{ FORM 28 (See rule 4) NOVINATION PAPER . ,, Elecrion to Ihe Legislarive Assenbly ol..H!..5..19...... (Slate) ( i
b l'a
STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE'I PART I
(To be used by candidate set up by recognised polirical party) I nominate as a candidate for election to the Legislative Assembly from ft ...6.8....[2..4). e.lfl TAssembly Constituency. candrdare's nu*".|1r!a.e.5.+.n.g.L".....r1r.€,.h4.^ ...... Fati'er's mother's/husband's ,u postal addressftT..4!+LPst*'.,EeJ+6i'r'.1?P:t..2d?! AnlAeJ.e+g.Lt'..'.',.,z:-'.'',-,...... His".|o4*.5ud.Ar it is entered at st. No. 7.../d..in rart ?:d/./.. A:...... Assembly constituency. J^ i1.-tofs'^t "^o7*- Kat''f Date a{/3./.t.X U Signature of the Proposer PART II hereby nominate as "^y,te for election to the Legislative Assembly fiom the .As Candidate's name...... i ...... Father's/mother's,4tusband's narne...... -...... His .His name is entered at S1. No...... in Part No...... of the roll for ...... Assembly o tr constituency. d o We declaxe that we are electors of this Assembly constituency and ollr lames are entered in the electoml roll for this Assembly constituency as indicated below and we append our signatures below in token ofsubscdbing to this nomination: - atrd their Elector Roll No. of Full Name PartNo. of S.No. in that part Electoral Roll l. 2. ..."1j-e- 3. 4. I o)l)t 5. tJ!* 6. '1. 8. 9. 10. N.B.- There should be ten electors ofthe constituency as proposers. PART III I, the candidat€ mentioned in Part L/Part II (St ke out which is not applicable) assent to this nomination and hereby declare that- (a) I am a citizen oflndia and have not acquired the citizenship ofany foreign State; (b) that I bave completed....l..d...... years ofagel [STRIKE OUT c(i) OR c(ii) BELOW WHICHEVER_IS NoI APPI,ICABLEI (c) (i) I am-set up at this election tt, ttt" /n.*.L.1:ffiffffift is recognised NatMnal Party/Sta&+a*y in this State and that the s]'rnbol reserved for the above parly be allotted to me. OR (ii) I am set up at this eleb{ion by the...... pafiy, which is a registered u ecognised polltical party^hat I am contesting this election as an independent candidate. (Strike\t which is not applicable) and that the syrnbols I have chosen, in order ofpreferenbe, aret (D...... (ii)...... - (iiD...... (d) my name ard qy father's/mother's,4rusband's name have been correctly spelt out l-t, above n.t:,^.i..k ...... (name olrhe language); and (e) That to the be"st offiry knowledge and belief, I am qualified and not also disqualified for being chosen to fill the seat in the Legislative Assembly ofthis State. * I further declare that I am a member ofth€...... **Caste/tribe which is a scheduled **caste/tribe ofthe State of...... in\elation to...... (area) in that State. I J r iar I also declare that I have not been, and shall not be nominated as a candidate at the present €eneral elecrion_/$e bye_elecrions - bejng held simultaneously. to the Legislative Assembly 0,/r.(fI3..... of(Sure) from more lhan r\ o Assembly consriruencies. Date.2*/.a/./../.. Signaturd ofCandidate * Scoe oul tne words not applicable. N B l politial partv 'tecognised deans a polirical pany reognhed by the Elarion comission uder rhe El€clio, synbols iR$eryation and Alloheno Order, 1968 m lhe Starc concemql. PART IIIA (To b€ filled bv 6€ candidate) (l ) whether the candidate- (i) has been convicted- (a) ofany offence(s) under sub_section (l); or (b) for contravention ofany law specified in sub_section (2) ofsection 8 ofthe Representatiolofthe people,Lct, t*i ' +""/N,i- (43 of 1951); or (ii) has been convicted for any other offence(s) for which he has been sentenced to imprisonment for two years or morc. Ifthe answer is'iYes,,, the candidate shall fumish the following information: (i) Case/First infomation reportNo.,Nos...... AJ1L...... fii)Policestarion{s)...d4...... Disrrictrs,...A14...... Stal.G)...... Jt. (iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been convicted .....V.4..... (iv) Darets) of conviction(s).....^L.4-.... (v) Court(s) which convicted the candidate (vi) Punishment(s) imposed [indicare period of imprisonment(s) and/ (x) Name ofthe court(s) before which the appeal(s)/application(s) for revision filed....61.{...... (xi) Whether the said appeal(s)/application(s) for revision has,&ave been disposed of or is/are pending. . .1r{.j.. (xii) Ifthe said appeal(s)/application(s) for revision hasAave been disposed pf1 (a) Date(s) of disposal...... l-JA..... (b) Nature oforder(s) passed.... lJ.* *-T (2) Whether thc candidate is holding any office of profit under the Govenrment of lndia or b State Government?...... (Y€€Alt' lfYes,details.oftheofficehpld...... AlA.....-...... (3) Whether the candidate has been declared insolvent by any Coult?...... 1V.*n'f31- -IfYes, has he b€en discharged from insolvency.../L(.