!.

~~ ~11 ~JIIM 43AB 623417

FORM 26 (See rule 4A)

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH

NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR

:~ .~ ELECTION TO (NAME OF THE HOUSE) FROM THE ~ '~.' STATE OF WEST BENGAL CONSTITUENCY (GENERAL) (NAME OF

l1 3 MAR 2020

M tv(M Ovwt N I---t-f? ?J.£-~ '13 CJ b \ (38 \~~~13 No•... , ~. Rs....•.... ,. Date . Name ..•.•.~~.~ ~ q Cj ~ . ~ \\ C\"'~ • Address ...... •.• ~.;;r...."•..H••QN.. '\ P.S•... ~ .... ~..~ ... DlST .... ~ ~ .

»r

Spdhan Kr. Kundu Stamp \lendar. L. No.- 33 Habibpur. A.D.S.R.O. Ma.lda.

) 2

_""J- I:) I, MAUSAM NOO~\:';'r~",," PLf\~ of Late SYEDMOHAMMAD NOOR,

Aged 40 years, SAHAJALALPUR,P.O. KOTWALI, P.S.

ENGLISHBAZAR, DIST - MALDA (WB), PIN-732144, a candidate at the above election do hereby solemnly affirm and state on oath as under :-

(1)

(name of the political party)/ Hffi-telRtef.5H1~-a5--'ttfHf**!-ae~eRt ~ candidate. (Strike out whichever is not applica

(2) My name is enrolled in 51-English Bazar (General LAC,West Bengal)

(Name of the Constituency and the State), at Serial No.253 in Part

No.60.

(3) My contact telephone number (s) is/are 9830448612 and my e-mail

ID (if any) is [email protected] and my social

media account (s) (if any) isfare

(i) www.facebook.com/Mausam Noor

(ii) www.twitter.com/MausamNoor

(iii) www.instagram.com/MausamNoor

(4)

Income tax return: 11 3 MAR 2020 \ ., 3

SI.No. Names PAN The Total income shown in

Financial year for Income Tax Return (in

which the last Rupees) for the last five

Income tax return Financial Years completed

has been filed (as on 31"t March)

l. SELF ADSPN5362M F.Y. ill 511790/- CF.Y. 2014 -15)

(ill 496110/- CF.Y.2015-16) MAUSAMNOOR 2018-2019 iliil 480720/- CF.Y.2016-17)

{jy} 481780/- CF.Y.2017-18)

Jy} 10 14450/-CFY 2018-19)

2. SPOUSE F.Y. ill 308320/- CF.Y. 2014-15)

(ill 272260/- CF.Y.2015-16) MIRZA KA YESH ALHPB3578N 2018-2019 (ill 330690/- CF.Y.2016-17) BEGG iliil 345860/- CF.Y.2017-18)

{jy} 467510/-CF.Y.2018-19) 3. HUF (if candidate Not Applicable Not Applicable n Not Applicable

is Karta ill Not Applicable

/Coparcener) ill} Not Applicable

fu} Not Applicable

{y} Not Applicable

4. Dependent 1 No PANAllotted Not Applicable i) Not Applicable

MIRZAAYMAN ii) Not Applicable

NOOR BEGG iii) Not Applicable

iv) Not Applicable

v) Not Applicable

5. Dependent 2 No PAN Allotted Not Applicable U Not Applicable

AMYRANOOR ill Not Applicable

BEGG !.ill Not Applicable

M Not Applicable

Y1 Not Applicable

6 Dependent 3 Not Applicable Not Applicable i) Not Applicable

ii) Not Applicable

iii) Not Applicable

iv) Not Applicable

v) Not Applicable ,&.~£~,;.-=:., £..~

it 3 MAR 2020 ~r~{ q-~'!"'j.\J'}.\, jq ~""~i)-\i ~~.o~, :t:. $: •

?; ",t1-~ o:.:,~-.~...j.,~'''''' .. ~ K~\":. ~ 4

Note: It is mandatory for PAN holder to mention PAN and in case of no

PAN, it should be clearly stated IINo PAN allotted",

(5) Pending criminal cases

(i) I declare that there is no pending criminal case against me (Tick

this alternative if there is no criminal case pending against the

Candidate and write NOT APPLICABLEagainst alternative (ii) below)

