abroad, and details of all assets and liablMies in foreign counlrks. (Fi.in Rupees)

posits and all other types f deposits induding saving ccounts), Deposits with inandal Institutions. Non- anking Financial Companies nd Cooperative societies nd the amount in each

onds, debenhrres/shares

Postal Saving. lnsura policies and investment i

any Financial instruments ' Poat Office or lnsuran

given to any person o entity Including firm company. Trust etc., a other receivables fro

etc. year of purchase an

valuable thing (s) (giv

value of claimslinterest rchase) at the lhre of (8) 1 give herein below the details of liabllitiesl dues to public financial institutions and government:-

ues to departments dealing with ovemment accommodation furnished namely:- (i) The address of the Ooremrnent accanmodation 1. Z.P. Vice President Qualter, Behind Z.P. Osmanabad -41 3501 (ii) There is no dues payable in respect of abmGovernment acoommodation towards- (b) Electricity charges: (c) Water charges: &and (d) Telephone charges f& as on 30/08/2019. date should be the last date of the third monUI priw to the month in the eledlon is notified or any date thereafter) (9) Details of pmfesslon or accupation (a) Self - Aariculturiot and Service I.t, (b) Spouse - Aariculturis$ ' of source (8) of income (a) Self - Salary income, Income from other sources, Agriculture income. (b) Spouse- Income from Maharashtra Legislature Secretariat, Rental Income, Income from capital gain, income from other sources, Agriculture income. # (c) Source of income, if any, of dependents - Not a~~licable. (Pel ~ondc*with appropriate Government and any public company or companies (a) Details of contracts elltered by the candidate - Not a~~licable ' (b) Details of contracts entered into by spouse -

rNo DeIcription of Contrad entered by spouse Name of appropriate Date of Contrad (Lease agreement) Gomment and any public company or- wmpanlas 1. Gala No. 101 to 106,119. Plot No.& 265 Turbhe Navi Mumbai MlDC 10101/1994. 11/12/1995, 15/02/1999 2. Gala No. 120,122,123 Plot N0.D-265 Tutbhe Navi Mumbai MiDC 04/07/2002

(c) Details of contracts entered into by dependents - Not aDDlicable (d) Details of contracts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have interest -

Sr. Desuiption of Conlrad entMed by Tema PuMi Name of appropriate Government and any Date of

No. Charitable Trust (as~ per~ information pbnby Trust) public company. . or companies Conlrad I I I 1 Pkt NO12, Sector 22,Ne~lNavi Mumbai I ClDCO 1 10)11/1997& I I I r ,w 1.u urn. ue~ur42. Neml Navi Mwnbai ClDCO OJIU~L , 1wirt.-. .. 3 Plot No 126, Sector 22. Ne~lNavi Mumbai I ClDCO ~wn?, 4 lot NO3. Sector 12. Nerul Navi Mumbai CIDCO 2wu1n 171MI

8 plot No 11. Sector 12. Panvel. Navi Mumbal I CIDCO I 06/09/19W I MIAOI4- I .-. ., ~d ClDCO .am,

IMC w,r,r mrm)P Jawhar Disl I I I I I Palghar I I (e) Details of contracts, entered into by partnership Firms in which candidate or spouse of dependents are partners - Not aDDlicable (f) Details of contracts, entered into by private companies in which candidate or spouse of dependents have share - Not aDDlicable (10) My educational qualification is as under:

Name of SchooUUnlversity Year Educational Qualfflcatlon Abhinav Vidhylaya English Medium 1986 SSC Pune Board Galware (M.E.S.) College Pune 1988 HSC Pune Board Waharashtra Institute of Technology, 1992 Bachelor of Engineering Pune (University of Pune ) (Electronics & Telecommunications)

(Give details of higheat School IUnlvenity education mentioning the full form of Ule cerUi7cate Idlplomal degree coune, name of the schooV wllegU University and the year in which the cwnewaa completed) PART- B

**BSTRACT OF THE DETAILS GWEN IN (l)TO 10 OF PART -A

otherwise write Independent)

) Self-acquired asset VERIFICATION I I, the depoient, above named, do hereby verify and declare that the contents of this affidavit are d correct to the best of my knowledge and belief and no part of it is false and nothing material has . ybee oncealed there from. Ifurther declare that: ( 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: P* ) I, .my spouse, or my dependents do not have any asset or liability, other than those mentioned in d1Items I and I of oa~A and Iterne 8,s and 10 of part B above. Verified at ~smanabadthis the 3" day 0ctobe;of 2019 ..