+...... -..... (4) Whether the candidatc is und€r allegiance or adherence to any foreign country?...... (rlsrNlf Jf Yes. givc derarls .....At.B...... (5) Whether the candidatc has been disqualificd under section 8A of the said Act by an order of the President?...... (:leMid -If Yes, the period for which disqualified....N.'a...... (6) whether the candidate was dismissed for corruption or for disloyalty whil€ holdrng offlce under r he Govemmcnt of lndia or the Covemmenl of any Slale?. (+€€lNo r JfYes, the dat€ of such dismissal.....Al.A...... (7) Whether the candidate has any subsisting contract(s) with the Gov€rnment either in individual capacity or by trust or pa(nership in which the candidate has a share for supply of any goods to that Govermnent or for execution of works undertaken by that GovernnEnt l . .. . (Y€$ii -lf Ycs. with which Covemment and details of subsisting contract(s)... . A/. + . .. - .. . (8) Whether the candidate is a managing agent, or nmnager or Sccretary ofany company or Corporation (other than a cooperutivisocie9 in the capital of wlich the Central/ Govemment or State Covernment has not less than twenty-five percent share? ..... -. - (rles/nbf -lfYcs. with which Gov€rnment and the details thereof...... Al.A...... (9) Whether thc candidate has been disqualified by the Conrmission under section l0A ofthe said -If yes, the date of disqualification.....l:J.*...... Place: BJ-"?'Y w*i,$-k^* Date:;1r/:fll Srgnature of the candidate pARl.rv (To be filled by the Retuning officer) serial No. of nominarionpaper '0.fl|$.9 - Itol-n, n! This nomination was aetive,ea tJme'iil, tii,"" i.*os'.f!(Lo",; on}.FJ.fJ&"; uy rhe "caKdidate preposer { Name). %rr*_ Da," Lt -"SfAU."-dd#: l?lat1 - ii";.'t l**d ";a;r""bl" OtBaienOaAC FORI\I'B' NOTICE AS TO NAIVIE OF CANDIDATE SET UP BY THE POLITICAL PARTY (See paragraphs 13(b), (c) and (e) and 13A of the Election Symbo s (ReseNatjon and Allotment) order- 1968) 0 . The Returning Officer for the q,. B o LDe't.L'{.. constituency. Subject: Generai Electlon/Bye"electron to the Ho!se of the-P6ople/Leg s ative Assemb y fiom 68,.b oLr-r\q ih-. (Name 6f the consttuency) in . . o &,,ki.a. (state) - setting up of candidate. " Sir In pursuance oi paragraphs 13 (b), (c) and (e) and 134 of the Electlon Symbols (Reservation and Alotment) Order 1968, I hereby give nolice on behalf of Indian Nat onal Congress - 0 that the person whose panlculars afe fumished in columns (2) to (4) below is the approved candidate of the party above named, and - (ii) the person whose particulars aae mentioned ln columns (5) to (7) below is the substitlte candidate of the pady, who will step-in on the apprcved candidate's nomination being rejected on scr!tiny or on his/her withdrawing ffom the coniest, if the substitute candidate is sti I a contesting candidate, at the ensuing general/bye election from lhls constituency : tlz- 1 Na-ne of the co-stitLency 6 8 , f> oLa-1,4 ll\rgkta 2 \a1eo't-eapprovedcanooare I'Jat'o-'<""-VLo l'\ | e lr'-E-a 3. Fatrer's/notler's/-ugbdro's .ame of y wllit+t-i", approved candidate postat address of approved candidate kLlP,' . V"b'^f 5 Name of the Substitute candldate who wi | : step-Ln (i) on the approved candidate s nonr nation bejng rejected on scrutiny, or (ii) on his/her (approved candidate) /' withdrawlng from the contest if, however, the rornination paper of substitute candidate is accepted on scrutiny as an independent candidate and is still a contestlng cand date 6 Fathels/mothers/husband's name ofsubstitute i Z Candldate 7 Postal addfess of substitute candidate : f - 2 The notice in Form 'B given earlier ln favour of Shri/Smvsushri party's approved candidaie, and Shrl/SmVsushri ...... as party's substitute candidate is hereby rescinded. 3 t s certifed that each of the candidates whose name is mentioned above is a member of this po ltrcal paaty and his/her name is duly boane on lhe roLls of members of this party Yours faiihfully, Congress P ace Dated: " Score off, if not appllcable. NB 1. This musl be deLivered to the Relurning Ofncer not laler than 3 p,m. on ihe lasl date for maklng nom naiions. 2. Fofr. rnusl be signed in lnk by the offlce beare(s) mentioned above. No facsimile signalurc or signalure by means ofrubber stamp, etc. of any office bearer shallbe accepted, FORM'A' MMUNICATION WITH REGARD TO AUTHORISED PERSONS TO INTIMATE NAME OF CANDIDATES SET UP BY RECOGNISED NATIONAL PARTY (See para 13 (c) and (d) and (e)ofthe E,ection Symbols (Reservation and Allotment) Order, 1968) to 1. The Chief ElectoralOtficer Odisha 2. The Returning Officer for the ...... B.OL+,y8.