Gg_Vernment of Karnataka

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INDIA NON JUDICIAL
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Gg_Vernment of Karn ataka
e-Stamp
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Cedilicate No.
lN-tfl09413745290588K
Certificate lssued Date
31-May-2012 02:56 pM
Account Reference
NONACC (Fl)1 kaksfcl08/ RAMANAGnni Xn- n rur
S UBI N.KAKAKS FCLOB g 27 544g9877 BB7 K
Unique Doc. Reference
Purchased by
Description of Document
SYED MUDEER AGA
Article 4 Affidavit
Description
AFFIDAVIT
Consideration price (Rs.)
0
(Zero)
::,,
,
First Party
;
Second Party
: NA'.,.
Stamp Duty Paid By
Siamp Duty Amount(Fs.)
: SYED MUDEER AGA
:20
' (Twenty,Only),',, ,:; ,
l
SYED MUDEER AGA
,,'
$
.
- . - . please
' ",
write or type below this line
":?LT?1,
Affidavit to be furnished by the candiclate
before the Returning office
to Mernber of Legislative Corrnsel (name of the House) From rvr. r
(Nnnre of tlrc Constituency)
{"?
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resiclent of No, 4552, Maclar
SYED MUDEER AGA, son of Late Syeci Ahmed Aga, agecl about 63 years,
Khan Mohalla, Masjid Sh'eet, Ramanagram -
562159,
l1ow campiug at Bangalore a candidate at tl're above Election, do herebl' solenrnly
affirrn ancl state on oath as under':-
L. I w/
arn not accused of arry offence(s) punishable rvith irnprisoutneut for two
yeals or rnore in a pending case(s) in wl'rich a charge(s) has/ have been framed
by the court(s) of competent juriscliction,
If t\e cleponent is accusecl of any such fence(s) he shall furnish tl're folloiving
t)
/
First inforrnation repolt No.
ii)
Distlict
Station(s)
(s)
State(s)
iii)
ir)
v)
vi)
Sectior\s) of the concerned Act(s) and rort description of offence(s)
for u'l'rich tl're candidate has been char
Court(s) i,r\ich framed the charge(s
Date(s) on w\ch the charge(s) was/ were fr
\Mrethel all o\any of the proceedings(s)
court(s) of the colnpetent julisdiction
I h*+sbeen/ liave not been convicted of an offence(s) otlier than any offence(s)
leferred to in sub-section (1) of sub-section (2), or covered in sub-section (3), of
section B of the Representation of the People Act, L951 (43 of 1951) and sentenced
to irnprisonment for one year or lnore.
iii)
Irolice
Dish'ict
Station(s)
h-,/
State(s)
iu)
Section(s) of
for which the
Date(s)
o11
(u) i] /
\t /
e concemecl Act(s) and short descli
ion
e(s)
/\1
l,
c pdiclate l.ras been charged
rv\ch the
sentence(s)
wasf
we
;,'.xi
i-.
2
I
/
,i.,-,=i'-'
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|
/\'t)
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\/
n stal'ed by any court(s) of
Whetlie\en tence(s) has/
cornpeten\ risdiction
the
ature of depon
Place: Rarrgalore
VERIFICATION
I, the aboye named deponent, do hereby verify and declale that the cotlteuts of this
aff-idavit are hue ancl collect to the best of my knowledge and belief, no part of it is
false ancl nothing material has been concealed therein,
Verified at Bangaloie on this the 1't day of June 2012
DEPONENT
SWORN TO BEFORE ME
IDENTIFIED BY ME
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INDIA NON JUDICIAL
Government of Karnataka
e-Stamp
'*rt
{eia ;teil
Certilicate No.
rN-1G09414048781 195K
Certificate lssued Date
31-May:2012 02;57 PM
Account Reference
NONACC (Fl)/ kaksfcl0S/ RAMANAGAR/
Unique Doc. Reference
suBlN.KAI(AKSFCL0BP275458261 831 9K
Description of Document
_ I
.Article4Affidavit
',.'-...'-,_'
I|
Description
AFFIDAVIT
Consideration Price (Rs.)