Or

ii) ~he following criminal cases are pending against me:

(If there are pending criminal case against the candidate, then tick

this alternative and score off alternative (i) above, and give details of

all pending cases in the Table below)

Table

(a) FIR No. with name and F.I.R. NO. 175/2014 F.I.R. NOT APPLICABLE

address of Police Station Gazole Police Station No.557/2009

concerned English Bazar

Police Station

(b) Case No. with Name of GR Case N 0:- GR Case No:- NOT APPLICABLE the Court 1307/2014 at C.J.M. 2685/09 at

Court, MaIda. AT C.J.M. Court,

PRESENT (Special MaIda.

Case No.27 of 2019)

pending before Ld.

Spl. Judge, (MP &

MLA) Court at

Barasat (State of \1 3 MAR 5

West Bengal vs.

Mausam Noor)

(c) Section(s) of concerned V/s.188 IPC. RIW Vis. NOT APPLICABLE

Acts/Codes involved Sec.177 M.V. Act. 143/3411186/3

(give no. of the Section, and Section 34 of 53/323/379

e.g. Section ..... of IPC, Police Act, 1861 IPC, R1W

etc.) Sec.188I.P.C.

(d) Brief description of For alleging M.V. For alleging NOT APPLICABLE

offence Act. instigating the

supporters of

Piranapir

(e) Whether charges have Yes No NOT APPLICABLE

been framed (mention YES or NO 1 (f) If answer against (e) NOT NOT APPLICABLE ~ above is YES, then given 28/02/2015 APPLICABLE

the date on which charges were framed 1 (g) Whether any No NOT NOT APPLICABLE Appeal! Application for APPLICABLE I revision has been filed ~ against the proceedings

(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 APPLICABLEagainst alternative (ii) below)

OR

(ii) I have been convicted for the offences mentioned below: NOT

APPLICABLE {If the candidate has been convicted, then tick this 6

Table

(a) Case No. NOT NOT NOT

APPLICABLE APPLICABLE APPLICABLE

(b) Name of NOT NOT NOT

the Court APPLICABLE APPLICABLE APPLICABLE

(c) Sections of NOT NOT NOT

Acts/Codes APPLICABLE APPLICABLE APPLICABLE

involved

(give no. of

the Section,

e.g. Section

..... of IPC,

etc.).

(d) Brief NOT NOT NOT

description APPLICABLE APPLICABLE APPLICABLE

of offence

for which

convicted

(e) Dates of NOT NOT NOT

orders of APPLICABLE APPLICABLE APPLICABLE

conviction

(f) Punishment NOT NOT NOT

Imposed APPLICABLE APPLICABLE 7

(g) Whether NOT NOT NOT

any Appeal APPLICABLE APPLICABLE APPLICABLE

has been

filed

against

conviction

order

(Mention

Yes or No)

(h) If answer to NOT NOT NOT I

(g) above is APPLICABLE APPLICABLE APPLICABLE <

Yes, 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) and (6).

[Candidates to whom this Item is not applicable should clearly write NOT

APPLICABLEIN VIEW OF ENTIRESIN 5(i) and 6(i), above]

Note:

1. Details should be entered clearly and legibly in BOLD letters.

2.

against each item.

f1 3 MAIf 2021 8

3. Details should be given in reverse chronological order, i.e., the latest

case to be mentioned first and backwards 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 of joint

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 Bonds/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

respect of each investment.

1\ 3 MAR 2020 9

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';

S1. Description Self Spouse HUF Dependent Depende Depende

No. -1 nt -2 nt -3

(i) Cash in hand Rs.50,000.00 Rs.29,650.00 NIL NIL NIL NIL

(ii) Details of i) SBI, Parliament i)ICICI Bank, NIL NIL NIL NIL

Branch, New Delhi deposit In Gariahat Nc.30778287847 i Bank Branch, Rs.9,48,53 1.04 < accounts Kolkata A/c. ii)Axis Bank

(FDRs, Term 62780108779 Ltd., Mal da 1 Deposits and 6 Branch, A/c.

all other Rs.24,095.00 No.3890101000

types of ii) UBI, High 06873

deposits Court Rs.l,80,944.20

including Branch, iii)Oriental

saving A/c. Bank of

accounts), 357987 Commerce,

Deposits Rs.17,173.00 MaIda Branch

with iii)SBI A/c.No.0688215

Financial Sansadhiya 1001686

Institutions, South Rs.l ,36,427.80

Non- Branch, New

Banking Delhi, A/c. ~~~ ~r ""~~f\ '\; ~ \~>-)~ )"0 .cC. ~~~'bv'i. l> ~ -b.

