r-: " , " \1"~.' ' __.

00000

~nonn.,nn~~u uu.uu~

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(4) Details of Permanent Account'/

Tax return :SI.No. Names

,,"c;,.,7f1....i __ ·_

Au1horization No.

PART-A

PAN Total incomeshown in IncomeTax Return (inRupees)

The financial year forwhich the lastIncome-tax return hasbeen filed

AHTPM2910P 2015-16 4,81,170.00AJKPK0770E 2015-16 2,87,780.00

-t- /

ATT~,~TEPlllq~"\ \

MD.ADILWASHI~Notar Reg. No.-2714J)

("~vllCourt. Patna

c_.--' " i ,..,

Dependent 1- Mallika Kumar NIL NIL, ;

NIL.).

4. Dependent 2-Arnav Kumar NIL NIL NIL5. Dependent 3 ............ Not Applicable Not Applicable Not Applicable

(5) I ~am not accused of any offences(s) punishable with imprisonment for two yearsor more in a pending case (s) in which a chargees) has/have been framed by the court( s)of competent jurisdiction.If the deponent is accused of any such offence(s) he shall furnish the followinginformation.-

(i) The following case (s) is/are pending against me in which charges have been framedBy the court for an offence punishable with imprisonment for two years or more:-

(a) CaselFirst Information Not ApplicableReport No.lNos. togetherwith complete detail ofconcerned Police Station /District/State

(b) Section (s) of the concerned Not ApplicableAct( s) and short description .Of the offence(s) for whichChanged

(c) Name of the court, Case No. Not Applicableand Date of order takingcognizance :

(d) Court (s) which framed the Not ApplicableCharge(s)

(e) Date(s) on which the Not ApplicableCharge(s) was/were framed

(f) Whether all or any of the Not ApplicableProceeding(s)have beenStayed by any Court(s) ofCompetent jurisdiction

(ii) The following case(s) is/are pending against me in which cognizance has been takenby the court [other than the cases mentioned in item (i) above ]:-

Not Applicable

_2.-/

ATT~pl~.9~'1rVW'Y<1 \ I

MD. ADIL RASHIO IReg No.-2714J.Notar .,... I Court. Patna..,.,IVl

.~-::.>,_.-----':-. \ -<,

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I The details of cases where the court has I li 11(b) I Not App icaoietaken cognizance, Sections of the Act and i

description of the offence (s) for whichcognizance taken :

(c) Details of Appeal (s) I Application(s) for Not Applicablerevision (if any) filed against the aboveorder(s) :

(6) I haze-eeen/have not been convicted of an offence(s) [other than any an offence(s)referred convicted to in sub-section (1) or sub-section (2), covered in sub-section (3), of section8 of the Representation of the People Act, 1951 (43 of 1951)] and sentenced toimprisonment for one year or more.

Ifthe ,deponent is convicted and punished as aforesaid, he shall furnish the followinginformation:Inthe following cases, Ihave been convicted and sentenced to imprisonment by a courtof low: .(a) The details of cases, Sections(s) of the Not Applicable

Act(s) and description of theoffence(s) for whichconvicted:

(b) Name of the Court(s), Case No. and Not ApplicableDate(s) of order(s) :

(c) Punishment imposed Not Applicable

(d) Whether any appeal waslhas been Not Applicablefiled against the conviction order. Ifso,detailsand the present status of theappeal:

(7) That I give herein below the details of the assets (movable and immovable etc.) ofmyself, my spouse and all dependents:

A. Details of movable assets as on 13.04.2018:

\\\

Dependent -II

Dependent -

i) -<fJShin hand Rs.48.600.00 Rs.32.300.00 Rs. 8.500.00 Rs. 5.500.00Details of Deposit in Bank account (FDRs, Term Depositsand all other types of Deposits including saving accounts),