0
SYED MUDEER AGA
PLrrchasecl by
I
1
{
{
(Zero)
Firsr Party
SYED MUDEER AGA
Second Party
NA
Stamp Duty Paid By
SYE,D MUPEER
Stamp Duty Amount(Rs.)
50
AqA
i
(Fifty only)
-.. - -,Please write or type below this Iine- - - - - - -. - - - -.-
Affidavit to be Furnished by the caldidate along with Notnination Paper
Before the Returning Officer
For election to Member of Legislative Counsel (name of the Flouse)
Fronr Ir4. L. A Constihrency (Nnlle of tlrc Cortstituerrcy)
Star.ualory Alert;
;
Jf
.(.,.1?cl DEI:ilsal iC(ls SllClLLlfliaesar)ilSRosar-oai:llafile.rlher.irebsile
vr,.!'rsltci estarTrlrccrrl
rI
I
SYID I\,IUDEER AGA, sorr of Late S),erl Ahmecl Aga, aged aborrt 63 1,ea1s, r.esiclelt of No.
'1552, Nlaclal I(ran lr4ohalla, N'tasjicl Sh'eet, Ramarragran^t - 562759, lto\v cautpilrg at
Baugalole a carrdidate at the atro'e Electirn, rlo here[,1,soleuru11,affirm
llndef
(1)
arrc1
state olr oath as
:-
I atn a caucliclate set up try Janatadal (S) (name of the political
. eentesting-a5-anlnfundenfeandida+e.
o
(2)
paLt1,)
/
Details of PAN and statrrs of filing of Incorne tax return:
Sl. No.
Narnes
Pelrnanerrt
Account
Nr"rurber'
(PAN)
1
Self
2,
Spolse
Ll,
Deperrdent
AEPPAOl36C
Tlre fir-rancial year
for rvhich the last
Itrcome-tax
retunr has been
Total income
sholvn In
filed
Rupees)
2,65,306 = 00
31-03-2011
Incorne Tax
Return
(in
Nii
Nil
NiI
1
Nit
Nil
Nil
4
Dependerrt 2
Nit
Nil
Nil
5.
Depenclent 3
Nil
Nil
Nil
(3)
The follorving case(s) is/ are pencling against me in rvhich cognizalce,6as been
takerr b)'the cotrrt:-
sl.
No.
Offetrce
Description
ihe details of cases rvhere the court has taken
cogniztince, Sections of the Act ancl description
ol tlre offerrce fol rvhiclr cognizance taken
-.t\lI -
(b)
Nanre of the court, Case No. aud Date of order.
tal<irrg cogrrizance :
-l\rl
(c)
Details of Appeal (s) Application(s) for revisio,.,
1if
any) filed against the above oLder(s) :
(a)
:
/
-Nil
D >q/:
[*-'$,'fffi
-
am
n
Cases in
which l have been convictecl by a court of law (other those referred
to i.
Form 26):
The details of eases, Sections of ttre
Act and description of the offence for
lvhich convictecl :
Name of the Court(s), Case No. and
Punishment imposed
:
That I give herein belorv the cletails of the assets (morrable and imrnovable
etc.) of
myself, my spouse and all dependents:
(5)
A. Details of movable assets:
(Note:
Assets in joint name iuclicating the extent of joint orvnership
given.
1
ill
also have to be
In casd of deposit/Investmettt, the cletails including Serial Number,
Amount, Date of
Deposit, and the scheme, Name of Bar-Lk Institufi6n arrd
Branch ar.e to be giu"r.,.
/
value of Bonds/share/Debentures as per the current market value
in stock
Exchange in respect of listed companies and as per books in
case of no1- Iistecl
2
3
,1
6
sl.
r.t
cornpanies shoulcl be given,
Depetrdent', here means a pel'sor.r, substantially clepenclent on the income
of the
candidate.
