DECLARATION OF ASSETS AND LIABILITIES BY MEMBERS OF LOK SABHA FORM —I A.ASSETS AND LIABILITIES OF MEMBER 1 Name of the member Sri Pratap Chandra Sarangi 2 Father's/Husband's Name Late Govind Chandra Sarangi 3 Permanent Address A-Gopinathpur, Po-Dhobasil, PS- Nlagiri, Dist-Balasore, Odisha 4 Delhi Address 10, Pandit Pant Marg, New Delhi- 110001 5 Party Affiliation BJ P 6 Date of election/Nomination Dated 23.04.2019/Dated 09.04.2019 7 Date of taking oath/making affirmation in the House Details of immovable property (1) Name of the State, District Subdivision Odisha State, Balasore District, and village in which property is situated Nilagiri Sub Division, Village- Gopinathpur and Kahlia (2) Details of property (a) House and Buildings and their present 1200 sft mud wall thatched roof value house at Gopinathpur Village of Balasore District, Odisha. Member share value at Rs. 4.00 lacs (b) Lands and their Present Value 11.85 acres land jointly held with siblings member share valued at Rs.5.00 lacs (3) Whether held as owner or beneficiary Co-owner (4) Whether held jointly or severally. if 1/5 of the property held jointly properly held jointly with another person with siblings. share of property held (5) If not held in member's own name. State Held in the name of mother of the in whose name held and his /her member late Sidheswari Sarangi relationship with the member. (6) How acquired Inheritance (whether by purchase lease, mortgage inheritance, gift or otherwise with date of acquisition and name of person from whom acquired) (7) Any other relevant information which 0.26 acres Land on which house is the member may like to mention situated has been included in the joint holding landed property as per Annexure-I II Details of Movable property (1) Description of the property Cash in Hand -15,000/- (i,e,car/motorcycle/jewellery/investment SB Account-UCO Bank, State in banks/stock markets/companies Assembly Branch , Bhubaneswar- ./financial institutions/insurance policies Rs.3,81,236.86 etc) SB Account —UCO Bank, Nilagiri- Rs.9897.00 SB Account -Union Bank of India- Bhubaneswar Branch-Rs. 10000/- 5000 equity share of APPSTIL(P) Ltd-PRs.10/- each , Total 50,000/- Grand Total-4,66,133.86 (2) Make ,model(and also registration No motor car-Not Applicable number in case of vehicle)where necessary (3) Mode of acquisition Not Applicable (Purchase /gift/mortgage lease or otherwise. (4) Purchase price of the property Not Applicable (5) In case of purchase. source or sources Not Applicable from which financed (a) Personal savings (b) Other sources (6) Any other relevant information which Properties of point No-1 above the member may like to furnish held as owner. (7) Whether held jointly or severally Not Applicable (8) Any other relevant information which The above properties is as on the member may like to furnish. dt. 09.04.2019. The date of filing nomination III Details of Liabilities of the member to public financial Institution /Central Government/State Government (1) Details of loans raised from Nil Banks/Companies/Financial Institutions/Central/State Government (2) Amount of loans raised in each case Not Applicable (3) The period for which these loans Not Applicable were raised in each case. B. INFORMATION REGARDING IMMOVABLE AND MOVABLE PROPRTIES HELD BY MEMBER'S SPOUSE 1 Name of the member's Spouse Not Applicable as no spouse 2 Father's/Husband's Name Not Applicable as no spouse 3 Permanent Address Not Applicable as no spouse 4 Delhi Address Not Applicable as no spouse I Details of immovable property (1) Name of the State, District Subdivision Not Applicable as no spouse and village in which property is situated (2) Details of property (a) House and Buildings and their present Not Applicable as no spouse value (b) Lands and their Present Value Not Applicable as no spouse (3) Whether held as owner or beneficiary Not Applicable as no spouse (4) Whether held jointly or severally. if Not Applicable as no spouse properly held jointly with another person share of property held (5) If not held in member's own name. State Not Applicable as no spouse in whose name held and his /her relationship with the member. (6) How acquired Not Applicable as no spouse (whether by purchase lease, mortgage inheritance, gift or otherwise with date of acquisition and name of person from whom acquired) (7) Any other relevant information which Not Applicable as no spouse the member may like to mention II Details of Movable property (1) Description of the property Not Applicable as no spouse (i,e.car/motorcycle/jewellery/investment in banks/stock markets/companies /financial institutions/insurance policies etc) (2) Make, model (and also registration Not Applicable as no spouse number in case of vehicle)where necessary (3) Mode of acquisition Not Applicable as no spouse (purchase/gift/mortgage lease or otherwise. (4) Purchase price of the property Not Applicable as no spouse (5) In case of purchase , source or sources Not Applicable as no spouse from which financed (a) Personal savings (b) Other sources (6) Whether Held as owner or beneficiary Not Applicable as no spouse (7) Whether held jointly or severally Not Applicable as no spouse (8) Any other relevant information which Not Applicable as no spouse the member may like to furnish. C. INFORMATION REGARDING IMMOVABLE AND ABLE AND MOVABLE PROPRTIES HELD Y MEMBER'S DEPENDENT CHILDREN. 1 Name of the member's dependent children Not Applicable as no Children 2 Father's/Husband's Name Not Applicable as no Children 3 Permanent Address Not Applicable as no Children 4 Delhi Address Not Applicable as no Children Details of immovable property (1) Name of the State, District Subdivision Not Applicable as no Children and village in which property is situated (2) Details of property (a) House and Buildings and their present Not Applicable as no Children value (b) Lands and their Present Value Not Applicable as no Children (3) Whether held as owner or beneficiary Not Applicable as no Children (4) Whether held jointly or severally. if Not Applicable as no Children properly held jointly with another person share of property held (5) If not held in member's own name. State Not Applicable as no Children in whose name held and his /her relationship with the member. (6) How acquired Not Applicable as no Children (whether by purchase lease, mortgage inheritance, gift or otherwise with date of acquisition and name of person from whom acquired) (7) Any other relevant information which Not Applicable as no Children the member may like to mention II Details of Movable property (1) Description of the property Not Applicable as no Children (i,e,car/motorcycle/jewellery/investment in banks/stock markets/companies /financial institutions/insurance policies etc) (2) Make,model(and also registration Not Applicable as no Children number in case of vehicle)where necessary (3) Mode of acquisition Not Applicable as no Children (purchase /gift/mortgage lease or otherwise. (4) Purchase price of the property Not Applicable as no Children (5) In case of purchase . source or sources Not Applicable as no Children from which financed (a) Personal savings (b) Other sources (6) Whether Held as owner or beneficiary Not Applicable as no Children (7) Whether held jointly or severally Not Applicable as no Children (8) Any other relevant information which Not Applicable as no Children the member may like to furnish. DECLARATION I, Sri Pratap Chandra Sarangi, hereby declare that the information given above is true and correct to the best of my knowledge and belief. In the event of any change in the information given above, I undertake to intimate the Speaker as provided under the rules. Yours Faithfully Date: Signature /thumb impression of member .