{,L constituency. Subr General Elections to the Legislative Assembly from Odisha - Allotment of synbols - Authorisation of oerson to intimate the names ofcandidates. In pursuance of paragfaph '13 (c) and (d) and (e) of the Election symbols (Reservation and Allgtment) Oder, 196E, I hereby communicate that the following peGon has been authorlsed by the lndian National Congress, which is a National Party, to intimate the names ot the candidates proposed to be set up by the party at the election cited above. DistricUArea/Constituencies Name of person authorised to Name of Office held in the party in respect of which he has seno nolce been authorised. PRESIDENT, ODISHA All Assembly constituencies SHRINIRANJAN PATNAIK PRADESH CONGRESS COMMITTEE of Odisha The specimen signatures of the above mentioned person so authorised are given below: Specimen signatufes of Shri Niranjan Patnalk: 1. aAg 3. Lo'H,Yours faithfully, ( MUKUL WASNIK } General Secretary lndian National Congress Place: New Delhl, Dated: 18'n March, 2019 NB: 1. This must be delivered to the Retufning Officer and the Chief Electoral Officer not later than 3 p.m. on the last date for making nominations. 2 Form must be signed in ink by the office bearer mentioned above. No facsimile srgnature or signature by means of rubber stamp, etc., of any office bearer shall be accepted. No form transmitted by fax shall be accepted. RUPEES' oOerr ertftsrT oDISHA 44AA 059729 i,,;' "i'rir' ::;ffiirlt ""i"1ri,o.iil"lil?1i," +ffa-u'v '- - q"8#g b'A..'.e' 9&,'st4 \-,'- ^tu n ^ i%N\ w -:;ffi;rlt* '-I>Fpo FlFNrT c. ,, + i _. i "... e*' Form 26 (See rul€ 4A) FFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO MEMBER ODISHA LEGISLATI\,'E ASSEMBLY. (NAME OF THE IIOUSE) FROM 68-BALAI\ICIR ASSEMBLY CONSTITUENCY (NAME OF THE CONSTITUENCY) PART A I Narasinsha Mishra, **son/daughler/wife of Late Yudhisthir Mishra Aged Z! years, resident of Clubpada. Balansir Town. P,O./P.S./District- Balaneir-767001 (mention full postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under:- (l) I am a candidate set up by Indian National Coneress (**name ofthe political party) / **am tontesting as an Independent candidate. (+*strike out whichever is not applicable) (2) My name is cnrolled in 68- Balangir Assembly Constituency in the state of Odisha...(Name of the Constituency and the stat€), at Serial No. 6E3 ...in Part No. 2!4...(Clubpada, Balangir town, Ward No.l2 12\ (3)\,Iycontact1clcphoncnumbe{s)aiE@..,andmy eillail id (ifany) is [email protected] .....:rand my social media account (if any) are (r) rwrrrer:- (rn:!mstngnmtsnra (ii) Facebook:- @NarasinghaMishralNc O{M Connect) (iii) (4) Details of?ermanent Account Number (PAN) and status of filing oflncome tax r€turn : The financial Total income year for which shown in Income the hst Tar Return(in lncome-trx Rupees) for the retutn last live Financial has been filed Yeers (is on the 3l'r Mrrch ffi'ffim' ,,, rI l. Self ACEPM727lK 2017-18 (D k.24498r9/- 2016-17 (ii) Rs.21270811 2015-16 (iii) k. 21839s4f 2014-15 (iD Rs.1506320/- 2013-14 (v) Rs.13001204 { Spouse ACHPM9OS6D 2017-18 (i) Rs.14173d0/- "'1 tt (Smt, Kusum 2016-t7 (iD Rs.1195758/- k-; ,'\ Mishra) 2015-16 (iii) R3. 1026739/- I6\k, tF1-$$iiiN'. 'ro'tfi,/ 2014-15 (iv) Rs.913l46/- ".'i$: 2013-14 (v) Rs.??8543/- '-r t' r!"/ HUF (If the NOT NOT NOT Candidate is APPLICABLE APPLICABLE APPLICABLE vffi, Karta or Coparcener) 4. Dependent I NIL NOT NOT NOT APPLICABLE APPLICAALE APPLICABLE Dependent 2 NIL NOT NOT NOT APPLICABLI] APPLICABLE APPLICABLE D€p€nd€nt 3 ML NOT NOT NOT APPLICABLE APPLICABLE APPLICABLE Note: It is mrndatory for PAN holder to metrtion PAN and in case ofno PAN it should be clearly shted "No PAN allotted". (5) Pending criminal cases (i) I declare that there is no pending criminal case against me. (Tick this alternative ifth€re is no criminal case pending against the Candidate atrd write NOT APPLICABLE against alt€rnative aii) belo$ OR (ii) The follorving criminal cases are pendiiig against me: "NOT APPLICABLE" (Ifth€re are pendiDg criminal cases against the candidate then tick this altemative atrd score off alternative (i) abov€ and giv€ details of all pending cases in the Table below) Table (r, FIR No. with name and address ofPolice NIL NIL NIL Station concem€d (b) Case No. with Name ofthe Court NIL NIL NIL (c.) Section(s) of conc€rn€d Act(sycodes NIL NIL NIL involved (give no. ofthe Section, e.g. Section.,.....of IPC €tc). (d) Brief description of offence NIL NIL NIL ^r- n\Q I ,,Sffi"*ffi "{4' WD (e) Wheth€r charges have be€n framed NO NO NO (mention YES or NO) (f) Ifanswer against (e) above is \TS, then NIL NIL NIL give the date on which charg€s wer€ liamed (c) Wh€ther any AppeavApplication for NO NO NO revision has been filed against the proceedinqs (Mention YES or NO) (6) Cases ofConviction I declarc that I have not been convict€d for any criminal offence. 