Detajls including arnount is to be given separatellr
Description
Self
No.
i11
respect of each inveshnent)
Sporrse
Depend
ent -L
D"p
ende
Depen
dent -3
nt -2
(i)
Cash in harrd
6,'17,140
2,50,000
rc,000/-
N/A
(ii)
Details of inveshnent irr Bonds.
Debentures/shares and units in
companies/ \4utual Funds and
others and the amount
4,99,99,144
NIL
-Nit
N/A
N/A
-
Ago
Enterprises
Pvt. Ltd &
N/A-
Al-Ameen
Co-operative Socieby
(iii)
Details of investnlent in NSS,
Postal Sarrings, Insurance Policies
and inveshment in any Financial
Instrument in Post office or
Insulauce Cornpany and the
arnount.
-Nil-
-Nil-
-I\rl
-frffi3
r'-*;5.'y$iTi')
-
N/A-
t
(i.')
Personal loans/aclvance given to
arl)' pel'son or entity including
firnr, Company, Tr.trst etc. and
other receivables from'debtors
ancl the amount
vi)
-Nil
N/A N/A-
NIL
N/A
NI/A-
-Nil-
N/A
N/A-
-Nil-
N/A N/A-
10,400/-
N/A N/A-
traders
74,60,500/-
IVIo tor Vehicles/ Aircraf ts/
Yachts/Ships (details of Make,
Regiskation No, etc, Year of
Irurchase and arnount )
(1')
-Nil
Advarrced
to tlie
NIL
Jert'elry, btrllion and valrrable
thing (give details of r.veight ar-rd
value)
NIL
-Nil
2.5 Kgs
value of
Rs. 60
lakhs
(vii)
An1'other assets such as value of
Claims/interest
-Nil
(viii)
Gross Total value
52,236,107/-
-Nil
62,50,000/-
B. Details of Immovable assets:
(Note:
1,
Properties in joint or'vr-rership inclicating the extent of joint ownership rvill also haye
to be inclicatecl
2,
Each lancl or
building or apartment should be mentionecl separately in
sl.
No
Description
(i)
Agricultural Lancls
Self
Spouse
Depen
Depend
ent-2
Depen
NIL
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
dent-l
No.1
Location(s)
tl-ris for.rnat,)
NIL
'
Waddaralialli
Village, Kasaba
Hobli, Rarnanaglam
Dish'ict
Sy. No. 1.47/2
dent-3
Srrrvel number(s)
Area (Total measrrre
ement in acres)
4A includinglG
\{hetl-rer inlierited
Yes
NI/A-
N/A-
N/A-
I\T/ A-
NI/A-
N/A-
N/A-
N/A-
I\T
I{rarab Lancl
proprertlr (Yes or NO)
Date of purchase in case
of self acquired
property
l,lohamedffshsdAhmd
Bangdoro Helropolilan Arta
Reg. No. 6368
/ A.
E
Cost of Land (in case of
pulchase)at tlie t'irne of
Y
N/A-
N/A-
N/A-
N/A-
N/A-
IJIL
N/A-
N/A-
N/A-
N/A-
2,40,00,000/-
N/A-.
N/A.
NIL
NIL
I\T
/ A-
N/A-
N/A-
N/A-
N/A-
N/A.
lrurchase
Any Invesfment on the"
lanc{ by
rvalr of development,
construction etc,
Approxinra[e Cun'ent
market value
No.2
N/A-
erlent inacres)
Waddarahalli
Village, Kasaba
Hobli, Ramanagram
Dishict
Sy. No,142
6 A-19 G including
2 G prrt Kl'rarab
l'\{re ther inl-rerited
Yes
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
Nil
N/A.
N/A-
N/A-
N/A-
1,60,00,000/-
N/A-
N/A-
N/A-
I\T
.
Location(s)
Survey nurnber(s)
Area (Total lneasllte
Lar-rd
proper;$' (Yes or NO)
Date of purchase in case
of self acqtrireci
property
Cost of Land (in case of
purchase)at the time of
purchase
Any Inveshnent on the
lancl by
rvay of clevelopnbnt,
consh'uctioll etc.
