i'f~

~illri":'~

[I .1;1', ~oi1 0

, \

fWrf)f"l'~ ~.~ Itt W.IJI:4aen •• ,\, ~./r.::-c: - ~ ~(; _,~._ 42AA 973681

ITF\l -()5

to he Iu rn is h c d 11.' t h c c a n d idn t c along \\ ith \"ominCltioll PeIIH'1"

Before the Rcr u r n in o Officer/"">

~ For c In" i()11 t () L c ~~ix Ia t ive ass e III b 1,\ (n (\ !11 c () f t Il_~_ Ill) II S c )Fronl ~N R.-\:-\..\(;IL\T l·TT.·\\{ Pl'I(IL\(.\..;C) Cnnst itucu cv

~ (V{/I//(' ofth « (/lII\/ifllt'If('.l).

- ---------I .vn uvu fi.kdl'l" (\Ltlli~-\\ if'l' (It' Bl!llp'l~i 1~'lllian Sikd c r il.ged .lh:;'PI ·L) year ...., I'l·,I:klll II!'

ViiI. PllrYlap:lr;l, P.O. !Lq!.uLL Dixt. \,l(lltI, \\'l'~{ Bl'llg,lI, Pill. 7-41 ::-.02.(fllt'llil,1I1 11111p'"lal

addf"l:s~). jetllldid:ltl' :It fill' "hol (' Llt'l'tiffll. do h c rvh , so\enlnh .t lfir m :I lid ~tall· UII n:llil :h Idld,,!:-

(~t r i 1\ l' ()II t \\ h il· II l'\ cr i" 1111t ;) PI' I iL·;II II l' ) .

(1)1 alll:1 c'lll(lici;lte set lip il.\ \irj:llil:1 Silillaj 13iplalJi Pal·i~ (n a m c nft lu. poiilil':tIp~lrt\) / '11l1etillfolillg ll~; ,Ill IlItiepclltierl! t'.llltiitlilfc ~-vC! ~

(2) Ih1aib or p.\\' .i ntl St<!tIIS or lilill!.!. or IIll'OIIlC 1:1\ rct u ru:

SI. '.\:IIlH" 1\'rlll;IIll'llf Till' lill:llll'i:!I, v.t r fllr \\ Ili,'1I fill' 1:1'-1 ·"1I·"i iJl\·"P1L ·liol\\!: I:!\fl. '

I,I

; Sl'lf Ii Srlilisc·

: ·lkPiHil'1I1 I.. I

: ,-Ih'PfdL'"1 2

IkPl'llfkll1 .J,

······9·· .. "

~

\ L' L': 11111t

'x u m lur

(I' \ \)

.\il

.\ I(lTS2KS2(·i··I 2.i13.I· .".

211(1<1-I () It~. -' I.:\kll

\il \"11

-I. \11 \," f· [k \ n i ,I, ,'.1 i ,I,I.

\il '\(11 I ill-

.--------~--~- p------

(~)Thl' folio" illg t';1."d-.;) i"/;ll"t' pelldillg agaill"l Ill(' III 1\ lticilcoglll!:lIll'l' h .•', III !'1!.I:lkl';:

by the cou rr:'--,

--, --_._- .-

JI . \:'1I The dclail\ of C:1\l'," II IIlTl' 111('ro u rt 11:1\1:11,('11

I c()glli:t,;IIlU', Sl'rtioll' of 111\' \CI ;111(\d\'\\'riplioll III' I lieoflclll'c I'llI'II lIi('1I \'llglli/:llll'\' t.rl.cu:

() Ill'lll'l' Ih:;.criplillil

\111 :\pplil':llJk

I (h) Name of till' cuurt , (':1\\' '\11. u nd \}:lll' III' o rrl er I:lkillg

coguizancc:

(e) Details of Appeal ('J 1 \pplil':lIioll' ('J fill' rc ivio n (if

anv) filed :l!!:lill\l t h« :11)11't' ordt'l"I'):. I,' .'

