INDIA NON JUDICIAL

Government of National Ca_pi~a!Je!__r.. . : : :·~_..-•--• LIE••~

------ ------ ---·

.f ~ ·J.f ::i.2:.XR:"1..
e-Stamp

~
~
Certificate No. • IN-DL191265921 m97X
0
~

Certificate Issued Date • 16-Jan-2025 10:56 AM

Account Reference • IMPACC (IV)/ dl1053203/ DELHI/ DL-DLH
Unique Doc. Reference ' SUBIN-DLDL105320383422051606760X
Purchased by • Vl$HAL, SINGH
Description of Document • Article 4· Affidavit
· , ::t Property Description • Not Applicable
.. < ~
0
~
Consideration Price (Rs.) • 0
' "'N (Zero)
'<o:, ~
_ ~ First Party • VISHAL SINGH
i Second Party • Not Applicable
~
0 Stamp Duty Paid By • VISHAL SINGH
•- "'~
N
Stamp Duty Amount(Rs.) •• 100 -
cco
7
<O (One Hu_ndred only) J I ENDER

clJ:
- (/)
t ' ~( "'9 : 1
e below this line ···············································································••ii.s ••
~ ~old""!
iii
~Cl)

>
:i:: IAII~:
i1n
~
DER PAL HAN I
•
Cl)
I > ~-W-i
J:
Advocat (!)
z
.. ; . o.16987/202 iii