ApPlgxlnt.te Curreut
inarket value
No.3
Location(s)
Survey number(s)
Area (Total lneasule
ernent inacles)
Wl-rether inheritecl
property (Yes or NO)
Date of pnrchase in case
of self acquilecl
property
/ A-
Waddarahalli
Village, Kasaba
Hobli, Ramanagram
District
Sy, No.43
2 A-22G
NIL
NIL
N/A-
N/A.
N/A-
N/A-
N/A-
N/A-
Yes
N/A-
N/A.
N/A.
N/A-
N/A-
N/A-
N/A-
N/A.
N/A.
7-
{'ti
gsls
#il:[,#ffit*:
n'g.
rur.
il;l
5
rI
Cost of Land (in case of
Nil
N/A-
N/A-
N/A-
N/A-
N/a-
N/A-
N/A-
N/.{-
N/A-'
N/A.
N/A-
N/A.
NIL
NIL
N/A-
N/A-
/
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
i\/A-
N/A-
N/A-
N/A-
N/A-
1\/ A
N/A-
N/A-
N/A-
N/a-
Rs.50,000/-
N/A-
NT/A-
N/A-
N/A-
rS,utl,uuuf -
N/A.
N/A-
N/A-
N/A-
purchase)at the Hme of
purchase
An1' Investnteltt 0n tue
lancl by rvay of
clevelopment,
I<s, l,5U,0tJ0f
construction etc.
APpl'sxi6ote Crrrrerrt
market value
1,25,00,000f-
-
No.4
Location(s)
Survel' nr-rmber(s)
Area (Total measrlre
ement inacres)
Whetl-rEr inheritecl
properg (Yes or NO)
Date of purchase in case
of self acquir.ed
\{addarahalli
\zillage, I(asaba
Hobii, Ramanagr.arn
Dish'ict Sy. No, 44
25 Guntas
re5
^r
A
I
iv/a_
propelry
Cost of Land (in case of
purchase)at tlie time of
lrurchase
Any Inveshnent on the
lancl by
. rval' of developmerrt,
consh'uction etc,
Aprprsxipute Cur.rent
market value
---;-
. No.5
Lakslunipura
Village, Kutgala
Hobli, Ramanagram
Taluk
S)'' No.49
NIL
NIL
N/A-
Area (Total measure
ement inacles)
BA-28G
N/A-
N/A-
NIA-
N/A-
Whether inlierited
1-rloper['(Yes or NO)
No
N/A-
N/A-
N/A-
N/A-
Location(s)
Survey rrun-rber(s)
*il'Ji,{["#r$!!l$
"Reg.
No' 6368
n
,
uare ot purchase in case
of self acquired
30-06-1983
N/A.
N/A-
N/A-
N/A-
Rs.30,000/-
r\/A-
N/A-
N/a-
N/A-
N/A-
N/a-
N/A-
N/A-
rts.JLtlu4uuu/_
N/A.
N/A-
N/A-
N/A-
Rarnalingeshwara
Temple Sheet,
Division No. BZ
NIL
NiL
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
i wZE
N/A-
N/A-
pronel't\/
-l---=:-
tost ol l_and (in case of
purchase)at the time of
purchase
Any lltveshtrent on the
land by
rva)/ of developmen!
\s.
/-rt./u,uuu/
^
construcbion etc.
Approximate Current
rnarket vaiue
(i
i)
Non-Agricrrltural Lar.rd
No.1
t
Bangalore-S60 005.
o.utionlf
Froperty olcl No. 24
Stlr'\,ey nurnber(s)
:\rea (Total measltre
A, Nen'No.
Latet 12/!
12,
yor )cl.rrs (A4y Share
ement in Sq,fts)
so%)
lVhether. inireriied ploperty (Yes or NO)
r\o.
N/A-
Date of pl:t.l.toiu iniu.ru
of self acquired
z/-u5- I98g
N/a-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
property
Cost of Land (in case of
purchase)at the tirne of
Conh'ibuHon
1rulchase
l1\r lrlrrechnorrf nn
Nil
1\/A-
N/A-
N/a-
N/A-
10,00,000/-
N/A-
N/A-
N/A.