. (4) Cases in which I h nv c hcc n co nvicrcd hv a cnu rr ofLl\\ (other t h oxe r"rn:'cd to ill

Form 2())

I ·tiH:~'l:tail •. III' (,:I,t'" ' l'\"l iOIl' III' 11t\'

I ACI and dcxc rip t inn of t hv oll\'IILT fill'

! \I hich corn ict cd:

, ,1111C0 I' Ih~' ( 'nu r I (•.l. ( ':I \ L' \ II. :III d,Datc(s) of o rd crt s):

'\ot \ppli('"ll",

'\ol.\pplil':IIIIl'

(S)That I gin.! herein hel()\, Ihe d ct a ilx of the as 'l'h (muv u b!c a n d I III 11/1,'·,.!,:, .' .,1'myself, m~' spouse a nrl d c pcn d cn Is:

A. Details of' mova hlr as'l'h:(I\ole:

I, Assets injo int nu nu: ill<iil':llill;.! 111('c xt cur u lju i n t uw ucrx h i p II ill al,;, h:1\ I f •• ~',I'.t'i'2, III ('aq' Ill' i1t'p",il/'", vvt nu-n t , I ilL' t1t-I:lil., illl'illdillg :-'eri:ll '1lInhcr, .\111011111,Ih:l' ",' \)",,,, ..; .h I

St:llCIIIl', ;'\alllt' III' 1\:llIkl l nxt i t u t iun .uul Ilr:lllch :lrt' III Ill' gi' en

J, Vallie ()f' B(lIld,/SII:lrl'lt>cIll'IlIIlI'l',;1" pel' the cu rrrn! m.ukct vn lue in Siork ('\t:!!'III~',(' in /"'·.perl PI'listed companies a nd " •. per hOIlI" ill l'll\l' of no n-Iivt cd co mpa nics xhou ld nc gi 'l'll.

-L Dependent. here IlH'all~ a pcrxo n. vuhvt an t in ll , dl'fh'lldclll Oil 1111'incorn« "I' thl' t:at:did,:k.5, Details incilidillg amou nt i•.'(II ill' gi, l'1l 'l'par:lll'h ill 1'l"IH'l't III' each in, (',IIIlUlt)

I - - 91I SI. Dl'''lTiptillllI j\o. !

I(i)

I (ii)

I\...

. J

\(, If ,\ 1I"11'l' \)qH'lIdl'lll Ilt'!,,'nd"i:f ""p,'Il',kill

I~, , I (llltl/- I{ •., 211111Ii- \' i! \i! iI

:-';n i IIg.•. I{ •., 2 (101- \il \it 'I,:

I~v.I I (I(Itl/-

"oil '\ i I , , . "

,) Details 01"in v vvt m en t ill \s:-.. \i1 1 .. 1.( . .\" i I :'\i1 :-":il

Postal Sal·ings. I nxu r.uuc 1'!"l'1I1i 1111I

Pulicics nn d i nv cvt nu-u t III I{ v , '),H.X/-

; unv Final1cial l nvt tu mvu t illI)o~t ol"ficl' 01' In\III":IIIl'(,

, COI'lIpanl and till' .uunu n t~__--1- ___ . _ '.>.' __ . -

(v) ! Perxun n l Ina nx/u d , allCl' gil ,'II \il "\ i I ."\ i I \il \il

1 to an~ Pl"I"I.,OIl 01" rn t i t v

inl'illtiillg Iirm , ('0111p:lIl\,

I Trust ctc. anti o t h cr

I receivables trum rlcbt o r-, :lndI the a1110UI11.

, .< vi) .. f Motor Vl'Ilirie\I.\il"l"I":lft,1 "\ i I \" i I '\'il \il \ill. I Yachts/Sh ip» (rl ct a i l-, ot"

I i Mn kr, I~q~i.\tl"atilill .\0. l'!r,

"1.