1'RSi fhis alternative! if the candidate has not been convicted and write NOT APPLICABLE H alt€rnativ€ (ii) below) OR ii) I have been convicted for ahe offences mentioned below:-'NOT APPLICABLE" (lfthc candidate has been convicted, then tick this alternative and score off alt€rnative (i) above, and sive dctails in the Table below) Table (a) Case No. NIL NIL NIL (b) Name of the Court NIL NIL NIL (cl Sections of Acts/ Cod€s NIL NIL NIL involved (give no. olthe Section, e,g. Section....of IPC (d) Bri€f description of offence NIL NIL NIL for which convicted (e) Dates ofordels of NIL NIL NIL conviction (1) Punishment imposed NIL NIL NIL (s) Wheth€r any Appeal has NO NO NO been filed against conviction order (Mention YES or NO (g) (h) ] Ifanswer to above is NOT NOT NOT i YES, give d€tails and APPLICABLE APPLICABLE APPLICABLE Dresent status of aDDeal (64) I have given tull and up-to-date information to my political party about all pending criminal cases againsi me and about all cases ofconviciion as given in paragraphs (5) and (6):- NOT APPLICABLE IN VIEW OF ENTRJES IN 5(i) and 6(i), above. I candidates to whom this item is not applicabl€ should clearly write NOT APPLICABLE IN \rIEW OF ENTRIES IN 5(i) and 6(i), abovel err-l4m\\ ,gAh-V'""'' .o'"*l'9'"1"';"?ll{3"' f Note: l. Details should be ent€red clearly and legibly in BOLD Letters 2. Details to be given separately for erch case under different columns against each item. 3. Details should be giver in reverse chronological order, i.€., the lat€st cas€ to be mentioned first and backwards in the order of dates for the other cas€s, Additional she€t may b€ add€d if required, andidate is responsible for supplying all information in compliance ofHon'bl€ Supr€m€ ourt's judgm€nt in W.P.(C) No.536 of2011. 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: L Assets in joint name indicating the extent ofjoint ownership will also have to be given. Note: 2. In case ofdeposif,/Investment, the details including Serial Number, Amount, date ofdeposit, the scheme, Narne of Banl/ Institution and Branch arc to be given. Note: 3. Value of Bonds/Share Debentures as per the cu(ent market value in Stock Ilxchange in respect oflisted companies and as per books ih case ofnonlisted conpanies should be given. Note: 4. Dependent means parents, son(s) daughter(s) ofth€ caDdidate 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 ih€ candidate for thei livelihood. Note: 5. Details including amount is to be given separately in respect of each investment Note; 6. Details should includ€ the inter€st in or own€rship of offshore assets. Explanation- For the purpose of this foiin, tlr6 expressioir "offshore ass€ts" includes details of all d€posits or investments in Foreign banks and any other body or institution abroad, and d€tails of all assets and li|bilities in foreign countries s. Description Self Spouse HUF Depend€nt-1 Depen D€peDdent-3 \o. dent-2 (i) Crth in 1.79 , t*.,1 Lacs 9.56 Lacs N.A N.A N.A NJ. (ii) Details of deposits Andhra 4810025000 Savin 1501492-68 SelfA/. N.A N.A N. N. in Bank accounts Bank, 635 g BBSR (open (FDRS, TeIm dt,23,10,03) Deposits all and Andhra 5610100078 Sav n 48398.00 SelfA/c other types of Bank, 594(Open C Deposits including BBSR dt.19-03.14) savmg accounts), Axis Bank 2401010001 sav'n 249-70,57 Self Alc Deposits with sBSR 9151(open I q\e4 4't , satolfulG-u-{ Ndary' fr'.*4"lv^'"t" YI ,,8fl | ' '/$l(/rrc I qali lBA,$t AndtrE Bdn<, J6201000O??45 10,10124.00 i rugr.l BLGR (open l)"{' dl.31.12.10) Details of Candidate: Shri Narasingha Mirhra II) Spouse : Kusum N.A N.A N. N. 4R Inveshnent tn a) MIUSUTI : Rs.63,934/- Mishrr Bonds, b) Investmeni in unquoled Shees At Cosr a) MruS UTI : Rr. : Ovo Fam Pfi Lirniled : Rs- 2-00 Lacs Debcntures/shares 10,000/- b) Investnen in and units in companiesMutual Cost: Funds and others i) Ovo Farn Pvt and the amount. Ltd. Rs. 9.52 Lacs ii) K-handagni Pulp Pvi Ltd. Rs. 3.00 Lacs ( i!) Details of Candidate : LIC Amuity Plan Nil N.A N.A N. N. invcstrnent in NSS, (PolicyNo. 590336732) open A Postal Savings, dt.25.03.89) Insurance Policies I and investment in R€ceiving @ Rs645 per month any Financial rnstruments in Post office or Insurance Company and the (") Personal Candidate : Narshinsha Mishrr Spouse I SmL N.A N.A N. N. Ioanvadvance Kusum Mishra glven to any pe$on SournendrtrMishn Rs.2.92,717l- ale.ild- or entity including Mmishra : Rs Klandagili Pulp Pvl Ltd Rs. 2,65,062l- 44,500t- film. company, i:! (ii) ovo Fams Pvt Trust etc. and other KusM Mishra Rs- 2,24,517/- Ltd Rs. 75,64,900/- receivables from (iii) LIC HFL Care debtors and the Home Lt. amount. k33,71,15?/- 50% share jointly with Son- Saiiendra Misha { \,r) Motof ML NIL N.A. N.A N. N. Vchicles/Aircrafts/ Yachts/Ships (Details of Make, registation Number. etc, Year of Purchase and amount ) (vii) JeweLy, bullion Candidate : Narsbineba Mishra Spouse : Smt. N.A N.A N. N. and valuable 48 Gm Market Value Rs. 1,44,000 Kusun Mishra thing(s) (give 490 Gm Market saroj3fft6 Notary, Balangit yq,rrJ1t l-l"2"-' details of weight Value : Rs. and value) 15,10,600/- Any other assets such as value of clairns/interest Cr(,ss'l'otal value Rs1,58,77,121.31 Rsl,7148,216,74 oflmmovabl€ assets: 1. Properties in joint o'rnership indicating the extent ofjoint ownership will also have to be indicated | 2 . Each land or building or apamnent should be mentioned separately in this format t€: 3. Details should include the interest in or ownershiD of offshore assets. cription Aericultural Land Chhatamakhan Chlatamaklan Not Not Not Location(s) Survey a, PlotNo.220 a, Plot No.168, Applicable Applicable Applicable ofHolding