N/A-
Rarnalingeshn'ara
Temple Sh.eet,
Division No. B7
NIL
NIL
N/A-
N/A-
N/A-
N/A-
N/A-
N/a-
+1.^
land b)'
rvay of clevelopment,
corxhuclion
l\S. 1,r3,/5U/_(My
509/")
etc.
APDroxi n-ra te Cr r rrent
uol,ru
I tr'rait
"t
No.2
Location(s)
Sulvey nuntber(s)
Barrgalore-S60 005.
Area (Total rreasure
ement in Sq.fts)
Propertl, No.
r/yJ )q.rrs
B/l
(fi4y
Share 509/")
,fl,
ln otr am
fu4alor
id{
rEtre{
e lrletro
Ahle d'
golltln{Be
heg. No. s368
I
\{hether inhelited
property (Yes or NO)
No
N/A-
N/A-
N/A-
N/A-
Date of purchase iu casg
of self acqrrirecl
29-05-1989
N/A-
N/A-
N/A-
N/A-
Rs. 1,71,015 /- (NIy
Corrh'ibution 50%)
N/A-
N/A-
N/A-
I\T
Nil
lJ/A-
N/A-
N/A-
N/A-
20,00,000/-
N/A-
N/A-
N/A-
N/A-
Byahairyapura
Village, Bangalore
City.
NIL
NIL
N/A.
N/A-
N/A-
N/A.
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
N/A-
properry
Cost of Land (in case of
purchase)at tl-re time of
purchase
Any lnvestrnent on the
lancl [r1'
rvay of clevelopment,
constructior-r etc.
Approximate Cur.rent
market value
No.3
Locatibrr(s)
Survey number(s)
/ A-
Property No. 340
Area (Total lneasure
28.5 Guntas 1/3'a
ement in Sq.fts)
Share purchased
2/3'a Share by rvay
of Hiba
Iryheil1er irilrerited
propertJ/ (Yes or NO)
No.
Date of purchase in case
of self acquired
28.08.1972
propertlr
Date of Hiba
25-03-1983
Cost of Land (in case of
purchase)at tl-re time of
prrrchase
my 1/3'a Share
Any Investrnent on the
4,43,700/-
N/A-
N/A-
N/A-
N/A-
15,00,00,000/-
N/A-
N/A-
N/A-
N/A-
Rs.7,000/ - tor,vards
larrd by
!valr of development,
consh'uction etc.
Approximate Current
rnarket value
t/
*th
/h
o
f-,*ffm
[$-$"snsl:
n
/ Conrnrercial Rrrildings
/ (inclrrding apa rtrnents)
I Locahion(s)
Survel' nr-rmber(s)
NIL
NIL
N/A-
N/A-
N/A.
N/A-
N/A-
N/A-
i'J/A-
No
N/A-
N/A-
N/A-
NT/A-
No. 65/3, vacant site
l.lo, 32, measurilg
1,800/- Sc1. ft
Built up fu'ea (Total
rneasurement in sq, ft,)
\{hether irdrerited
ploperty
(Yes or NO
Date of purchase in
Ramanagram
APN,IC formed in Sy.
case
74-72-2071
of seU
acquired pl'operty
1,,,,,
Cost of pl'operq/ (in case
of purchase) at the tirne
of purchase
Any Inveshnent on the
propert.i. by ryay of
development,
construction etc.
4,04,000/-
Approximate Current
malket
value
11s.4,0O000
Nit
Residential Ruilding
(including apar tments)
NIL
NIL
NIL
N/A-
N/A-
N/A
N/A-
N/A-
N/A-
N/A-
N/A
N/A-
NI/A-
N/A-
N/A-
N/A
N/A-
N/A-
N/A-
N/A-
N/A
N/A-
N/A-
N/A-
N/A-
N/A
N/A-
N/A-
N/A-
N/A-
Location(s)
Survey number(s)
Area (Total
measul'ement in sq. ft.)