Financial No.30777135

Companies 36

and Rs.9,300.00

Cooperative

societies and

the amount

in each such

deposit

(iii) Details of i)ALM Real NIL NIL NIL NIL NIL

investment Estate Pvt. Ltd.

in Bonds, Rs.2,00,000.00

Debenturesl ii) Mahila LLP

Shares and (Capital A/c)

units III Rs. 7,50,000.00

companiesl iii) Mahila LLP

Mutual (Current A/c)

Funds and Rs.35,4651-

others and Total:

the amount. Rs.9,85,4651-

(iv) Details of i)LIC Policy i)Max Life NIL NIL NIL NIL

investment No.456365982 Insurance

III NSS, Sum Assured:- Policy

Postal Rs.12,50,0001- NO.32648016

Saving, ii)LIC Policy 7

Insurance No.495408572 Sum Assured:

Policies and Sum Assured:- Rs.6,05,0001-

investment Rs.IO,OO,OOOI- II) LIC

in any Total Premium Policy NO. ~.Qy~

-\. Financial Paid: 465646482 1#0 .;:.0,~~ ~ )!~ «:..•C~"t:j:;.;\ l Il~{ ~~::~-", t~ b,·

~ , .., ,y .'" ~ ,I 3 MAR 2021 ------~------

12

receivables

from debtors

and the

amount.

(vi) Motor i)Mahindra i)Maruti NIL NIL NIL NIL

Vehicles/ Air XUV 500-2019 (Ritz)-2009

crafts/Yacht WB 66 AE 3879 WB-06B-

s/Ships Rs.19,00,000/- 1980

(Details of ii) Mahindra Rs.75,000

Make, Scorpio-20 19 ii)Corolla

registration WB 66 AG 3000 Altis-20 13

number etc. Rs.17,70,426/- WB-02-AE-

year of 3345 ~

purchase and Rs.4,16,377/-

amount) ~ (vi i) Jewellery, Gold 145 Grams Gold 22 NIL NIL NIL NIL 1 bullion and Rs.4,77,320.00 Grams ~ valuable Rs.96,800/-

thing(s)

(give details

of weight

and value)

(vi ii) Any other NIL NIL NIL NIL NIL NIL

assets such

as value of

claims/

interest

(ix) Gross Total Rs.86,99,114.00/- RsI8,38,895/- NIL NIL NIL NIL ~F;.G.QY~ Value /(:.ov.V ~ !J~I ~O. 1.ci\-. ~~~~~ ;;')'~ \1 3 MAK L02D ~ q;~.J.j') , ~-b.~ '~~ 13

B. Details of Immovable assets:

Note:l 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.

SI. Description Self Spo HUF Dependent-l Dependent- Dependent

No. use 2 -3 ~

(i) Agricultural NIL NIL NIL NIL NIL NIL ~

Land

Location(s) ~

Survey

number(s) ~

~ Area (total NIL NIL NIL NIL NIL NIL

measurement

in acres)

Whether NIL NIL NIL NIL NIL NIL

inherited

property (yes

or No)

Date of NIL NIL NIL NIL NIL NIL

purchase in

case of self f/O'-\.J'~~ acquired y~. ~ i~fl...-:' ,....t~~o· ""'t.- I~I ~. ...9.- IQ property -c ~ 'l~J l> \f~ (.j>Y- ;,