DELHI ' ;-.,

i .......
>
J:
i
~ ii5

i • ~
~~~
C/l
>
:r

iii

l
Statutory Alert:
1. The a~thenticity of this Starryp certifi_cate s~ould be verified <!t 'www.shcilestam_p.com' o_r using e•Stamp_ ¥obile
Any discrepancy in the details on this Certificate and as available on the website / Mobile App renders 11 invalid.App of Stock Holding.
2. The onus of checking the legitimacy is on the users of the certifi~ate.
3. In case of any discrepancy please inform the Competent Authority· r1
6 - J All '>Q25
I-\ \1 l- •
 ENDER ?~l \-\~
Advoca~
'{ eg.No.'\6007120
OELH\
Fo rm 26
(See ru le 4A)

.
A FF ID A V IT TO
BE FI LE D BY
N O l\1 IN A Tl 01 \ PA THE C A N D ID A
PE R BE FO R E TH TE ALONGWIT
TO.~t-P.►.t1'tl.S E RETURNING OFF H
n~~(NAME ICER FO R ELECTI
ON
FR O M .. ~ .~ .A iS OF THE
> I.. Hl.\¼M...CON H O U SE )
C O N ST IT U EN C Y STITUENCY
) (NAME OF TH E

PART A

I. ... \J.1.. S H .~ ..
.S:J}H..(l):1 .. **son/daug
e
of... . ~- E. N\ ..CH ~
I. C ) ... . S nf.-1.l/.\ ~J
hter/wife
........... .Aged ... ... ... -~ ~
years, resident of - ... ... ... ... ... . .
... . Y.~ ..... ~ ~ .H
Q \l( t ..{)£-L\-1'1- . .J ,.~ .S JT .., .. ~.nH.A
full postal address),
a candidate at the ab
m.m.O... (mention
ove election, do here
state on oath as unde by solemnly affirm an
r:- d

(1 ) I am a candidate set
up by -- t: tA no H P
\L__inITTH PA Kt-/.
(**nan1e of the polit
ical pa rt y) / **am contestin
g as an Independent ca
(**strike out whichev ndidate.
er is not applicable)
(2 ) My na1ne is
... . ~~~ ... 1.-:+<...... ~~
enrolled in ... ... ... . NG
Constituency and the -~, ... .. (NTam e6 Fof D 'i?Ll--t/
the
state), at Serial No.
$ o... .in Part N o .. .S .~
...... .. .
(3 ) M y c~ntact teleph
one number(s) is/are
... .i~ .~ ~ /( ,_ j.. t'J.o ...... ..........
e-1nail id (i f any) is .S and ffl Y
i.~~.\/.(.~+~~4J&,,,
,JJ,,. and my social
any) is/are n1edia account(s) ( if

(i ). ~ -~ \. .J .S ,~
(ii) ... ... N.1.L ... . . £_\\\)t.R~tl •
~d'4
(iii) ... ... . ~ \L . ... ..
. ~~o.\~~,w
• \)tU\\

1 '

1 G J~M 101~
 (4) De tai ls of Pe rm ane nt Ac cou
ret urn : nt Nu mb er (PAN) and sta tus of
filing of Income tax
\SI. No. Na me s PAN e financiaV. otal income -----
ear for 1sho\vn in Incon1e Tax Retum(in
\ I \
\vhich the Rupees)
last lncome-
1 ax return has
een filed

I (i)
A-rJ.L
(ii) I
f--/ 1l_
(iii)
I f-l lL
l
\ ~iv )\
}J IL. .
)
\
' V) I. }-I JL _
Spouse
(i) JJ JL
.\ !
r

ii)
i
I
M 1L
(iii)\
\
I \ /-4,
I
I (iv)
1
I I I
N IL
I

3. . .
ri) lI
~
I H\ L
I
fJ JL I
I J.t1L
J..•IL (ii)
N IL
rjj ) 1 1'--JIL
(iv )
;
I
I 1L• 1L
\(v) \ J'-- J}L _
I

' (i)
\ 1'-' 'L
II N IL . µ• L (ii)
JJ IL
(iii )' ----
}JJ L
~iv) J-JIL

'\
l ____ \.L-(v)_..Ll·_ _f-l_lL.._ - -

, );,\J\~ ,• f1 6 JAN 2025 2

0\ 5
 Dep endent2 !(i)
N'l___
'(ii)
11'''L
,_, 'L
Ntl__ (iii).
I

I "-''L
1
! 1(iv)
I
I
I ~,l......
I I
i(v) I ""-'' l_
'6. Dependent 3 ... I I :ci)
1
I
]Jll_
'
(ii)
tJ1l__ 1'-''L NIL
{iii)
' fJJL..
{iv)
fJJl__
I'

~
I
:(v)
' l I I "-•'L

(5) Pending criminal cases

eclare 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 APPLICABLE
against alternative (ii) below)

OR

(ii) The following criminal cases are pending against me: ~ l)T

(If there are pending criminal cases against the candidate, t_hen tick this altern •
score off alternative (i) above, and give details of all pending cases in the ~ ·1:
Table
cNDERPGJ.
. -----;------- - - - -----,---------,---
----7T""&--i---~Advoca
1 FIR ~o. ,vith name
I ( a) oo.No.lo~-31 ,2
DELHI.
of I
V
and address
Police Station
✓' •
concerned
.. , t,J

1
I

-~-- - ____ __.__--3-----L.1_6 __ J_A_N_Z0-2--1~-"'-,~-s\..-~~

•. -

(b) Case No. with Name

of the Court ~L_
f..1JL ~,,~\
(c) Section(s) of