(ii) Deposits with Financial Institution, Non BankingFinancial Companies and Cooperative societies and theamount in each such denositIndian Overseas Bank , Lok Kala Maneh , New Delhi -S.B. Ale No. 149801000032156HDFC Bank , NRI Complex, GK IV , New Delhi -S.B.Ale No. 05781930000205 (Jointly with spouse)Bank of India , Nehru Place ,New Delhi - S.B.Ale No.601810100019641Indian Overseas Bank , Lok Kala Manch , New Delhi -S.B. Ale No. 149801000032157Bank of India, Nehru Place ,New Delhi - S.B.Ale No.601810100020959HDFC Bank, NRI Complex, GK IV , New Delhi -S.B.AleNo.50100153589047HDFC Bank, NRI Complex, GK IV , New Delhi -S.B.Alc No. 50100153586640

PPF Ale with Post Office, Lodi Road, New Delhi

Fixed Deoosit with Bank of India Nehru Place DelhiDetails of investment in Bonds, Debenture/shares and

(iii) units in companies/Mutual Funds and others and the<>n1nnn~

Rs. 46,834.58 NIL NIL NIL

Rs.7,82,931.00 NIL NIL NIL

Rs. 8,884.54 NIL NIL NIL

NIL Rs.56,114.28 NIL NIL

NIL Nil.. Rs.24,300.18 NIL

Nil.. Nil.. Rs.26,358.94 NIL

NIL xn, NIL Rs20,277.20

Rs. 1,67,423.00 Rs. 2,42,700.00 Rs.l,30,lOO.OORs.42,149.00

Nil.. NIL Rs. 75 000.00 NIL

Investment in quoted shares Investment in quoted NIL NILRs. 46,278.00 shares Rs.4,49,373.00

(iv)Details of investment in NSS, Postal Savings, InsurancePolicies and investment in any Financial Instrument inPost office or Insurance Company and the amountLIC of India - P.No. - 114779117LIC of India - PNo. - 113216047LIC of India - P.No. - 334239452LIC of India- PNo. - 127641243HDFC Life Insurance- P.No.- 1293399HDFC Life Insurance- P.No.- 12933879B~~ Allianz Life - P.No. 0126702840TataAIG Life - PNo. - C100241947AvivaLife Insurance - P. No. - 122N103V03ICICI Prudential Life Ins. P.No. - 19749872HDFCULIPNo.18974451

Rs. 1,21,850.00Rs. '·53,706.00Rs. 43,016.00Rs. 95.680.00Rs. 54,850.00Rs. 54,850.00Rs.2,00,318.00Rs. 34,956,00Rs. 1,36,156.00sm,

Nil..Nil..xn,Nil..Nil..rm.Nil..NILNil...Rs.2,21,456.00Nil..

NIL NILNIL NILNIL NILNIL NILNIL NILNIL NILNIL NILNIL NILNIL NILNIL NILRs.2,07,443.00

NIL NIL

NIL NIL

Personalloansladvimce given to any person or entity(v) including firm, Company, Trust etc. and other receivables Nll, Nll,

from debtors and the amount (poonam Singh, Wife)Motor VeruelesiAirerafis/YachtsiShips (details of Make, Toyota Qualls - Year 2003

(vi) Registration No. etc, Year of Purchase and amount) DL3CM3420 Nll,

Rs.9,70,OOO/-

(vii) Jewelry, bullion and valuable thing (give details of weightand value)Gold Ornaments ( Ring, Chains ,Coins etc.) 180 gms. Rs.4,60,800/-

Gold Ornaments inc!. Gold Biscuits inherited from Grand Nll,Mother after her death on 11.09.2016Silver Ornaments (Utenciles) inherited from Grand Nll,Moth .... "ft....h;" rt"",th nn 11 ()Q 7011\

[ix) Rs.l,37,45,185.12

450 gms. 200 gms. Rs. 100 gms. Rs.Rs.l1.52.000.00 5.12.000.00 2.56.000.00950 gms. NIL NIL·Rs.2432.000.002.5 Kg. NIL NILRs. 1 17 "i00 00