.~ &",-:;:-RC\..~

-I r" 14

Cost of Land NIL NIL NIL NIL NIL NIL

(in case of

purchase) at

the time of

purchase

Any NIL NIL NIL NIL NIL NIL

investment

on the land

by way of

development, construction ! etc. ~ Approximate NIL NIL NIL NIL NIL NIL

Current

~ market value

NIL ( i i ) Non NIL NIL NIL NIL NIL i Agricultural ~ Land:

Location(s)

Survey

number(s)

Area (total NIL NIL NIL NIL NIL NIL

measurement

in sq.ft)

Whether NIL NIL NIL NIL NIL NIL

inherited

property (yes ~W OV,. - Ic~O '0 or No) e7 ~~~~ ~ H~f \'!tC~,'..,~O O~·'\. }!Q Date of NIL NIL NIL NIL NIL NI~~.>. \' ~::¢\>~\,; .•.l:> ~t,.~\~ .J'" .~"'(: ( 15

purchase In

case of self

acquired

property

Cost of Land NIL NIL NIL NIL NIL NIL

(in case of

purchase) at

the time of

purchase

Any NIL NIL NIL NIL NIL NIL

investment on the land t by way of ~

development,

construction ~

etc.

NIL NIL 1 Approximate NIL NIL NIL NIL ~ Current

market value

NIL NIL (i i i) Commercial Noor NIL NIL NIL

Buildings) Mansion,

(including Station Road,

apartments)- Ma lda,

Locations(s)- Mouza-

Survey Maheshmati,

number(s) JL No.66, Plot

No.-98

NIL~V ••••.M: V1.' 0 Area (total Total Area NIL NIL NIL NIL r~ ~ ~ ~ •..~ Co. ~ measurement 10,252 sq.ft. ,:!i ~( ','.' ,. "~""v~ )0-I\\' -b' ,~~' '/ ,..::; il 3 MAR 2020 ~ --...~.-..... - ~

------16

in sq. ft) Share 1/3 of

Total area

Built up Area 113 of 9000 NIL NIL NIL NIL NIL

(total sq.ft. measurement in sq.ft.)

Whether NIL NIL NIL NIL NIL NIL inherited property (yes or No)

Date of NIL NIL NIL NIL NIL NIL purchase In case of self acquired property

Cost of NIL NIL NIL NIL NIL NIL property (in case of purchase) at the time of purchase

Any NIL NIL NIL NIL NIL NIL investment on the property by way of development, ~GO~ o'V. 0-<, construction etc. I~~&.~. ~~:'t·\V...J ~1 -'t.;'i1/II

~~ ~.-. ~' r1 3 M~R 1028 .- 17

Approximate Rs.60,00,0001- NIL NIL NIL NIL NIL

current

market value

(iv) Residential Mouza- NIL NIL NIL NIL NIL

Buildings) Sahaj alalpur

(including Kotwali, JL

apartments)- No.34, Plot

Locations(s )- No.288

Survey

number(s) Area (total 5760 Sq.ft. NIL NIL NIL NIL NIL f measurement Share 1/3 of

in sq. ft) total area <

Built up Area 1000 sq. ft. NIL NIL NIL NIL NIL

~ (total

measurement ~ in sq.ft.) ~ Whether YES NIL NIL NIL NIL NIL

inherited

property (yes

or No)

Date of NIL NIL NIL NIL NIL NIL

purchase III

case of self

acquired - property

Cost of NIL NIL NIL NIL NIL NIL

property (in :v. ~ '6' r~,[.§r-..~P"'" ~- case of (~ ~v,,~.{,,> }~, ~- ~J~.~ .)r\ ~~h ~ {"if 2020 ~Qav.;:'I§:;f 1 3 MAR ~-.-....,.. .~ 18

purchase) at

the time of

purchase

Any NIL NIL NIL NIL NIL NIL

investment

on the land

by way of

development,

construction

etc.