t'7 |736, No.83/15 with t72/'73'7, 160, fa1m house r57, t56, there on 120,108 and .221 of Holding No.83/14 Area (Total Ac2.48odec, measuiement in butpossessing aores) Ac2.500dec Whelher inherited prcpeny Date ofpurchase in case r4.06.19'77 05.05.80 2',7.01.82 scli - acquired propcrty 01.02.80 alost olLand (in case of pulchas€) at the time of purchase Any lnvestment on the Construction Not land by way of of farm House Applicable dcvelopment, Rs2,00,000/- Plantation construction approx- of Rs1.50.000/- Rs 13,00,000/- Aericultural Land Hoiirvl'CaangirToryr"Iffi: Chhatamakhan , Claim Plot Applicable Applicable Applicable a, Except plot No.91,92,93, of No.247,248, Holding no.9 by 249 and 603 of Holdidg No.32 rest lanals have Possession been Cifted .ffi"' and sold away AcI.94odec Ac3.l6dec N.A, N.A N.A N.A ei sulemenlln Whether inherited No No N.A. N.A N.A N.A propeny (Yes or No) Date ofpDrchase in case 2't.09.66 In the year N.A. N.A N.A N.A of 197'7 sell- accluired DroDerfv Cost of Land (in case of Rs500/- N.A N.A. N.A N.A N.A puchase) at the time of purchase Any Invesiment on the Rs2,00,0004 NIL N.A. N,A N.A N.A land by way ol for construclion of residential house over DlotNo.603 Approximate Current Rs10,00,000/- Rs4,00,000/- N.A. N.A N.A N.A market value Agricultural Land Kandhpali, NIL NIL N,A N.A N.A Location(s) Survey Plot number(s) no.463/560164 9,3671522/ 648, 508, 463/641,462, 389 & 390 of Holding no. i 06/41 Afca (Toral Acs.240. (Rest N.A. N.A. N.A N.A N.A lands have been sold) Whether inkrited Yes No N,A. N.A N.A N.A property (Yes orNo) Dat€ of purchase in case Not applicable Not applicable N.A, N.A N.A N.A of self - acquired properh/ Cost ofland (in case of Not applicable Not applicable N.A. N.A N.A N.A Qvl.rr{ I ffiffiffi;16.Gd re,*\*,r Lr, purchase) at the time of purchase Any Investnent on the NIL NIL N.A. N.A N.A N.A land by way of development, coisuuction Approximate current Rs5,50,000/- NIL N.A. N.A N.A N.A market value Asricultural Land Tulandi, plot NIL NIL N.A N.A N.A Location(s) Sui,'ey no.218,628, 631 , 632, 633, R 634,63s,638, *'/ 639, 796, 801 &296/953 of : {et Holding no.44 {.plot no.2961953 is :,; .: rmder possession of \w others) Area (Total Ac5.25 dec N.A N.A. N.A N.A N.A treasurement in acres) Whefter inherited Yes N.A. N.A. N.A N.A N.A propeny (Yes orNo) Date ofpurchase in case N.A N:A N.A. N.A N.A N.A seif - acquired pmperry Cost ofland (in case of N.A, N.A N.A. N.A N.A N.A puchase) at the time of purchase Any Investment on the NIL N.A N.A. N.A N.A N.A land by way of development, conshuction etc Approxirnate Curent Rs5,50,000/- N.A N.A. N.A N.A N.A martet !alue ( ii) \on--4gricultural Chhatamaklan Balangir N.A. Not Not Not Land a, Plot no.603 'KHA' plot Applicable Applicable Applicable Location(s) suvey of Holding no.6l'7 /1482 number(s) no.32 ofHolding no.888/1535. ,.ffi",:ffim' y,-Wk*' t0 Afca (Total Ac0-l4dec Aco.060dec N.A. Not Not Not 616 sq.ft Applicable I Applicable Applicable in sq. ft.) Whether inhedt€d No No N.A. Not Not Not properry Appl;cable I Applicable Applicable fYes or No) Date of purchase in case 27.09.66 08.06.1976 N.A, Not Not Not of Applicable Applicable Applicable self - acquired property Cosl ofLand (in case of With other Rs3000/- N-A. Not Not Not -t agricultural Applicable Applicable Applicable lands Rs500/- ffiuttn"t"""ot as stated above Rs2,00,000/- NIL N.A Not Not Not .lll].: as stated Applicabl Applicabl Applicable ffi""""'"'"n" above, n, d&;Xdevelopment. ->{t ffism:ction etc. Ap+oximate Curent Rs5,00,000/- Rs6,00,000/- N,A Not Not Not Mark€t value Applicabl Applicabl Applicable Non-Aericultural Titilagarh'KH NIL NIL N.A N.A N.A Land A',Iand of Location(s) survey Holding I'o.463/l6l number(s) Area (Total Aco.010 dec N.A N.A N.A N.A N.A measulemenl (Does not rn sq. rr.l claim right or titlei Whether inherited Yes N.A N.A N.A N-A N.A properly (Yes or No) Datc ofpurchase in N.A N.A N.A N,A N.A case of self - acquired property Cost ofland (in case N.A N.A N.A N.A N.A N.A of puchase) at the time of purchase Any Investment on the NIL N.A N.A N.A N.A N.A By way ofdevelopmeni, Approximate Curent N,A N.A N.A N.A N.A Market value NA. -,.#m\ K{."AyV"-/' (iii) Commercial Builalines NIL NIL NIL Not Not Not (including apartments) Applicabl Applicabl Applicable -Location(s) e -Survey number(s) Area (Total NIL NIL N.A Not Not Not measurement Applicabl Applicabl Applicable in sq. ft.) e Built-up Area (total NIL NIL N.A Not Not Not measurement in sq.ft.) Applicabl Applicabl Applicable Whether inherited N.A N.A N.A Not Not Not Applicabl Applicabl Applicable ffi\ e N.A N,A N.A Not Not Not Applicabl Applicabl Applicable , t,.i. l 0n N.A N.A N.A Not Not Not |': Applicabl Applicabl Applicable \\X: ) at the time of Any lnvestment on the N.A N.A N.A Not Not Not land Applicabl Applicabl Applicable by way of construction etc. Approximate Current N.A N.A Not Not Nor Market value Apphcalll Applicabl Applicable ov) Residential Buildinss Jaagmara, NIL NIL Not Not Not (including apartments,) Bhubaneswar, Applicabl Applicabl Applicable -Location (s) plot e e Lo.