' l \
concerned r,

Acts/Codes involved 1" JI }'1 IL__

(give no. of the
NtL__
Section, e.g.
Section.......of IPC,
etc.).

(d) Brief description of

offence J''1l 1J'L .. }Jl L__
(e) Wheth er charges
have been frame d
(mention YES or
N-o /'ID Alb
NO)
.
(f) If answer against (e) • \
I,o \ j

above is YES, then

give the date on f'L- - JdlL NIL
which charges were
framed

(g) Wheth er any

Appeal/Application
i .. \ .
for revision has been
filed against the ,.._, b
. f-f b f-FD
~i~ procee dings
~i~Y.;~~ ~~~~
\ (Mention YES or
~~\D t
'IJ~ ~
~~;~ \)~'J ~1_., NO)

• t .. / )

~
,~s,~~ -
4

f ~
,,. '1 6 JAN 202~
,
 ---------

(6) Cases of conviction

~ ! a r e that I have not been convicted for any criminal offence. (Tick this
_alternative, if the candidate has not been convicted and write NOT APPLICABLE
against alternative (ii) belO\\')

OR
(ii) I ha,,e been convicted for the offences mentioned below: ~ 0/ A/ I l Il 11 f, Lt=-
(lf the candidate has been convicted, then tick this alternative and score off alternative
(i) above, and give details in the Table below)

Table
r------,-----------,----------.--------~----

1 (a) Case No. f,..IIL_ /VI l... I NIL

(b) I Name of the Court 1 11l 1
,- -- f\n L_ I
(c) I Sections
t
of
"''L
l Acts/Codes involved 1
II

I/ (give
. no. of t he
-I
I

JJ1L I

: Section, el.g. I J.J IL_

Section... . . . . of IPC,
etc.).
I I
I (d) Brief description of! - - - - + - - - - - - - - ;!
I l
I

I I
II offence for which J"' r L II
convicted JJ'L I

J
I

I (e) Dates of orders of - - - - r _. ._·_-_ _ _

I

i I conviction f'J\ l
/\.11 L__
I
I fl!L
Punishment imposed
NIL
Whether any Appeal
has been fil ed I
;l
f-/0 I

against convictio n eg.No.~r;:r.

order (Mention YE··s
Ba
--•·-
-- -·
 ----i

/1'-'b
or. No)

to (g)
ND "' ~
i (h) If answer I

above is YES, give fJIL _ NI l I

f-'I L I

details and present I

I

f
I , status of appeal __J
I I
i i

my polit ical party abou t a11 pend ing

~A ) 1 have given fulJ and up-to-date into1mation to
ictio n as give n in para grap hs (5) and
criminal cases against me and about all cases of conv
(6).
le should clearly writ e ~OT
(candidates to whom this Item is not applicab
6(i), aboveJ /'-lo T MPl-1t:_Ai l_ fj'
APPLICABLE IN VIE \\' OF ENTRIES IN 5(i) and

Note:
BOLD letters.
1. Details should be entered clearly and legibly in
' 2. Details to be given separately for each case under different columns against each
item.
order, i.e., the Jatest case to be
3. Details should be given in reverse chronological
s for the other cases.
mentioned first and backwards in the order of date
4. Additional sheet may be added if required.
mation in con~pliance of Hon'ble
5. Candidate is responsible for supplying all infor ••
2011.
Supreme Court's judgment in W. P (Cj No. 536 of

s (n1ovable and irnn1ovable etc.) of n1yself,

(7) That I give herein below the details of the asset
my spouse and aJJ dependents:

A, Details of movable assets ;

t of joint ownership will also have to be
Note: 1. Assets in joint name indicating the exten
-- - given.
Serial N un1ber, Aino unt date of
n case of deposit/Investment, the details including
ch are to be given . '
posit, the scheme, Nan1e of Bank/Institution and Bran
I

et value in _Stock Exch ange

l~e of Bond~/Share Debe~tures as per the current_ mark
1espec t ~f hsted con1pan1es and as
per books 1n case of non- hsted cotn panj es
ould be g1ven.
of the cand idate or spou se and any
• 'Dep ende nt' mean s paren ts, son(s ), daughter(s)
bloo d or n1arriage, \Vho have 110
other person related _to the candidate whet her by
hate means of income and who are depe nden
t on the cand idate for the1•1.
s~paJ~
1ive 1 ood.