I ~'Vfi)'

'1 Year 01"l'lIl"l:il:r.\l' :l11t1

'1 ,1111o 1In t)I.lew",,,. ""IIi"" "',,, vu lu.rb l,: 711L 1':1111 III (;1':1111 III ( ; 1':1111 I II t: 1':1111 \il

\. th illg (gin' dl't a i 1\ 0 I" II l'iglt t

and value)

,I(\:iiilj

\" i I \il ,\iil \il '\ i I1 Anv ot lu-r ;1\'('(" xurh :r> I .r l uc

l~;)-I of Claim.,/inkr,·.\t

! Gross' T;ltal value I{\, I{, . It\, 1l) (J(J 0/- J<,, '-IiI 1 :'011001- :2 :,OIlOf- Il)OOOi-I

B. . Drtaib of.! '1111I01.i h lc :r\\l'(o,:

( 1011':1, I'ro(.ll'l"til" ill joillt 1.11 n rrvh i p ill<iil':ltillg tltl' rvt rn t oi".joillt Olllll"r~lripll ill :r!'I, 11;\\ " tll :ll'

indicated2. Eal'i1 la ud 01' hu ild iuj; 01" :rp:rrtllll'lIt \llIIlIld hl' ru rn t in ucd 'l'pal"all'h ill t h i-, 1"III"Ill;It.1

\l'It" .t.; po 1I'l' Dqll'ndelll- 1 f)l'j1l'Jld('Il!-: i)(.p"lIdl' II i "-'.

.\"i I '\ i I \il '\ i I(II)

ILlglIl:r.\1111I;;1

III \il .IX \il \i1 \il

J)l'ciilk-'1""

.\"iI \' L'S \" i I .\"rI ,

:'\ i I \il :'\ i I \il -;.• 1 i

xu \" i I '\it :\"il \i!

r:

\" i I "\ i I "\ i I '\ i I l.cii

Approximar« Cu rrt-u t III a 1""l'1 "\ i I I~v. ~ \il \r1 ,"I uluc l.;ri,h

1.:111 d \" i I ,'\ i I v .; '\ i I \iJ \ 11

III 'q. '\ i I "\ i I " i I\""1 II'

l'd propl'J't~ (\ l" \il \il "\ i I "\11 'il

\il \il, \iI \d.,

. \,

II Cost or 1 .a nd (in l'<1~I'or, purchase) al till' t im c "I'

plIl'cliase<t"'j Any Invcxunc n t on t h c 1:111<11)\i , way of' dcvclop ru cut.

I ., .. : runxtrurt inn ere.1- - -, ('j •

ApprOXIIl)atl' ( IIITI'n! 111:11'1,1')value

(iii) : C'~Ollllercial BlliIJill!,!'(including npa rt m e n tx j >-Locatinnts). Survey num hcrt«)

--.-- ~- .BlIilt IIp...\rl':J (Total

l_n~~(.~~III·I'Il:Clltin '<i. FI.)

I 'y\hcthl'l" in lurit cd propl'l'h (\ I"i o'r 1'111)

1

6at~ I;" purrha «. ill cuxc or sl:lf''ucquircd propert.' .

F(;ost-;)r propl'rt\ (ill CI'I' III'purchuxe) at tltl' t iuu orpurchaxc

I ..

Any Investment Oil tltl' propl'rt.'by wa~' of dcvclnpmc n t,

constructiou etc.--~--.~..- -.Appro ximntc .Cu rrcm mnrk c t

["lvniLic .I'(~T-'I"~~;si-ti~il'tiH~1 'g II i1(\ i 11gs\ ,.' (includiuj; a part rucntx.]

1.- l.ncarioutx) ,

\

• Survey n umhertx)Ar~;i-(l':otalllll'a'llI:l'IllI'"1 ill 'IJ,ft.)

. B'Ufit"lIp Arca (Tnt al

IlleaSIII"l'Il1I'1l1ill .''1, 1'1.1I.i Whctlu-r inh cri tvd propl'r!.' (\ (',I,", No)r 6;11~';!f' purrha «: ill em' 01' ,('II'

1 a~'!l~.L~:'~!.p":·(!jl.e.l~r,'

rf'ost of propcrrv (in (''',l' 01'purchase) at the time of'purchase

I, All." l nvcvt nu-n t Oil t h c I:IIHI 1)\

\\;1.' 01' til" l'iOPIlIl'IlI,i coIlS trill' t iOil etc.

ti APprO\,ill1att: CIIITl'll! 11I:11'1,1'1, va luc

-- - I .(v) I Other-:- (.~IIl'i1:ISin t crvvt ill

dJ)L~l).C~..t..'~

l(n) I Total Of,\lltTl'llt :\hlrkl'1. _ Vallie of JIJ. to (.I) a hove

~"""""-:;,0'~~2:Ii£

'-.i1 xu

\il .\ iI

\il \il

'-.i I \il

'-.i1 \i1

'\il \il

.'-.i I :'\il

,'-.i I '\il

\il '-.i I

:"il :"il

'-.iI 11011'1'(,I)

Bagliia,\IfllI;;1

\il lIJ\)n' i IIIIt-

liS"" '<i'II.