('4'0/5904 -Survey numbe(s) of Holding uo.ll521283, presently 221- Dharrna vihar, Khandagiri, Bhubaneswar Area (Tolal Aco.049dc N.A Not Not Not 2123Sq.ft Applicabl Applicabl Applicable in sq. ft) Buih up Area (Total 1232Sq.ft N.A N.A Not Not Not measurement in sq.ft) Applicabl Applicabl Applicable Whether inherited No N.A N.A Not Not Not properry Applicabl Applicabl Applicable (Yes or No) .ffi:'ffim' Detc ofpurchasc in 28.08.02 N.A N.A Not Not Not Applicabl Applicabl Applicable sclf acquired propefty Cost of property (in Rs4,56,11l/- N.A N.A Not Not Not Applicable case of Applicabl Applicabl purchase) at the time of purchase Any lnvcslment on the NIL N.A N.A N.A N.A N.A land by way of developrrent, Apprcximate Current Rs75,00,000/- N.A N.A N.A N.A N.A -4 iFEkLvalue Mishrapaii, N,A NIL N.A N.A N.A {l Binika, Dist- G Sonepur, plot no.108, Holdirq no.25 0.43 dec N.A N,A N.A N.A N.A 1900Sq.ft sm#, approximately Briilt up Area (Total in 1900sq.ft N.A N.A N.A N.A N.A sq.fl) Whether inherited No N.A N.A N.A N.A N.A propelry (Yes or No) Date ofpurchase in 11.01.02 N.A N.A N.A N.A N.A self- acquired propcfty Cbsl ofproperty (in Rsl'74/- N,A N.A N.A N.A N.A purchase) at the time ofpurchase Any Inveshnent on the 8,00,000/- N,A N.A N.A N.A N,A land by r,eay of development, conshuction etc Approximate Current 14,00,000/- N.A N.A N.A N.A N.A Market value Residential Buildings Balangir, Sabik N.A N.A N.A N.A N.A (including aparhnents)i plot no.2375 of Locatjon (s) Mishra & -Sun cy numbcr(s) received as gift from Late Yudhisthir Mishra Area (Total Ac0.69dc NA \.9 +{.A N.A N.A N.A N#rY'qatangir NW;-^V; 3000 sq.ft in sq. ft) Built up Area (Total in 3000 sq.ft N.A N.A N.A N.A sq.ft) Whethd inherited N.A N.A N.A N.A N.A N.A prcpefty (Yes or No) Date of purchase in N.A N-A N.A N.A N.A N.A self - acquired properry Cost of property (in N.A N.A N.A N.A N.A N.A case of A ffi&il: 10,00,000/- N.A N,A N.A N.A N.A $ffi:-- 40,00,000/- N.A N.A N.A N.A N.A x [PX"cu.'.''t Olhers (Such interest in NIL ML N.A N.A N.A N.A propefly Total of current maiket Rs1,68,00,000/ Rs 14,50,000/- N.A N.A N.A N.A value of(i) to (v) above (8) I give herein below the details ofliabilities/dues to public financial instihrtions and govemmentr (Not€: Please give separate details of name of Bank, institution, entity or individual and ahount for each item) S. Description Self Spouse IIUF Dependen Dependen Dependent- t-l 3 No. lu Loan or dues to NIL Nil NA Nil Nil Nil Bank/Financial NB: Personal Institution(s) Andhn Banl Bolangir i.o Name ofBank or credit Facilities Financial Institution ofRs. 10.70 Crore to lil/s Amount outstnnding Ovo Fam Pvt. Natue of loan Ltd. Bolansir Lorn or dues to any Nit Nit NIL Nil Nil Nil other individuals/ entity other than rih -..#t"S#g* WW0*/' l4 mentioned above, Name(s), Amount outstanding, Natu.e of loan {ny other liability Nil Unse.ured NIL Nit Nil Nil Loan ofRs. 68.22 From Friends and Family members Grand fotal of Nil Rs. 68.22 Lacs NIL Nil Nil Nil liabilities (ii) Co!ernment Dues: fA) Has rhe deponenl bee0 in occuparioo of accommodation provided Dues to department by the Govemftent at YESAIO j dealing wirl any time during the last ten years before the dat€ ofnotification ofthe current election ? (Pl. tick the appropriate I govemment Accommodation fB) Tfanswer to r A) above is Y ES. tle following altemative) declaration may be firmished namelyi (i) The address ofthe Govemment I L4-=\- xlE471 accommodation: r/ --\, tt\ (l) QRS No.MLA(D-I3/02, Unit-IV, Bhubaneswar, Dist- Khurdha (2) QRS No-UW02, Unit-I, ffiFl Bhubaneswar, Dist- Khurdha N';4$ry/-F'l (iD There is no dues pay;ble in respecr of r6 above Gov€mment accofmtodation Note- 'No Dues Certificate' from the agencies concemed in respect ofrent, elecbicity charges, water charges and telephone charges for the above Gov€mment accommodation should be submitted. (iii Dues to department NIL NIL NA NA NA NA dealing with ) goremmenr r'anspo|t (rncluding rircfafts ard helicor I'L r Incomc Tax Ducs NIL NIL NA NA NA NA Self Spouse HUF DepeDdent Dependent Dependeni-3 -1 -2 (\) GST dues NIL NIL NA NA NA NA (vr) Municipality/property NIL NIL NA NA NA NA lax dues :)r,#ffi; *.r*'W! t) (vii Any other dues N Nil NA NA NA NA ) (iii) Grand total ofall Nil Nil NA NA NA NA Govemment dues 0x) Whether any other Nit Nil NA NA NA NA liabilities arc in dispute, if so, mendon the amount involved and the authodty befbre which it is pending. (9) Details ofprofession or occupation: (a) Self. ..Advorate. practicine in Civiycriminal courts as w€ll as Ilish Cou ofOdisha.-. (b) Spouse...Business. Details of soEce(s) ofincome: Selt...... LEGAL...... Spouse...BUSINESS (?OULTARY). Souce of income, if any, of dependgnts. .Ngf APPLICABLE. ) Contracts with appropriate Govemnent and any public company or companies (a) details of conhacts entered by the cand.idate...NIL, {b) delails ofcoDrracLs enrered inio by spouse ...