Approximate Rs.14,00,0001- NIL NIL NIL NIL NIL

current

market value

(V) Others (such NIL NIL NIL NIL NIL NIL

as interest in

property)

(vi) Total of Rs.74,00,0001- NIL NIL NIL NIL NIL

current

market value

of (i) to (v)

above

(8) I give herein below the details of liabilities/dues to public financial

institutions and government :-

individual and amount before each item) 19

Sl. Descriptio Self Spouse HUF Dependent - Dependent Dependent

No. n 1 -2 -3

(i) Loan or Rs.8,40,890.66/ NIL NIL NIL NIL NIL

dues to -

Car Purchase Bank/

Loan from Financial

Oriental Bank Institution

of Commerce, (s)

Ma ld a Station Name of

Road, Bank or

Rathbari, Financial

English Bazar. Institution,

Amount

outstandin

g, Nature

of Loan

Loan or NIL NIL NILNIL NIL NIL

dues to

any other

individuals

/entity

other than

mentioned

above.

Name(s),

Amount

outstandin 1041. .9F~~.....•~/ g, nature '! ~ -; r<>:::: *~ t'·] ~Il of loan i~1t C·3- ~ .•~ ~ii.-.~ . E>. ~ iR G' ~ ~ ~~R lU1~ ~J.i1i17f~ * 20

Any other NIL NIL NIL NIL NIL NIL

liability

Grand Rs8,40,890.66 NIL NIL NIL NIL NIL

total of

liabilities

(ii) Government (A)Has the Deponent been in occupation of accommodation provided by the YbSINO (PI.

Dues: Government at any time during the last ten years before the date of tick the

Dues to notification of the current election? appropriate

departments (B)If answer to (A) above is YES, the following declaration may be furnished alternative

Dealing with namely:-

Government (i)The address of the Government accommodation:

accommodati 51, South Avenue, New Delhi-110011

on (ii)There is no dues payable in respect of above Government accommodation,

towards

(a)Rent

(b)Electricity charges

(c)Water Charges

(d)Telephone Charges as on 11.03.2020

[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 NIL NIL NIL NIL NIL NIL

department

dealing with

Government

transport

(including aircrafts and @~~ helicopters) t·\~!~O."'~ ~ - (~I V.\:~~;-< ,,~ ~ ~.jl~~\ Tax dues '"

(v) GST Dues NIL NIL NIL NIL NIL NIL

11 3 MAR 20la 21

(vi) Municipal! NIL NIL NIL NIL NIL NIL

Property

Tax dues

(vii) Any other NIL NIL NIL NIL NIL NIL

dues

(viii) Grand NIL NIL NIL NIL NIL NIL

total of all

Governme

nt Dues

(ix) Whether NIL NIL NIL NIL NIL NIL

any other

liabilities

are in

dispute, if

so,

mention

the amount

involved

and the

authority

before

which it IS

pending

(9) Details of profession or occupation:-

(a) Self-Advocate, Politician and Business

(b) Spouse-Advocate

\1 3 MAR 2020 22

(9A) Details of source(s) of income :-

(a) Self-employed Professional

(b) Spouse- Legal Practitioner.

(c) Source of Income, if any, of dependents.- NIL

(9B) Contracts with appropriate Government and any public company or companies.

a) Details of contracts entered by the candidate-NIL

b) Details of contracts entered into by spouse-NIL

c) Details of contracts entered into by dependents-NIL

d) Details of contracts entered into by Hindu Undivided Family or trust

in which the candidate or spouse or dependents have interest-NIL

e) Details of contracts, entered into by Partnership Firms in which

candidate or spouse or dependents are partners-NIL

f) Details of contracts, entered into by private companies in which

candidate or spouse or dependents have share-NIL

10. My educational qualification is as under :-

(i) LLB (Hons.) 5 years-Calcutta University- 2000 to 2005 Department of

Law Hazra Campus.

(ii)Lamartiniere for Girls School from Nursery to Class 12 till 2000.

Indian Certificate of Secondary Education (lCSE) 1998 and Indian School

Certificate (lSC) 2000

Give details of highest School/University education mentioning the full < ~ ff~d ·c !lOR-.... . form of the certificate/diploma/degree course, name of th ~ ~~).\.~~..;,'\. 'j:. ~~'b\)\••. -b O~"K.H'~ 1 3 M AK LLJLO 23

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 (WSlfit.~MAUSAM NOOR

2. Full postal address Vill. SAHAJALALPUR, P.O.-KOTWALI, P.S. ENGLISH

BAZAR, DIST.-MALDA (W.B), PIN-732144

3 Number and name of the constituency WEST BENGAL, COUNCIL OF STATES

and State

4 Name of the political party which set ALL TRINAMOOL CONGRESS

up the candidate (otherwise write

,Independent')