\il

'\il \ I','

'\il .'-.i I

\il '\il

\il \il

\' i I I{v. I {J

1.:1kh'-.iI'-.il

'-.i I I<" 12I.;rkh

,'-.iI \il '\il

\il '\il.\il

'-.iI .\i1 \iL

'-.i I '-.i I \11

,\i1 ,\'i I '-.iI

\i1 '-.i I'\ iI

I'iI ;\,i I

\' i I :\ i I:"il

~il \il\iI

\il ,il

:\ iI '\il il

,'-.i I ,'-.:I\' iI

'-.i I '\il

\il ,;',... ' ~\il

\il \il

:'iil .\ i I \il

'-.i I \11

'-.iI '\ iI

\' i I '-.i1

\' iI \il \il

.'

'j

\ ~OHIl or dill'S to\ Bank/ Finu ncial! lnstitution (s)I .,! Nn m c of Halik III' 1'1I Amoun: olltstalldill)!,I iaturc of loaII

\ Loan or dues to :\11)'

I individ uulx/ Entit\. .. 'I other thunImentiol1cd ill (i)! :lbm c.o I\,aflIt{,,) \1111111111

'Ii:E;;I;::':::~:~::::';::t:'Crnud total orliabilities

I (,OVCI'I1Illl'llt Diles:

IJ)l1C~10 dl'P:II'IIIII:,lIhdealing wit hnOVCI'nm~1I1

, ,I ~c{'nIll11l0d;Jljon

1-:~~"16;,(~ II) dl:p"rllll('III~

" I dl'alillg II illi \llpph III'i.,.....:_1 II ;'..!.~I'

"

\il 111111\ l'BuildingI,IIIll'1'..\,1\,\aihali.I lakh

\il \' iI \il

\il \if ,\il \il \il

\il ,\i'l \il \il \' i I

\iI I{ " \il ;\ i I "\ii

.\ 1,:11\11

\il \il \' i I \il \iI

\il \il \il \il xu

(6) I give herein helm, t hc d cru i!s of' liub ili t icx.' d ucx to public fi nan ciu l inxri t u tio ns :lll·igovc r n rnc n t

(Nnrc: Please gi.' l' ~l'p':lr:lll' dl'l:lils III"n.un c III' Hank, invt it u t iuu , en r itv III' in dividu.i l :111(::11111111111fill' (':1, 1[iem)

,i J)l1C~10 d('P;lrtlll('III'I

I dealing wit h ~uPJlh 01"I elect ric i t\11b.u:..L1O<it-pal'l'lIe,,',

(killing \\ i t h 'II pph Ill".~_~ t~~ph()I!(',/II'lllJi Il"

Diles 10c!t-par!l11l'llhi (/talillg w i t l:I govl'rnllll'nl 11':'n~plll'l

I (including "irrl':1fl\ :IlidI. I ht'liropt('I'.qI-t--- T - - _. .

I l ncumc T;n \J)lIl"I ,-........,~~~N-.~'ioIra\ J) IIe:

\il \il \if \il\il

\il . \il \il\il

\il \iI \il \il \il

\il \' i I \il .\il " iI

\il \' i I \il \if 'il - :

\il \il \il \il iI

\il \'il \il il ,'\ II

\' i I ,\il .\' i I \il \il

\il -, i I \it" \iI -.i!

'\ i I \il \il \il ' 'I'I.

) I) Ct tl iIs () f p r ()fl' SSio n 0 I' ()l' (' II PaIi()II :a, l lnux« \\ ift-.h. S('I'\ i('L'(em'!. I IId(:rl;lI,ing)

(8) My cd ucu tiunu l q u alificn t inu is ax u nrl cr: I il,-'I)~II\:,

,gi,'c d cta ils of highest School/ l n iv IT.,it.' cduc.u inn 1\ i t h 1'11111'01'11Iof the ccr ti fi cu t c/ dipkunu/ dl'gi'l'l'coursl~/( a me of th« Scho()l/ Collcgl'll'llil crxi t v a nd the ~car ill \I hir h the co urxc \I a" c oru pf ct ed.)