\IL, (c)details of contracts entered into by dependents . . . NOT APPLICABLE (d) details ofcontracts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have idterest ...NOT APPLICABLE (e) details ofcontracts, entered into by Partnership Firms in which candidate or spouse or dependents are partneN ...NOT APPLICABLE (0 details of conhacts, enteied into by private compaDies in which candidate or spouse or dependents have share ...NOT A?PLICABLE (10) My educational qualilication is as under: ComDleted Bachelor's Deqree in Comm€rce from Utkal Universltv in the vear 1961... ComDleted Bachelor,s Degree in Law from Utk4l University in the vear 1963... (Give details oflighest School / University education mentionitrg the firll form of the cetificate/ diplomt degree course, name of the School /College/ University and the year in which the course was comDleted_ ) #.ttrffi' \y*i"-U--t' \rd0 PART - B ABSTR{CT OF THE DE AILS GIVEN IN l() (10) OI PART-A: I Name of rhe candidat€ Shri Narasingha Mishra 2. Fullpostal address At. Clubpada, Balangir town, P.O.P.S.,Dist Balangir 3. Number and Name ofthe constituency and state 68- Bal/ngir As\embl) Constiruency iD Odisba Name of r,\e Political Party which set up the candidale Indian National Congess Party (other$ ise writc'IndcpendenC) Total numb$ ofpending criminal cases NIL 6. Total Number of cases in which convicted NIL and sentenced to imprisonment for one year of more [except lor o{fences referred to in sub-sections ( l), (2) or (3) ofscction 8 of Rcf-e-enrd io ofr\c Pcoplc Acl. l05l_ '7. PAN of Year for which last Income Total Income Shown P: \ Tax Retum filed ACf,PM7271K FY20l7- l8 Rs.24,49,819f ACHPM9()S6D FY 201?-18 Rs. 14,17,340/- No PAN Alotted NIL NIL W9)dr Depcndenl NOT APPLICABLE NOT APPLTCABLE NOT APPLICABLE i Details ofAssets and Liabilities (including offshore assets) in Rupees Des \ i Dcscriptioo Self Spouse HUF Depe Depen Dependent-Il _ I ndent dent-ll : -I Vloveable Assets Rs.1,58,77,121.3 Rs.1,71,48,216.? N.h' (Total vahe) I 4 N.k Nh il.} ' lmmovabl€ Asset Rs1,68,00,000/- Rs14,50,000/- N.A N,A N,A B. I Purchase Price Rs4,58,885/- Rs14,300/- N,A N,A N,A N,A, ofself-acquired properry II Development/constructi Rs23,50,000/- NTL Not Not Not Not Applica on cost ofirnrnovable Appl Applic property after purchase Appli icabl able (if cable aDDlicablel III Not Not Not Not Applica Current Markct Appli Appl Applic icabl able cable (a) Self-acquired assets (Toral Value) Rs3,15,77,121.31 Rs.1,85,98,216.7 (b) Inherited assets 4 (Total Value) Rs.11.00.000.00 Nit Sarol Ku ffii'ur"v " .lotary, Balanglf TotdFr Y6r-J""lf \d l'7 9. Liabilities NIL NIL NIL NIL NIL NIL (D Govcmment dues NIL NIL Not Not Not Not Applical Applic (Total) Appli Appl icabl able cable (ii) Loans from Bank, NIL Rs.68,22,000f Not Not Not Noi Applical Financial Appli Appl Applic Instibltions and icabl able \ cable {l others (Total) :\ Liabilities that are und€r dispute r\ i! Apphc y) Goverrment dues NIL NIL Not Not Not Not KS (Total) App Ap Applicable \<& I 9 lica plic a ble abl /,vy>. \ (iD Loans from Bank, NIL NIL Not Not Not Not Applrc Financial App Ap Applicable Instihrtions and plic lica others (Total) abl ble ll Highest educational qualifi cation: Completed Bachelor's Degrep in qo+rmerc€ ffpm Utkal Universitv in th€ vear 1961"' Completed Bachelor'9 D€gr€e in Law from Utkal U[iversitv Ln thp vear 1963"' (cive details ofhighest School / University education meDlioning the firll 6iri of tlt iertifical€/'diplomL Name of the School /College/University and thgy"@ VERIFICATION . I, the deponent, above named, do hereby veri! and declare that the contents ofthis affldavit arc true and correct to the best of my klowlealge and belief and no part of it is fals€ and nothing material has been concealed there from. I funher declare that: (a) there is no case of conviction or pending case against me other than those mentioned in items 5 and 6 ofPart A and B above; in (b) I, my spouse, of my dependents do not have any asset or liability' oiher than those mentioned items 7 and 8 ofParl A and items 8, 9 and 10 of Pan B above Veified at B4b4gE this the 24d Day of March 2019 t-Y'o a - 4. v.l 0-/ f{\r' ,Tffi-q" l-..-? Government of 0disha General Administration & Public Grievance (Rent) Department Bhubaneswar No... .., .,, .. .,...... /Rent Date vr.t,A.3/2019 to The Secretary, Odisha legislative Assembly, Bhubaneswar. Sub: lssue ol Clearance Ceftificate in favour of Shri Narasigha Mishra, Hon'ble Leader of 0pposition, Odisha Legislative Assembly, Bhubaneswar, Odisha. Sir, I am directed to say that, no due is outstanding against of Shri Narasigha Mishra, Hon'ble Leader of Opposition, Odisha Legislative Assembly, Bhubaneswar , Odisha towards house licence fee for occupation of Govt. quarters. N0.13/2, Type-MLA-(F), Unit-lV, Bhubaneswar iiil 31,05.2016 (i.e. the date of vacaiion) & Quariers. No. 2, Type-Vlii, Unii-i, Bhubaneswar till 31,03.2019. Yours faithfully, sql_ Rent Otficer ,^..