Rs.43,33,618.00 NIL NILRs. 58,33,865.00 NIL NILRs. 1,85,000.00 NIL NIL

Rs.l,50,50,926.28 Rs. Rs.9.83.70217 ,,, Q71\70

(viii) Any other assets sueh as value ofClaimsfmterestCapita in Partnership-1:'; . 1>.. ier Ceramic Industries Rs.45,53,995.00Capita in Partn~ l"!P -~~ dustries Rs. 57,04,057.00House HOId~jR~ -,-' ""'-:fi' ~r, T.V.,Laptop Rs 160000/-etc. /[ ~ . '" I ,,-tu~ . , ,

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MD. ADIL'RASHIDNotar Reg No -2714J)

-~,iVIICourt. Patna

~.~:.. - "",.,:- _"

~,

B. Derails ofImmovahle assets: 13.04.2018Note: 1. Assets in joint name indicating the extent ofjoint ownership win abo have to be gi\'c:n .-~;:.:;.-:-,~~,.i::l!)te: 2. Each land or building or aprttment should be mentioned senarateiv in this format. I : '

Self SpouseIDependent - 1!' Dependent-2I

Nil.

S. No. Description

Agricultural LandLocation( s) Bhupbhairo , Sitamarhi NIL NIL NIL

(i)

Survey (Khata) numberts) Khata No. 170/3406 NIL NIL NIL

Area (Total measurement in acres) 16 decimal NIL NIL

NILWhether inherited nrooertv (Yes or NO) No

NIL

NILNIL

Date of purchase in case of self acouired property 21.06.2017 NILCost of Land (in case of pur.chase) at the time of 7,63,200.00 NIL NIL

NILAny Investment on the land by way of development,etc.

NIL NIL

NILApproximate Current market value Rs. 9 00 000.00 NIL NIL~ Non-Agricultural Land

a) Bhasar Machhaha ,Sitamarhi b) Khurja,Bulandsahar , UP c)PanchwatiColony,Khurja,

TTl>

a) Green Field Colony,Faridabadb) Khurja,Bulandsahar , UP

NILLocation(s) NIL

a) 5.6 decimal & 4 decimalb) 1897 Sq.mtr.(50% Share a) 202 Sq.yd.Jointly with Father inLaw- NIL NILS.M.Taneja)

b) 5720 Sq.mtr.

C) 100 sq.yardNo a) Yes b) No NIL NILa)16.02.20 18 &04.07.2015b) 21.03.2007 b) 22.03.2007 NIL NILc) Year 2015a) 12,84,800.00b) 9,50,000.00 b) 6,48,000.00 NIL NIL'" 7.c:;n nnn onNIL NIL Nil. NIL

Rs.I 7570000.00 Rs. 3 43.20 000.00 Nil. NIL

GT Road , Khurja, UP Okhla , Phase II,New Nil. NILIDelhi

Shop No.6 & 7 ,NHPlaza Shed No. 14 , DSIIDC, NIL NILScheme-ill1200 sq.ft, (33.33%

400 Sq. ft. share jointly with NIL NILmother Jir .;0:+....)

No No NIL NIL03.03.2008 07.02.2009 NIL NIL

Rs.17,18,200.00 Rs.14,39,000.00 NIL NIL

NIL Nil- NIL NIL

Rs. 38 00 000.00 Rs. 65 00 000;00 NIL NIL

a)KhataNo. 413 & 1080b) KhataNo. 108c) Junction Road Khujra ,TTl)

a) Plot No. B 1392b) Khatano. 106Survey (Khata/Plot) number(s)

Area (Total measurement in Sq. ft.)

Whether inherited orooertv (Yes or NO)

Date of purchase incase of self acquired property

Cost of Land (in case of purchase) atthe time ofpurchase

Any Investment on the land by way of development,etc.

Approximate Current market value

(iii)Commercial Building(including apartments)

Location(s)

Survey numbens)

Built up Area (Total measurement in Sq. ft.)

Whether inherited orouertv (Yes or NO)Date of purchase incase of self acauired orooertvCost of property (incase of purchase) at the time of

Any Investment on the property by way ofetc.