,1 6 JAN 2025
l
 -- -- -

Note: 5. Details including an1ount is

to be given separately in respect
of each inve stn1ent

Exp lana tion ,- For the purpose of

this Form, the expression "offsho
re assets" includes,
details of all deposits or investments
in For eign banks and any other bod
institution abroad, and details of y or
all assets and liabilities in fore
countries'; ign

iS. No. Description

l Self \Spouse ·I 1Dependent-l 1Dependent-2 Dependent-
I \ 31

l~( i-) --~ C- a-s h-i n_ h_ a-n d-- ---

~-. ~~ ~l- -~1 --- -~
o~ ; ~,v I Nt L- NI L.
I
!( ii) f'-O L J-.'' L
Details of deposit in Ban k .
accounts (FD Rs, Ter m
Deposits and all othe r type s
of deposits including r
I saving accounts), Deposits I
:I with Financial Institutions,
f-'/L
I Non-B~nking Financial
JJ IL. f\JJ L 1 I

I
NJ L l /V J~
;. Companies
I Cooperative societie~ and
and ,
,I
~~
I
the amount in each such
deposit
(iii) Details of investment in
Bonds, Debentures/Shares
and units 1n f"' l l--l'L
1
companies/Mutual Funds I ,-.., IL
l f--11 L /u IL '
and others and the amount. NJ(___
1
(iv) Details of investment in
I

I
NSS, Postal Saving,
I insurance Policies and
I
I tL- µJ L
investment in any Financial
instruments in Pos t office
)JJ L- ,._,,1__ f11 L }'-' IL-
or Insurance Company and
1
the amount

--- I
 (v) Personal loans/advance I
.....
-r----. ...__·, '
f
given to any person or
entity including firm, I
I
I
''
I company, Trust etc. and ,L 1-'' 1'}1L. }-/IL fl/' L_
"''l.__
other receivables from
I
I

i( vi)
debtors and the amount.
Motor Vehicles/Aircrafts/
. Yachts/Ships (Details of
,._., L.
''
I
Make, registration number.
etc. year of purchase and ~" t-'''- f'-'JL- ,NIL Hll._
, amoun t)
{ vii) i Jewellery, bullion and
I f valuable thing(s) (give IL
I \ details of weight and va\u~) H,I f-0~ fJIL__ }.JJL.....
I
I ! "''L...
l(viii)
I
/ Any . other assets such as
! value of claims/interest
1
,... I f-''L- f-'1L ~,, ...._ /'-IIL /'ll L
(ix) 1 Gross Total value
I
1,.t>D'i
~' f-JIL ,-,, L _ ,.._, IL NIL_

B. Details of Immovable assets:

Note: 1. Properties in joint ownership indicating the extent of joint owners
hip will also have
to be indicated

Note; 2. Each land or buildin g or apartment should be mentioned separately

in this format

---
1S. No Description !Self Spouse ,Dependent-1
I H0 f I
ependent-2 Depen dent-3
I

/(i) /· A2ri~ultura1, Laud

I .
l I
l
on(s)
mber(s)
I ~' J-''L ..tJ'L- 1~,L t''L ,..., 1 \_

I !
I
-
. ~ meas urem :1~~~ ~I\...-
I
I~ I
,-...,, L-
1'1' l-
I

~~<,_~~~ / f"lL-- I
"'' L..
@ {/y~
~~;
~~·~
\)
J

8
.I,_..,,
'
'
,,.

16 JAN 2025
 •

- .
\\'hether inherited I I -- ----- -·~-- ----- .-!
property_
i
I I

(Yes or No)
I

I Jlt, flo Ho Na
l Date of purchase in case
I
i of self - acquired property
I
I P-ftL HILi NIL }-l)I,_
I Cost of Land (in case I

I
I I purchas of
e) at the time of
--·---------------

i
purchase
I
f'IL! J.flL }JIL__ 1'11L
I I
I
. I -
Any lnvestn1ent on the I
I I
i land by way of
I developn1ent, construction 1--llL J'-t 1L
I

~HL A'JL fVtL

etc. "'' L
1
! Approximate Current
1 1narket value
I
~•L f--UL N•L /V'JL 1'1 IL
!
fii) 1 Non-A2ricultural Land -
I
. .
I '
Location(s)
Survey number(s) ~JL
I

}ulL 1'-l 1L N\L J\.f /L NIL_

'
I I . I

1--A-re-a-(t-o-ta-l-n1-e-as-u-re-n-1e-n--t--l-- -~t- --l-1 ----" '---- ----.

----- ----- ·----
I in sq. ft.) ~ JL, NIL NIL JV 1L JJ IL 1'I I L
1
•· ! Whether inherited
1 property IN0 •
I (Yes or No) Ho }lb No
1
Date of purchase in case
, of self - acquired property /\,JL J,.JILI NIL

Cost of Land (in case of I

purchase) at the tin1e of

, purchase
f-tl J /\/IL
II
f\l IL
>·"L
Any Investment on the
land by way of
development, construction J,-11L ~''L • }.J IL..