^// G.A & P.G $ent) Departmenl Memo No...... 1 1..1.15....iRent Date .t,? .1. Osi a0l7 Copy fonvarded to P.S to Leader of opposition, Odisha Legislativg Assembly, Bhubaneswar for information and necessary action. _d Ltt il, V Rent officer \ G.A & P.G (Rent) Department *.Jl,.\r-'?''- \*wm ,uj,f[oi:i;,'"r,,r,,," tililililililt|il]illtIt|| Gq ors. OFFICE OF THE ASSISTANT EXECUTIVE ENGINEER, P.H.RE NT sUB: DlVlSlON, BHUBANESWAR *******:l** ,.75t4s-o, lLt- f \ NO - DUES CERTIFICATE REGARDING WATER / SEWERAGE CHARGES Certified that, the Water / sewerage Chatges against the Consumer Consumer No : 40s9002 Name : NARASINGH MISHRA Address . qRs No-vu-02 UNITI BHUBANESWAR is cleared up to March-2019, This may be treated as No- Dues Certificate against consumer for Water / Sewerage Charges Concerned. \ k a-tri Assistant +et-dtive Engineer, P.H. Rent \ub: oivision, Bhubaneswar S..c"**^\ '.,t. girpta Notary -ialangirTown ll | ilililililIiltilitiltl Gn Q.s. OFFICE OF THE ASSISTANT EXECUTIVE ENGINEER, P.H.RENT SUB: DIVISION, BHU BANESWAR ********** Q quu No rz a lDt 1s-3-17 NO . DUES CERTIFICATE REGARDING WATER / SEWERAGE CHARGES Certified that, the Water / sewerage Charges against the Consumer Consumer No : 433s026 Name : NARASINGH MISHRA Address i qRs No,Mr-A{F)-13l02 UNIT-IV EHUBANESWAR is cleared up to March-2019. This may be treated as No Dues Certificate aga;nst Consumer for Water / Sewerage Charges Concerned. P.H. Rent 5ub: Division, Bhubaneswar \twt' *e*d'' cwffi\ Saroj Ku. '.j!F:-: l'|&ry BalangirTow't ELECTRICITY SUPPLY UTILITY OF ODISI-IA orrtcp oF rne sUB-DIVISIONAL OFFICER (COMMERCE) ELECTRICAL SUB-DIVISION NO.II, B.C.D'D -I, BBSR a . 067 4-2531507 11,o9. t1 No: {'l Dt: NO DEMAND CERTIFICATE ,.- ,., N atf43;q?46- [4 rXl.\r.- ras C(rlillcd |hcl 5I lisf l. V ,n' vidc moncl' clcarcd up his/ her clcctricity ducs Rs' 9ft8 upto roceinr No. Sra. ,/ rs"4l'P tlt: l?'9' 4Dll ''--'"'------t-lllllilllllii_ -_- 4#aring con'umer o{,aovi o*"in., ,t Qr. tuu. I-- " '9lr.,ql+t'?,4 e9-.^1, fi':) public Wor RECEIPTFORPAYM Recerpf l,/o. N l,t ,I,4, -S4eceittedt on \,' t/"-. ',r.d-" Rs..#Rup66 ,f o'7"'-o, on accounf of Signaturc Designation. ,IG c"r rl. s rJ-ppJ_) L-r| L 1*L!"Tl"_Ec-rRrcr rry oF o Drs H A ""i11[;1;llfi ahubanesrar *filg:,^,:* _ 7sr 022 ' " ^'L'#1.^1?l9J:::,::*T*th.I |it'.i.+,litji :,:g;T::ffi ;;#il: No.ncnntr Q)t) nt. 1&/oslt 7 NO DUES CERTIF'ICATE This is to certify that, the electricit1, bill in respect of Consumer No. I-A-2I-MIN residence office of Sri Narasingha Mishra, Hon,ble Leader of opposition(olA), odisha against etr. No-Type-vlly2, unit_I, Bhubaneswar, amounting to Rs.9235.00 up to February 201g has been paid vide MR No. CN285240, dt.1g.03.2019. Hence, there is nothing outstanding agarnst this consumer up to February 2019. nx ecutivME'ii-e, rurect. r *o'r' BBSR dr,rf;1'o' "*'on ' W't't' ryA"+/' \"yX^\ Saroi Ku. Gupta Notary BalangirTgwn '"20/0.q 20LS 5:26 PU FAI 01124879205 ]IA\AGER ODISA BEAIAN @ oool f- Fr--_ ,' Government of Odisha Oflice of the Chiaf RosideDt CoEmlssiorer 4-Bardolai Marg, Chara&vaPuri Nei'i D€lhi-l 10021 49 8, F ax-2467 9m 5 Shri B.I(IIota' OAS T el-230 lgl 7 L, 230:18 Manager, OdidE Bhawan Emril :- t$auagercbld(asnail'com x'-83rce, n"tud-L0Jqdll NO pUES CERJIFIoATE fto wl{o4ilsovER lT MAY CONqERNI Thi! iE to certify that no duas are pendlng against Shrl Narasingha Mishra, Hon'ble Leader of Opposition' Odisha Legislative Assembty, Odisha in respect of Odisha Bhawan i Odisha Niwas, New Delhi as on till date. 14' 62 Mana$eT 1F1? MEnagEr Odisha Bhe\,!En Ggrlt. oi Odlsha, New Delhi ,":\\- lufla'$244"' Saroj(f3upta ll Nobry BalangirTowr ug.j*"wtw SECRETARIAT OF THE ODISHA LEGISLATIVE ASSEMBLY Date 23.03.2019 NO DUES CERTIFICATE Certified that No Due is outstanding against Shri Narasingha Mishra, Hon'ble Leader of Opposition in respect of Odisha Legislative Assembly. ,l If ' I el lzz'z'' 1' SECRETARY Socrclart llfisha Logishtire Assernblv **lY# I'|('bry, Batangir Town ODI SA 5i26 PI Fltr 01124879205 U.ANACER 6hri B.l{-IIota' OAS Manager, Odisha Bhawan 6re pendlng *-t1 This ic to cdrtify thet no du63 ,::'l Leader of Opposition' Odlsha l.larasingha Mishra, Hon'ble / in r6spect of Odi6ha Bhawan Legislative Assembly, Odlsha on tlll Odishe Niwa3, New Delhi as date' R**"e,. 0 Manager ill6t|ageJ OdhhE thswEn Govt, oi odlgha, Nq\iY Dslhl *i3ll''$i"i't* SECRETARIAT OF TITF ODISIIA LEGISLATIVE ASSEMBLY No.NbLl6&12+l NO I'UES CEETIFIC.ITE NllgHXA cenified that shn Epz N+PAStNqHA who was a Member of the Odisha Legislative Assembly in +he 0 6 3 '' floL4ll 4 P" ' Assembly Constituency has no outstanding ftom the Odisha Legislative Assembly LrDIary. W<'*ltlu / ASSISTAIITI DIRECTOR (A&D) Odisha Legistative AssemblY m.fir:,4iF},i?r,y*rsn) ' n' u^\""'"V *r-* SECRETARIAT OF TFIE ODISHA LEGISLATIVE ASSEMBLY Dare 23 .03.2019 NO DUES CERTIFICATE Certified that No Due is outstanding against Shri Narasingha Mishra, Hon'ble Leader of Opposition in respect of Odisha Legislative Assembly. lr lf ' || \ -vM oao!"tf"'