Approximate Current market value

NIL

(iv)Residential Buildin T~'''''.{_(including ~. ) A, ~"<{'X

a) Greater Noida, UPb) L .N NRI Complex, G.K. NIL

axmi arayan. . N ,New Delhi /Apartment, Morbi, Gujrat .. >If-.,

- s- ATTE;S.~T. ~~,.J,\\ \',\. .", '\i\\ I'\~\ '\.Y \ .

MD. ADIL NASHIDNotar Reg. No.-2714J)

'~,ivdCourt. Datn$

NIL

I::_' vev iKhataPlot) numoerrs:

~~~.~ \: \.c>

!~)~.6 ~:5t ~~oor), , In)~lm;"Q QU' i

I],;ILIArea r Turai measurement in Sq. ft.) taJ 1665 sq.ft. b) 950 sq.ft. )8-+.31 sa. rntr. INILI Built up Area (Total measurement in "fL. ft.) a\ 1665 sq.ft, b) 950 sc.ft, 234.32 ;ill: mtr, NIL NiL

t+ IWhether inherited propertyNo Yes (Gift from Sister) NIL NILI(YesorNOl

Date of purchase in case of self acquired property a) 1L 10.2007 NlL NIL NILh t2.6..il? N 16

Cost of property (in case of purchase) at the time ofRs.39,41,300.00 NIL NIL NILourchase

Any Investment on the land by way of development,NIL NIL NIL NIL

ietc.Aooroximate Current market value Rs. 1 1500000.00 Rs. 4.75.00 000.00 NIL NIL

I(v) Other (such as interest in orQ12erty) NIL NIL NIL NIL(vi) Total of Current Market Value of (i) to (v) above Rs. 3,37,70,000.00 Rs. 8,83,20,000.00 NIL NIL

(8) I 2ive herein below the details ofliabilitiesl dues to public financial institutions and 20vernment:­(Note: Pleasegive separatedetails of name of bank, institution or individual and amount before each item)

S. No. Description Self Spouse Dependent - 1Dependent - 1

n Loans or dues to BankIFinancial Institution!s}Name (5) Indian Overseas Bank ,

LokKala Manch , New NIL ' NIL NILDelhi

Aunoutoutstandrnng Rs.16,54,693.72 NIL NIL NILNature of Loan Home Loan NIL NIL NILLoan or dues to any iodividualsl Entity other than

NIL NIL NILmentioned in (i) above.Any other liabilitv NIL NIL NIL NILGrand total of liabilities Rs.16 54 693.72 NIL NIL NILGovernment Dues:

(ii) Dues to departments dealing with govermnent NIL NIL NIL NIL• ..1••

Dues to deoartment dealing with supply ofwater NIL NIL NIL NILDues to deoartment dealing with su__wlyof electricity NIL NIL NIL NILDues to department dealing with supply of

NIL NIL NIL NIL.1.. .1..'

Dues to department dealing with government transport NIL NIL NIL NIL. ...., .aircraft andIncome Tax Dues NIL NIL NIL NILWealth Tax Dues NIL NIL NIL NILService Tax Dues NIL NIL NIL NILMunicloolL Pronertv Tax Dues NIL NIL NIL NILSalesTax Dues NIL NIL NIL NILAnv Other Dues NIL NIL NIL NILliliil Grand Total ofall Govt. dues NIL NIL NIL NIL(iv) . Whether any other liabilities are in dispute, if so , NIL NIL NIL NILmention the amount involve and the authority beforewhich it is~nding.

(9) Details of profession or occupation:(a) Self: Business and Social Service(b) Spouse: Business

(9A) Details ofsource(s) of income :a. Self - Rental Income. Business Income and Interestb. Spouse -Rental Income. Business Income and Interest

I ~~~~~~is~as~under:"" 001, New Delhi - Year" 1998

J;)e1l1t'1J:1irii~AiDlItespondance- Year - 1999ucation mention the full form of the certificate/ diploma /

~~~,t~..

2. Full postal address Vill. Bhasar Machhaha (Ansh) ,P.O. - Bhasar Machhaha, P.S.­

Sitamarhi, Dist. Sitamarhi -843314 (Bihar)

\\C":¥~C\.iUil,:....:~I..oi.;:x:; ~ 1 '~Vi.~:V--"'"........rr-.