1 etc. "' J L..
: Approximate current I

1narket value ,, LJ .NIL NIL

(iii) •
1
commercial Buildin2s
I (including apartments)
1 -Location(s) ILi 1'.
I -Survey number(s)
___ ___ ____.___ l I
J.l'L
Il

r
 JI

Area (total measurement -r 7

in sq. ft.) NIL NIL, I
~nL NIL _L }-IIL /vlt.__ I

Built-up Area (total

n1easurement in sq.ft.) ~UL J..lll
I
.N'L }JIL
-
- I
I

- r - - - - ~
,-.,,L Hll__ -7
vVhether inherited I

property I
(Yes or No) ~'O }.lb, No I
f.)b H t::,
I I #1.:, -~
Date of purchase in case I
I I
of self - acquired property J-liLI J-IJL ,AJJL
I
I
/'-1J L
I
I
I
Cost of property (in case I
I
i
'
of purchase) at the tin1e of ~,,~ I
I

N'L I N'l... /'UL I

· /\/IL IJ'L
purchase i
Any lnvestn1ent on the
property by way of
7

,-..Li JJtL • ~,,L

I
I
I J
I

development, construction l J..t,L N•L ~''l l

etc.
---;---;---:------+-+---+------4-----+-----+---
. Approximate current - 1 J
market value /
1',ltl ,.._,, L ~J t L "" L 1'-J JL }.•f It_
-~=--=--= ----=--=-- =--=--::-: ----+--;__
I _ --l-_ _ _ _ _.,___ _ _ _ _ _ _ _ -· --i
__,i _ _ _ _
Residential Buildines •
(including apartments): \
-Location(s) 1J•Ll"11L NIL ]'..UL 1'JIL Nil_ ,
-Surve.y nurnber(s) •
jl

~A-~
rea ota(T~~ l----- -t--t- -~--- -+--- --~,l
measurem -~1
ent 1 1

___ _._ft_)_ _ _ _ _-+-~-'L_-t--·I·_N_,_L_,..\__,-..,_,_L_.-·-+---" '-'L

in--:-~q~ ___j_ __N_l__._,~_•t_~--- I
Bm 1t up Area (Total
n1easuremerit in sq. ft.) '-•1u
r NIL ,"-'., J l
I
___,,____I____
-Vv-,h-et-h-er-inh_e_ri-te_d_.._..L.. , - - - - . . - -NIL... - - - - 1'/1L "•111, I

r---------·1 I

property "1~ I fh, I 1'-1 b f.1 b : NO 1'1 l) I

(Yes or No) I ; ; l
-~-~-:_J_f_~--~-c~-~-:-di-;r-~-~-~-y~f-,-,~-~-~-,-,e-:-N-,L--~--N-,L--:-µ-,L----N-JL--_~

Cost of property (in case 1

of purchase) at the time of ,-.1\...

purchase
1-IIL \ NIL , NIL I NIL Ntl-
- _J
Any Investment on the
I I
iI
I

land by way of J,-hL

I ,

development, construction
1

I
~,,L l ,,, I L
I
}-JJL
I I I
I i
I I

-t-
I I

I • - --1

f.-'IL t-,.liL l >1/L l NIL} J-JJL

· - - t - - - - - - ' - - - - - - . . l . . . - - . . . < -_ ____...L_I_ _ J . _ _ _ _ - -

10

·1 6 JAN 2025
 -- ~ -----
r \ Others (such as interest in
\ property)
I ~\L
-! It

·i) "'' N ii ~f JL N IL I
I
I y
Total of current n1arket
\ value of (i) to (v) above "-''L- ~\
1 ~tl l 1',AI N ll- I

1'. ttL }J JL i
I "', L I

,,

(8) I give herein bel ow the

details of liabilities/dues to pub
gov ern me nt:- lic financial institutions and

(N ote: Please give separate det

~ils of name of bank, institution
an1ount before each-item) , entity or individual and

Description Self ~pouse

~o . IA\ ) y rependent-1 \i5ependent-2 ~ep
j(i)

Il
I
!

I
'I
, Loan or
Bank/Financial
lnstitution(s)
dues t-0 ---- -+- 1

I
-- -~ -- -1 ·-
l
I
i ; - 7'
endent-3 \

1-tJL 1 J.11 L !
I \
-~ N.ame . of Ba nk . or
I F1nanc1al lnstttutton, l1 ,
~I L

NI l...
1 Am oun t
' outstanding, \ \
1 Nature ofloan L ~ \- - + - - - - - - - +
----
' Loan or dues to an)' i
I other
1 me nti
individuals/
l entity other than l
Ii
I
I

I
I
\
oned above.
~, Li ,-.11L l
N IL NI L-
Nan1e(s)~ Am oun t I
I
: outstanding, nature of
1
loan
I l Any oth er liability
I

I ,
1 ,
I I

I
I 1~ •L I NI L l "1 L
1 \
I

I Gr and total of liabilities l

I
l

!f-.-flL.
;
l~t L-
1
1
/'11L f\J 1L
I N IL
L--L----
----- _L_.L-:- ' - ~ ~ - - t - ~ - - . . . : \
- /

(A) 1-las the Deponcr~-been in

occupation of YES7No-
/(ii) Go1'crnp1e11t Dy es ;- vernment at (Pl. tic'rr;h,
accon11nodation provided by the Go
before the appropriate ,
Dues to deparrrnenrs any tin1e during the last ten years
dealing ,vith rent election '? aitcmative)
/ Govenu11ent date of not ific atio n of the cur 1