Brrilt up area (Total
meastlrement in Sq.ft
Whether inherited
propeltl' (Yes or NO)
Uate of pltrchase in case
of self acquired
proper[r
Cost of property (in case
of purcl-rase) at
of p111shsr.
f
I
tl-re
tirne
W-+*
/l
./'
U
1
.t:w'fffil
'illn''i'it'tt*
I
Any h-rveshlrent on the
ploperty by way of
rlevelopment,
consh'uct-ion etc.
Approximate Current
market Value
Otlters (such as interest
in
Property
N/A-
Total of .Current
Market
Valrre of (i) to (v) above
(6)
N/A-
20,68,00,000/-
I give herein below the cletails of liabilities/ dues to public firrancial institutions
and government:-
(Note: Please give separate details of name of Bank, irrstifution, entitv or irrdividual
and amount for each item)
sl.
No
(j)
Description
Self
Spouse
Depen
dent-L
Depend
ent-2
Depen
dent-3
Loan or dtres to
Banly'Financial
Institution(s)
Name of Bank or FI
Amount outstanding
Nature of loan
Personal Guarantee
NIL
NIL
N/A-
N/A-
NIL
NIL
NIL
N]/A-
NIA-
Amount orrtstanding
Nature of loan
Any other liability
NIL
NIL
NIL
N/A-
N/A-
Grand total of
8,00,00,000/-
NIL
NIL
N/A-
N/A-
toJ&KBankon
behalf of Aga
Enterprises Private
Limited
B,00,00,000/-
Conrmercial loan
Loan or drres to any
individuals/ Entity
other than
Mentionecl in (i) above.
Name(s)
liabilities
')\//'
-T/:.
10
,{:mf'fnn'pl
ll"' olts
t.s.
I
bovernment Dues:
Dues to depalhnents
ciealing
n'ith gorrernmerrt
accomrnoclation
Dues to d"portrr-,*r-,t,
NIL
NIL
NIL
N/A-
N/A-
1\tL,
NIL
NIL
N/A-
N/A-
NIL .
NIL
N/A-
N/A-
I\IL
NIL
NIL
N/A-
N/A-
NIL
NIL
NIL
N/A-
N/a-
lL
NlL
NIL
N/A-
N/A-
IL
NIL
NIL
N/a-
N/A-
1\
lL
NIL
NIL
N/A-
N/A-
1\
lL
NIL
NIL
N/A-
1\lL
r\lL
NIL
NIL
NIL
NIL
NIL
N/AN/aN/A-
VA"
N/A
dealing
n'ith srrpply of rvater
Dues to
i
depotffi-
r\
dealing with suppll.ot
lL
elech icitl,
I
I
Dues to clepartments
dealing
rvitli
supply of
I
I telephsnss/mobiles
h--._.'-
uues to cleparhments
clealing
lvith govemment
transport
(incluclLrg ajrcr.afts
helicopters)
aucl
I
I
Incorne Tax Dues
1\
l,Vealth Tax Dues
Selvice Tax Duei
irlunicipal
I ax Uues
/propefi
Sales Tax Dues
Any other dues
Grand total ofill Govt
I\IL
dues
(7)
N/A
Details of profession or occupation:
a.
b.