?ATN,-il, sccss; PA~~A*

3. Number and Name of the BIHAR VIDHAN SABHA constituency 131#.lJ1(and state

4. Name of the Political party Janata Dal (United)which set up the candidate(otherwisewrite

1. Name of the candidate

U'J,VVV

...._,n~i~nn'~'r\~~\,;',,;llli\l",-

Sh./~. RAMAISHABAR

sentencedto imprisonmentfor one year or more[except'for offencesreferred to in sub-sections(1),(2) or (3) of section 8of Representationof the

1957.

Not Applicable !'I / L

PAN of Total IncomeShown

Year forwhichlast Income T~Return filed

NIL NIL NIL

8. Detailsof Assets and Liabilities in rupeesDescription Self Spouse Dependent -I Dependent-

II

A. Moveable 1,37,45,185.12 1,50,50,926.28 9,83,702.12 3,23,926.20

Asset (Total value)B. Immovable Asset

I. Purchase Price of self- 94,07,500.00 20,87,000.00 NIL NILacquired immovableproperty

II. Development/construction NIL NIL NIL NILcost of immovable propertyafter purchase (if applicable)

m. Approximate CurrentMarket Price of-a) Self - acquired assets 3,37,70,000.00 3,51,00,000.00 NIL NIL(Total Value)

b) Inherited assets (Total NIL 5,32,20,000.00 NIL NILValue)9. Liabilities

(i) Government NIL "NIL' NIL NILdues (Total) -

(li) Loans from Bank, 16,54,693.72 NIL NIL NILFinancial Institution andother (Total)

10. Liabilities that are under dispute(i) Government dues (Total) NIL NIL NIL NIL(ii) Loans from Bank, NIL NIL NIL NIL

Financial Institution andother (Total)

11. Highest educational qualification:SeniorSecondary, NationalOpen School, New Delhi - Year - 1998

B.Com( First Year) - Delhi University Correspondance- Year - 1999

(Give details of highest School/University education mention the full form ofthe certificate/ diploma! degree course, name of the School! College/ University andthe year inwhich the course was completed.)

VERIFICATION

I, the deponent, above named, do hereby, verify and declare that the contents of thisaffidavit are true and correct to the best of my knowledge and belief and no part of it isfalse and nothing material has been concealed there from. I further declare that:-

",..,.-'

ATTt4~TEJ~v. J r~t~/PI/\

MD. ADf~ RASHIDNotar Reg. l'Jo.-2714J)

(..-iv!'Court Patria.: ~.

)t-. (b) I, my spouse, or my dependents do not have any asset or liability, other thanthose mentioned in items 7 and 8 of Part A and items 8, 9 and 10of Part Babove.

Verifiedat Patna this the \5 day of April'2018

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.Note: 3. All columns should be filled up and no column to be left blank. If there is no

information to furnish in respect of any item, either "Nil" or "Not applicable",as the case may be, should be mentioned. '

Note: 4. The affidavit should be either typed or written legibly and neatly."_9 -

~ bl~.-r).atl tn. .}epl..'-;~ .

..., il<=8 ~I1.;j. l. L~"F'1WE •.

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,JUO~C:AL ;:;

""

. .' (3/HfW-,. VIJ>HA-N P~fSHPr]) .'Electton to· .•.•._ {Name of the House},from ..Q.••I.~.~ .•.y.U?!:.~.':J ?.fr.9..f:I.~<..•constituency.

RA1VIA-I~HP;l3fTR IV)ITH0-ro . ~A-M PfZftC-frSH I>1ITHfiio1. (name of candidate), son/~r/~of ,

J agedJ:lli years, resident of '!.!!-.'-;::..!?i;!!!.~~..!.:!.15-H}I.{t.'!.~~.rf.~!2...e.":.=.!}J:I.~f.'t!::..:;f~..~~:e/-If}-. f-S- 5'(t/H'Y7~ I l>rs....,.f'- S )-;f1-r'?~ HI - 0'-133.1 '1

a aru:lldate at the above election, eo solemnlY affirm and $tate on ~~f:las uRder:- .'

fi) f have not been -allotted any g<)Vt. acconUnodation at any tiMe dUrinI the period

Of last 10years prior to the date of notification of the ~rrent election.