' acco1111nodation S, the foll ow ing

(B) If answer to (A) c1bove is YE
j
I
I declaration 111ay be furnished namely
:-
I
I
I
The address of the Government
I
I
(.i)
acco1n1nodation:
I

I
I I .
I .... .... .... ... }:~ .1.L ....................
.................. N..' L .................... .
..

I
I
.
!
I ................. -~' J.L.................... .
I
I pec t of
There is no dues payable in res
I
(ii)
ion
I It above Govemn1ent accommodat '
towards-
I
I I
I
(a) rent;
,._, 1 ,_
!
I I
'I (b) electricity charges;
I
I I

I
l (c) water charges; and NI L-
I
.' i charges as on
L (d) telephone
I
t4t L... (da te)
I

I I
j
I
of the
[tJ~e date should be the last date
I third month prior to the month
in which
I the election i~ notified or any dat e I
I
i I
I I thereafter]. I
I I
I
.I
Note-. 'No Dues Ce1tificate ~ from
I
! the I

I agenc_1e_s concerned in respect of

rent,
I
I
!

and
I electnclty charges, \Vater charges I
I
abo ve
I I telephone charges for the I
I II Gove:11ment accon1modation should
be I
I

I sub1n1tted.
·-, ...1-(i-~i)--.....1.. ues to department
dealing
, ' ~ovemment transport
1
• ing aircrafts and \ 1'J f Hf L f.l lL
ers) f1 1L
_ _J _
~~t~\jt-i~ ~ ~ rl -+ -- -- _ _ _,_ __- L_ _ __
\ 'l?".J ,) <:('
e4~~~ ,
_ruuL..S\ 4
12

_ -.1 6 J/\N 202~

 I !\
I
I
Self !Spouse f..1u F- Dependent-1 Dependent-2 fDepen dent-3
.
I
I

Kiv) Income Tax dues l

I

~
I
i
, f'l 1 L; f'-11 L I
N•l._ f-'IL }41L I
H
I

(v) I GST dues I I

'I
I
I i
I'
~•L ,· µ1L I -NtL I I

I
I
J...IIL l'JI L NI I.._
I
\ . I
-- I

(vi) \ Municipal/Prope11y tax

I dues
I I

f',JU I-Ill N•L I

ff•L fJIL f.l
I
I
- - I
(vii) Any other dues
fUL f'IJL f!JL JJJL }.JIL.. I

.....
fviii) j
Grand total of
Government dues
all I

,.,,L }-ll L .,.,, L

I
I
NIL NIL }-11
I
! Whether any - --4-----~I
--
l I
I
I
oth~r '
I

bx) liabilities are in dispute, I

I
I
I
I

if so, n1ention the amount l-l'L ! flJL ,._,,

HIL NIL f\'JL
involved and the I
I l authority before which it I
I

. is endin . I

·(9) Details of profession or occupation:

(a) Self. .......... .... t~. L.r ... -~mf/Jl). Y. ,r-.c; ··

(b) Spouse .......... ....... N.'?~.>. .... W.,. FF. .......... .

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

(a) Self ....Sf:.(.:F. .. .. ~.~P. LO y Cc

(b) Spouse . .t,-:1.~U~~- .. -~I fE

(c) Source of income, if any, of dep_endents, ..... . /1. (L......... ..

(98) Contracts \Vith appropriate Government and any public company or cot

(a) details of contracts entered by the candidate .. H.'L.... • ~

(b) details of contracts entered into by spouse . .. J-:1.'.k.....
~\RE~DE~ ?~\.'·\~:~~~
.. •. :., •
eg.No.\u~til iLVL
(c) details of contracts entered into by dependents . .1:-!.J.k.-.. ....... OEL\-\\
(d) details of contracts entered into by Hindu Undivided Fan1ily or t

13 ·1 6. JAN_ 1n2~J.. , L.
• " S\"'-T"
.J\~

tt,
r
 -

candidate or spouse or dependents have interest ....... .H .I. L ••· · · · · · · · · ·

(e) details of contracts, entered into by Partnership Finns in which candida
te or
spouse or dependents are partners ....... ~ .... f.. r'. I .L_ ......... ......... .... •••••••
••
•
(t) details of contracts, entered into by private companies in which candida
te or
spouse or dependents have share ......... NJ. L:_.......... .

(10) My educational qualification is as under:

........... J.k.~. :..., 6S.i?.. .:.e.Q.6-.~.0.. f).. fJ:r.l..f..................

(Give det~ils of highest School / U~iversity education mentioning the full
form of the
certificate/ diploma/ degree course, narne of the School /College/ University
and the year
in which th~ course was completed.)

~i~
&,i·-~J..i ~ ~~i\)\i~
\~~J~"\\'t~
~~~\)~t,,\,~