(9)ABSTI3!\CT OF THE DETAILS CI\,U\ l~ (I) TO (H) ABOVE:'-'

\~, \-~-3.

I

\ N~~~l' of the calldidatl'

I Full postal addl'l's,

I-N-;;-;;-;-h~'r;llldi\'alllC of t hc l'ollstitlll'IIl',1 u ndstate,-

4, Naill(' or tlil' I'olitil'al jl:lrt.' \I h ich ,'ct IIJI till'cal~_d.id:lte(otlll'!'\\ i,(' \I rite '1I1d('pl'l1dl'llt')

"5., ,(a) Number ()f cases ill \I hich co nvicr iu n..' order pnxxcd (other th;111those ref(,rrl'd tll in

\,':

-''''"''''Y~!'~:'~(~):", . ':', '(b)'Total nu mhvr of "l'IH,ling ('a'l" \I Iil'rl',", 'Ith~ court (s ) h;1.'l' t nk cn l'lIglli',1I1(,('.. ,'(), PANcd'

".I," ~ _ ~. _ •.'(:'I ' a) Cuudidnrc". • . '(I;) -SPOllSl':

, lJ:Z1t0~c:,p_e,1l0(,l1ts,

r-r-r'-,~"-l 'j !)~sL:riptill;1';\: I : i'Movcahle Asset

I jlT...9t'~_~-"~~!~le),B.! Im m ovnb lc Axxct

17:/-7i) I-p~c-il;';"'(' "rin:' and

I' 'i)(,l'l'llIjllll(,llt ('OS! oflmmo , ;lhk I'rllpl'rt\(Total v'n luc )

(ii) I App rn xima t c Cu rrcn t

Market "ric(' Ill' .'\S,'L'tI -' (Tula I va l uc)

I -x-:-:'-- Libilitil's

I "I I1 i (i) CO\'('rl1llll'lll d uc:I I,, : (Total)

.Lll).J,O;lIh Irom \lallkFin:lllci:li l nxt it u t io nv

! alld o t hcr (Tol:lI)'1Iigi/('.'1 l'l~l':ltillll;li q unl ific.u iuu:

, Sh.l Slllt.ll'lIlIl, AIlII\'a Sikrl c r (!\1,liliclq'"ill. l'u rhn paru, ",0. Bagul:l, \list. "'aelia, \\'c"tl~clI~al, I'ill, 7-11"i~)2,

Xl) I~ANi\(;IIAT liTTAJ< Plll~B/\(SC)'\'l"t Ill'lIgal.'-.irj:ltit:l \:lIll:lj nipl:lhi 1':11'1\

\'Ilt ,\pplinlhk

\ (,:11'for \I h irh 1;I~tlnro uu' Ta\ J<l'llirn filed

\ot Fill'd2(01)-1 ()

\'III/-'ibi

'I tJtal III('IIIIIC' \hllllil

'ot Shnwn1{",3 l.akh,\'I)t Shn» n

Det,lil" Ill' :\-.;sets and l.iuhili tic» in rupecs,'-;('11' SPIIII.'(, ill'pl'lIdl'III-I' ilepl'lIdelit-II

It" I<s, 1<" 1()OIIO/- ,I<s, I ()()DO/-I ~I)(I()(I/- 2~OOO/-

lll-p(,lIlit'lIt-111

\il

-,. -\' i I It" 12 \il :\' iI

I Lakh'-.i I \il \il ",'il

, (Give d('tllil~ of S('hllol/l nil l'l',it, cd ucu t iu n II it h 1'11111'111'11IIII' the vcr t ilil':I Il'l dipllllll:ll (\t-gl'l'(', I cnursv) (Nu m« or till' .\('hllllil ('III\t-gl'/ l Iii, el',il,1 :11111t lu ,I t':11'in \I h irh t h c cn urxv 11:1.\

, I, I ~t.:()/Ilpl('tl'd,)~

\il

'-. i 1

'-. i I

'-. i 1

Li t cr.u c.