5 Total number of pending criminal cases 02 (Two)

i)GR Case No.2685/09 E.B.P.S. Case No.557/2009, dt.22.09.2009

U/s.143/3411186/353/323/379 IPC RlW Section 188 IPC

ii)GR Case No. 1307/2014, Gazole P.S. Case No.175/2014

dt.12.04.2014 U/s.188 IPC RlW Sec.l77 M.V. Act. Rlw with 34 of

Police Act, 1861 (Special Case No.27 of2019) at present pending

before Ld. Spl. Judge, (MP & MLA) Court at Barasat (State of

West Bengal vs. Mausam Noor)

6. Total Number of cases in which NIL

convicted

7. PAN of Year for which Total Income Shown

last Income Tax

Return filed

(a)Candidate ADSPN5362M F.Y.2018-2019 Rs.1O,14,450/-

(b) Spouse ALHPB3578N F.Y.2018-2019 Rs.4,67,510/-

(c)HUF NIL NIL NIL

(d)Dependent NIL NIL NIL

8 Details of Assets and Liabilities (including offshore assets) in rupees

Sl. Description Snfi-')Vj~~ Spouse HUF Dependent Dependent Dependent '/X)"'~ . o,~. No. ~ q~.o· ~ -1 -2 -3 9( ,A.~ .. ~.." ~ ,~- ~.,)'--' \) L ,Ii' ~"'J ~. ~). ,u-t. :1 3 MAR '() -'!G'V 202b ~sv- ~". 24

A Moveable Rs.86,99,114/- Rs.18,38,8951- NIL NIL NIL NIL

Assets (Total

Value)

B Immovable

Assets

I Purchase NIL NIL NIL NIL NIL NIL

Price of self-

acquired

immovable

property

II Development! NIL NIL NIL NIL NIL NIL

construction

cost of

immovable

property

after

purchase (i f

applicable)

III Aproximate

Current

Market Price-

(a)Self- NIL NIL NIL NIL NIL NIL

acquired

assets (Total

Value)

(b)Inherited NIL NIL NIL NIL NIL Rs.74,OO,OOOI-

assets (Total

Value)

9 Liabilities 25

(i) Government NIL NIL NIL NIL NIL NIL

Dues (Total)

(i i) Loans from Rs.8,40,890.66 NIL NIL NIL NIL NIL

Bank,

Financial

Institution

and other

(Total)

10 Liabilities that are under dispute i) Government NIL NIL NIL NIL NIL NIL

dues (total) ~ ii) Loans from NIL NIL NIL NIL NIL NIL ~ Bank,

Financial

Institutions J

and others

(Total) 1

11 Highest education qualification ~

(i)LLB (Hons.) 5 years- Calcutta University- 2000 to 2005 LLB (Hons.) 5 years-Calcutta University- 2000 to 2005

Department of Law Hazra Campus.

(ii)Lamartiniere for Girls School from Nursery to Class 12 till 2000. Indian Certificate of Secondary Education (lCSE)

1998and Indian School Certificate (ISC)

(Give details of highest School/University education mentioning the full form of the certificate/diploma/degree course,

name of the SchoollCollegelUniversity and the year in which the course was completed)

~13 MAR 2020 , , 26

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

there from. I further declare that :-

a) There is no case of conviction or pending case against me other than

those mentioned in items 5 and 6 of Part A and B above;

b) I, my spouse, or my dependents do not have any asset or liability,

other than those mentioned in items 7 and 8 of Part A and items 8, 9

and 10 of Part B above.

Verified at Kolkata this the 13th day of March, 2020

DEPONENT

ifie b I~~~ h erson .j -4'lJ;lliynce it /'i~ocate Advocate Fro-oil ~o 27

Note:l Affidavit should be filed latest by 3.00 P.M. on the last day of

filing nomination.

Note:2 Affidavit should be sworn before an Oath Commissioner or

Magistrate of the First Classor 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 flNIL" 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:S 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.

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