---·--~. S\~
"'~
14

,1 6 JAN 2ff6
►
 PART - B
(1 l ). Al\BSTRACT ot THE DE~r AI·LS GIVE N 1N (1) To (to)
OF' PART -A=
[ I •

I
I

J. ; Nan1e of the candidate -- - .

I
Sh./Smt./Kum . "':J ~HA L~:t NLl )H.
'

,
-
N)~. ~~ ~ g;.;:s, l. ())i,HA,,,-,/'1AD P~-.
1
\ Full postal address
I • Nutnber ·and natne
lf"
~· , .
I constituency and Stat~
of the
l\'1- Q~K~ Pu~ f:\ r1'\ Ot: l \-1 ~
I I "\a1ne of the political party \vhich
Set up the candidate (othenvise t' A~b NA L 'JoVTJ1
- ..

I
\\Tite "Independent') ()A-R11
I
I 15, Total nu1nber of pending crin1inal
cases
'
t
--
I
I
L
t I
,.I
r.-I
I

.
Total Nun1ber of cases in which
convicted
t--f l

,-..,L
r?. PAN of Year for which last \ Total lncome Sho\vn
lncon1e Tax Return filed
\ I. I
I
(a) Candidate
(b) Spouse
r3P ~ :j,0 SOOil /.JIL - I }I IL
I• NtL -- 1I "-' IL-

~L~__
N1L
- .__M~
11
~
8.
1d) Dependent
_ __ ! _ _ _
_
_______J
___jl--#-~
--~.__
Details of 4,\ssets and Liabilities · ·· ~,,, !
I