\' i 1

\' iI

,\il ,'-.i I :'-.i I '-.i I

1<" .~ '-.iI \il ,\' i II ,:11, It\il \il -, i1 \il

'-.i I \il '-.i I ,\' i I

"

\Tl~IFIC,\TIO '

I, the deponent. ahol l' numvd. do lurct» I erilv and dcrlarc th a t l'OIlIl'nh of thi~ :IfTidal il arc I rill' andcorrect to the ill'.'-I ''''111.' I,noll kdgl' :lIlll hrl icf', no p:lrl or it i, I'alve and nothing m a t c ria l iJa, hccucnncrulcd ther(' 1'1'011I. I flirt her dl'ri;II'l' Ihal :

(a) There is no case of co nv ici iun or pending case againq me other than those mentioned ill itellls:I (II)!I,~ above; . .

(b) I, Illy spouse, or 11I.1 d ('lll'ndcll" do n ot hnvc a n~ a"el (J I' Iia hi Ii I~ , 01 h c I' I Ill! n I hO.';t, III l'lI I inn c'd inircms S and 6 al)(11 l' .

. Verified ;11 fI!-.~.~-: t h i-, t he ....•............ ~.c:.I:J!. ..or ; : ~, 2tlI1, .

nrc : I. Affid.ivi t vh o u l d ill' riil'd 1;11(·,1 il.1 .'.1101'\11111 till' la,1 d;lt(· of filing no ru inn t ion-.2. ,\lTidal il vh o u ld IH' ," o rn hvlo rr .r n O.u h ( 11111III i"illll('1' Ill' .\l:lgi,tl':lll· "I' t lu- i-'il',1 ( 1:1" 'II

hd'o 1'1' :I "01 a J'I I'll ill ic ..'\. All culuuu», vhuu ld ill' filled lip :I lid 11111'011111111to ill' lv lt hla n k. I I' th c rc i~ 110 inform a t iun 10

rllr~1~il ill 1'l"'jll'1'1 or :111\ it cm , ci t h cr "\'il" III' "\ot aJlJllil':lillc". a, rhc 1':I~l' Ilia." he. vh o u ld~ .bv nicn tinncd.

-4. The ,If Tidal it vh o u l d ill' vit hvr 1\ IH'd 111'11 ru u-n k:.!iilil and lIl'atl.l.

/'

.1

".~

-~-.-

BqSfaZX'fqx() 22('HTH'iifxiii'aHk ofii' _:HHGif_f;Xqb eK'!'NH'i' qfii' H'i'fifi'iifii!3-(i0'ifi/

-K_dfpi:iqfs_iX""_H2H22H-X(r/rk _ r i ofii' i il ru_ ) i ok k: JH) 2x/-XX/X(;HH-Vi q '!Cd.c.g-h-]hHc i'f T." ( k RHHHq' ()c' h e T i'()0iRHfHHii'Hii'-X)

C, 11111P,1 -Xff-ai'H'(Xi:iHf'i'f-)XXfc'b2)2 2x!IiHm;iof 2<:HHH/f':ci:.';ffaik ;ixq"g ,a],(fa]a-'4o '(:::2"

obpfabkq (x' X'fii- Or oe/om/r.r/ H)-()- HKHdiii-2/0)fi'q/ X;i(if-2/ XX'i'pi2)('22;-/';/22:Wifii/'; .i! 5-6()2TRk V]VZhV -HHqfii' ,,/)b(' TaTTh frr- Vd \ _fTS , /--()ii'Hii!H" I'efoiii-i pq;iib 1)11 BDa6!, :2'- ('fiif/A 'Y(

d9ccV/\x'7'c

x

[

f~.

.-11 973b3b

HiocLH'ikx "x'H"X.{{2PdB.o"4B.IhVaW"-,9-, :,a\ a,

/XxxE:XiixK 2:X.('(CG:XOSciw X- O/:X0w/:X.8/ 3)F() P XH3() (xK H-:H<K ' H/K 6 X)

/ ; q'a'ofX;;! w-g

P ]"

H/:'-fii'

! ffH/'

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