Note : 1. Aftidant should be filed latest by 3.00 PM on the last day of fillng nwnlnatlons. Note : 2. Ahidavt should be sworn before an Oath Commusioner or Magistrate of the First Class or before a Notary public. Note : 3 All wtum~should be filled up and no wlumn to be left blank if there la no infomation to furnish In respedof any item, either 'Nil' or'Not awliible' as the case mav be. should be mentioned. Nole :4 The affdavit should be either typed or v&en legibly and neatly Note : 5 Each page of the ARMavH should be slgned by the deponent and the AfMavit should bear on each page the stamp of the Notary or Oath Commluloner or Magistrate before whom the Affidavit is sworn. SCHEDULE - 1 I it in Bank accounts (FDRs, Term Deposits and all other types Of deposits including saving accounts), ~nancialInstitutions, Non-Banking Financial Companies And Cooperative societies And the amount in each

Self - ARCHANA R. Spouse- PATIL IrlName of Bank NO. I PATIL I UNAIAGJMNHA The National Co-op Bank, Nariman Polnt Saving A/c NA 146,499.00 ISaving A/C NA I 19,086.78 hhe Cosmos Co-o~.Bank I Ltd. Kothrud Br. 2 Saving A/c 29,348.27 N A Deposits 154,527.00 NA l~eposits I 159,692.00 ( NA IUnion Bank of , I Mumbai Main Office Saving AJc 220,498.99 41,949.56 Saving AJc 1,325.53 120,835.26 The Osmanabad Disrict Central Co-op. Bank

l~eposits NA 721,602.00 ITema Nagari Sahakari I I 5 l~ankLtd, Os'bad I I ]saving AJC I 19,565.00 8,855.00 _ l~ankof lndia, Os'bad D Saving A/c 127,107.45 NA Bank of Baroda Sangli 7 Saving AJc NA 2,504.00 - BMC-8050

= IsavingA/C I NA I 118,873.76 IState Bank of lndia,

lsav~ngAJC 492,208.00 NA ITerna Nagari Sahakari I 1 Bank Ltd, Os'bad (Election 2014 Savlngs A/c) 1 25.850.00 I ICurrent A/c I 10,800.00 1 NA IUnion Bank of India, I 12 Br.Osmanabad (Electron 2019 Current Nc) 29,379.22 35.000.00 SCHEDULE - 2 SCHEDULE - 3 investment in NS, Postal Saving, Insurance policies and investment in any Financial instruments in Jost ~~.or,lnsuranceCompany and the amount r. r. in Rupees, Self -ARCHANA R. Dependent-3

NIL

NIL

NIL

NIL

5 SA NIL l,OOO,ooO NIL NIL NIL NIL Policy No 981461070

, . SCHEDULE - 5

, kles/ Aircrafts/ Yachts/Ships (Details of Make, registration number etc. year of purchase and amount) ,' SCHEDULE - 6 ;bullion and valuable thing (s) (give details of weight and value)

Motor Vehicles SCHEDULE - 7 r I Details of Agricultural Land SCHEDULE - 8 ~etbf~ommerclal Building (Including apartments) r (Flg. In Rupees) HUF - Self ARCHANA R. Spou* - RANAlAGJITSlNHA Dependent -1 oependent-2 oependent-3 PATlL RANAlAGJlTSlNHA PATIL- HUF NA Nerul NA NA NA NA Flat No 101,102 Sagar Darshan Pallm Beach NA NA NA NA NA Road, Tower No 9 Sector 18 ' Area (total measurement in 101- 1164 sq.ft. NA NA NA NA NA w.fi.) 102 - 1164 sq.ft. Whether inherited properly (Yes or No) NA NO NA NA NA NA

Date of Purchase in case ofself- NA 17 Jan. 2001 NA NA NA NA acquired properly Cost of Land (in case of 101- Rs.12438901- purchase) at the time of purchase NA NA NA NA NA 102 - Rs.12438901- Any Investment on the Land by way of development, NA NA NA NA NA NA construction etc. Approximate cunent market NA 32,592,000 NA NA NA NA value 2 Location(s) Turbhe, Navi NA NA NA NA NA Mumbai surver number(s) Gala No 101to 106,

way ofdevelopment, NA NA NA NA NA NA construction etc. Approximate cumnt market NA 36,600,000 NA NA NA NA value 3 Locstion(s) NA New1 NA NA NA NA surver number(s) Flat No 5, Siddhivinayak CHS Plot NA NA NA NA NA No 11B Sector 21

Area (total measurement in sq.fi. 1655 sq.ft. NA NA NA NA N A (50 %Share ) Whether inherited pmpary (Yes NA NO NA NA NA NA or No) Date of Purchase in case of self- NA NA NA NA NA NA acauired property Cost ofLand (in osse of purchase) at the time of purchase NA NA NA NA NA NA

Any lnveshncnt on the Land by way of development. NA NA NA NA NA NA construction etc.

Approximate current market NA 6,600,000 NA NA NA NA value 112 ofeach

17 %

'ell hln QA77n69679 SCHEDULE - 9

NAlAGJlTSlNHA

measurement in 6q.t.

I

the Land by way of SCHEDULE - 10

,