NIL .
in_ru_p_e_e_s-.-----_.-....
__N_'....-L-_ \
. Description -ISelf :Spou se lI H tJ ~
---"---_..____
_ I De endent-1 De endent-2 !De ~
tA. ; :\lffveable Assets -\ ~IL 1
-~-__,.~_(_T_ot_a_l,_·a_lu_e_)_ _ ►·c,oi)lb ! ~IL /\JJL N•L
\B. , lmmoYable Assets f'l1L il"•L - 1 NIL -
~
\
-
I
--------- Purchase Pn.__·c of
self-acquired
in11110 \ able f',IIL
r~I
I
fJ/L ~UL - 1'1 IL-
}\lit_ _

\
N•L

1-JJL
property
' I "''L
I I__..
 -~~--=-----,---~-,---1-----,
III Approximate -----7-------
Current Market Price

1-JI L
(a) Self-acquired fJJ.__l- /'1/L J\.11 l_
assets (Total
Value)
(b) IQherited assets fJJL.. .... }JJ L
. (Total Value)
~9-~L-ULJ-i~ab~i~li!!ti~es~---Lll:liJ•~L---~+_rf\:~L.1-
,,~ -_.r!1..,
•~• 'IL
!.L~+- _c_l'J ~=--t NIL 1.
/...rt[
(i) Gove rnme nt dues -___. ::.__: __ _T ----
, _ (Total). ._ ~
NJI _ NtL
.r (ii) Loans from Bank,
. Financial Institutions
f and others (Total)
N\L JqJ L- HJL N1L 1'111 -
:
110. Liabilities that are un_d_e_r_d_is...=p__u"'T""'te__:_N..:...:.t_a..-----.-_ __:_N_I~l==--
I -N_I _L-- ,-_ _N_l_<--_ ~ N IC
( i) Goverriment dues
;
(Total)
(ii) Loans from Bank,
}IIL J-IIL /'-IIL }'JJ L I N'L ! }-Ill__
I ;,
Financial
Institutions and 1Jt L
. (_
1---1..&--4----------
, oclrers (T'oca{j
I
N1L 1
/\'1L I f'JJL_ _ J NIL _
-----...l....-
--------l.-------1-----
11. Highest educational qualification:_
----...l....--~~--~-__
._-----'-------

· .
~
s 13- oD A ~0- I'~ c._t,_ 1
(Give details of highest School /University education mentioning the full form of the certificate,
diplom~/, degree course, name of the School /College/ Univ
was completed.) ersity and the year in which the course
1 •

• l ,
. .

~
. I
..
... j \
_..
\ I
\

• -
' I •
'\
.. .'

t t

'.1", > . • • :,'

• I '

16

'1 6 JI\
 VERIFICA TION

l, the deponent, above named, do hereby verify and declare that the contents of this
affidavit are true and correct to the best of my kno\\,Jedge and belief and no part of it is false and
nothing 1naterial has been concealed there fron1. 1 further declare that:-

(a) the1~e 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) L n1y spouse, or my dependents do not have any asset or liability, other than those mer;itioned
in ite1ns 7 and 8 of Pait A and items 8~ 9 and 10 of Part B above.

\ ,' en.f.1ed I
"'t>l
at. .. ._.v. l-11"
.............. .. .. th'1s 1b the ....... .-;r.f.1..:1................day
of........... .?,,,-0. 1K. .............. .

~~
Note: 1. Affidavit should be filed latest by 3.00 PM on the last day of filing nominations.

Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First
Class or before a Notary Public.
1"ote: 3. All colurnns should be filled up and no colun1n to be left blank. If there is no
infonnation to fun1ish in respect of any item, either '~Nil'' or "'Not applicable", as
the case may be, should be n1entioned.

Note: 4. The affidavit should be either typed or written legibly and neatly .

..:,-..:.0
I ~~ti~~\ I

A.~'!~
~et-\C 'W}i\~11~00
NO•~- ".NOVt \Ii\UT\\\

~:-r;\~N 1~15 I '

~~~~
•

~stef EJ'~
te of E"tr~
Oa C
oeta\\ ot oo
umef\t ~aC}

ND 17