(n)...'). '. .

I ~ave been al~ed gOYt. accammodatiori at:..:..· .,....'-~_ (mention theOR

! :"~'

i ••...:.

address of the accommQdatiOQ)during' th'" eriod of last 10 years... '

e paid toWa;'ds relit for the

accommodation or any a ars to the agendes providing eIectridty,___ (the-

e last date of the 3nt month prior to the month in

eJectkln is announced) .

5 certificates" from the agendes concerned are attached'....

VERIFICAnON

I, the deponent abovenamed, do hereby verify ami declare that the

above statements are correct to the best of my knowledgeJ and no

part of it is false .

. V~ritiedat ./~!.~...this the .L~ay of ...¥.:(!:~.';;.~.?;.'?~.~...~.DEPON~T

. ATTK1..../..ST.....,..E.D\\~, :; /·{1 \. .MD.AD '.. ;(S~·UO·

Notar Reg. No.-2714J)'~..ivdCourt. Patna

~~~~<Jil' ~~~arr<Jil'~ ~~~~arr~ Wrr~~<fir~ ~cfit~

~Dateof applicationforthe.copy. Date fixed for notifying

the requisitenumberofstampsand folios•

Date of delivery of therequisite stampsand

folios.

Date on which the copy Date of making over thewas readyfor delivery. copy to the applicant.

..tv ~~-?JI~4~~

~ifi~~<Iir ~~warrt4il'~ ~~~~arr~ ~~CfiH~~ ~<&aIOO

m&fDateof applicationforthe copy.

Date on which the copywas readyfor delivery.Date fixed for notifying

the requisite number ofstampsand folios.

Date of delivery of therequisite stampsand

folios.

Date of making over thecopy to the applicant.

.'",....-:E&~ (SR ~/~-.__..;

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FORM 'AA'COrvI\ll"-iIC\TION 'vVITHREGARD TO AUTHORISED PERSONS TO INTIMATE NAMES OF CANDIDATES

SET UP BY THE POLITICAL PARTY

FOR USE AT ELECTIONS TO COUNCIL OF STATES AND LEGISLATIVE COLiNCIL.

To

1. The Chief Electoral Officer,

................................................................ (StateiUnionTerritory).

Y' The Returning Officer for the biennial/bye-election to the Co'lAsil 6f States/Legislative Council by

Assembly Members .B.t.fi.&.~ .

OR

*The Returning Officer for the biennial/bye-election from

* * , (Constituency).

Subject :- BienniallB;fe'-election to the ~egislative Council from (Statell,lDionTemtery- Authorization ofperson(s) to intimate name(s) of candidate(s).

Sir,I hereby communicate that the following Person(s) has/have been authorized by the JANATA DAL (United) Party, which

is a National Party/State PartylRegistered Unrecognized Party in the State of Bihar to intimate the name(s) of the candidate(s)proposed to be set up by the Party at the elections cited above.

Name of person Name of officeStatelDistrict(s)/area(s)/Constituency/

authorized to send notice held in the party!constituencies in respect of which he

has been authorized.

1 2 3

NITISH KUMAR PRESIDENT ALL OVER BIHAR

Place :New DelhiDate: s:04, :2.CJ18.NB.i. This must be delivered to the Returning

Officer and Chief Electoral Officer not laterthan 3.00 p.m. on the last date for makingnominations.

2. Form must be signed in ink by the office bearer(s) mentioned above. No facsimile signature orsignature by means of rubber stamp, etc., of anyoffice bearer shall be accepted.

3. No form transmitted by fax shall be accepted.

~ faithfully,

~~:t'dPresident

JANATADAL(United)7, JantarMantar Road,NewDeIhi-1 10001Tel.No. :23368833Fax No. :23368138

(Seal of the Party)

•

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MD.ADI~ASHJO"Iotar Reg. No.-2714Jl

',iv.'Court. Patna