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 ,. t • (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.