(B)
NIL
N/A-
Self Fruit lvlerchant ancl Cornnission
Agent
Spouse Houser,vife
My educatiorral qrralification is as unrler:
'(Il'I DII'LOMA)
(Give details of highest School
cliplorna/ degr.ee course)
/ University education rvith firll form of the certificate/
11
Bangalotl Melro1tolilNr Aroo
m
(Narrre of the School
/College/ Universi6' and the year in wliich the course
r,vas completecl,)
Government ITI College
(e). ABSTRACT OFTr,rE DETATLS GrVEN
rN (1)TO (B)ABOVE:
Name of the candidare
Full postal address
SHRT. SYFP MUDEEII AGA
No. 4552,
lvladar I(ran Mohalla, Masjid Sh.eet,
Ramanagram - 571511
Number and Natne of the conshituency
ancl state
Name of the Polihical party which set
u1t
the carrdi.{ate (ol.her.ivise vvri[e
\,ILA Constituency Karnataka
]anatadal
(S)
'lndependent'
a) Nurnber of cases in lvl'rich conviction
order
passed (other thar-r tl"rose referred to ir-r
Form 26)
c) Total mrmber of Pending cases lvhere
the
cor"u't (s) have taken cognizance
Year for
which last
Income Tax
Return filed
(a)
Candidate:
([r)Spouse:
AEPPA0136C
Total Incorne Showu
2010-11
NIL
Dependents NIL
Details_of Assets and Liabilities in rupees
Moveable
Asset (Total
5,22,36107 / -
Immovable
5,80,382/ -
Asset
(i) Purcliase
Price and
AND
28,63,700/ -
rx
Development
Cost of
Immovable
Property
(Total Value)
(ii)
25,90,36,1070/,
62,5A,000/ -
10,000/-
N/A
N/A
NIL
NIL
NIL
N/A
N/A
Approxirnate
Crtrrent
Jvlarket Price
of
Asset (Total
Value)
7.
Liabilities
(i)
Govermlerrt
dues (Total)
ii)Loaru from
Bank,'
8,00,00,000/-
Financial
Instihrtions
arrcl
others (Total)
u.
Highest educational qrralification
(lTI diploma)
Govelnment ITI College
(Give details of School / University education r,r'ith full forn-r of the certificate/
diplonra/ cleglee course) (Name of the School /College/ University and the year in
u'hich the course rvas completed.)
VERIFICATION
I, the cleponent, above namecl, do hereby veri{y and declare tl-rat the contents of this affidavit
are h'ue ancl'correct to tl're best of rny knorvleclge anct belief, no palt of it is false ancl nothing
rnaterial has been concealed there from. I further declare that:
(a)
there is no case of conviction or pending case against me other thau those menLioneil
I5
(b)
I' tn-y spottse, or lll)/ clependeul.s clo not harre any asset
ol liability, other than those
in items 5 atrd 6 aborre.
urentionec-l
Veril.ieclatBarrga1oreontlrisi1re31,rc1ayoflr,Ia1,2012W
Veril.ied at Barrgalole orr rlris ihe 31,rday of Irra1,2012 (L--A
IDENTIFIED BY
I
\i*Lrr'/A
\ .'.\$nr_--a
trurrlll
/l
ME
DEpoNENT
SflVONru TO BEFORE IVIE
stVORt{ Tg tfFOR€ ME
//wrrsll-:^
Xbt'ocarn
1'
2'
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l-lltl
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f'foFamerf'*tn6?enmrd, t-r.,*,1
Rc3" ltt..-.,..1...#..1i:...::.....-_.f
lXotrry _*:-;_
'.r'r....r....r...r.''rr....r,.!
Advocate ll Notarv publlc
|
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3'1 MIY rnnl rl}-uf-t''na rlDor' I6th A
'
I ., l:ir , .,:,..i ,',,r*rqnal
., -)
,,'.."::,:y.,:t) 9rh i|lin, -3rd Btocrr Jayar
Ef nSalon , 560 0l 1.
M':i 1t". I9243109t,,I
Affidavit should be filed latest by 3.00 PM on the last ciate
of filing no,r,inotionr.
Affidavit should
be srvortr before an
Class ol before a Notar.y public.
3'
4.
oath Commissioner or Nlagistrate of the First
All colttmtrs shouid be filled up arrd no columu to be left blarrk, If there
is
ilrfolmation to furnish in respect of arr1, item, either ,,Nil,, or ,,Not
'o
applicable,,,
case l-nay be, should Lre mentionecl.
as the
The afficlavit should be either. tl,pecl or n,ritten legibll,.ancl
neat11,.
ilY [0Ml'llSSl0ll
tlPl|iri
0N
?ll07n0l
lT6=ffiiffi|
I uor f.VAILABLE
I
lll KA R N irr/r
3
I
KA SJATEI
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