11
,,."o5698 pf.c.orv.ndo'.PAN^Jt,oetcJJgJ.L 3A A 55341 5 V r|. dtha St mP PrP.q '?-.e /- rrr|. ot fh. e"nn''x', 4. /iloNs EPA4 fE - e'{i'dlng *72/8,JrnG ol Fdh.t--- pu!Eo!. ?rantsotln! Ptrtl€--_ | -}eca ll ,.1 I Els tute t-ltrnr v.nd.r ,n#"; J'Arf, "a ' DtYanrnd A, KrrrFlfla? \b hr LIorEr Affidavit to be Furnis hed by the candidate alongwith Nomination Paper Before he Returning Officer F For rection i::::,%?::ti:3;il:l;;""t ri .l , At$rasio . Monserrate so n of Jo e Monserrate, ged 9 years, esident f House No . 167, Galli, Taleigao, oa, candidate t he above Election, o hereby olemnly ffirm nd state n oath as u nder$ ( 1 ) a m a candidate e t u p b y ndian ational ongress arty,

Atanasio Monserrate

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,,."o5698 pf.c.orv.ndo'.PAN^Jt,oetcJJgJ.L3AA 55341 5

V r|. dtha St mPPrP.q'?-.e /-

rrr|. ot fh. e"nn''x', 4. /iloNs EPA4 fE -

e'{i'dlng *72/8,JrnG ol Fdh.t---

pu!Eo!. ?rantsotln! Ptrtl€--_ |

-}eca ll ,.1 IEls tute t-ltrnrv.nd.r

,n#"; J'Arf, "a

'

DtYanrndA, KrrrFlfla?\b hr LIorEr lto. ACTSIPTVES?d03|E9

Affidavit to be Furnis hed by the candidatealongwith Nomination Paper

Before he ReturningOfficer

F For rectioni::::,%?::ti:3;il:l;;""tri

.l ,At$rasio . Monserratesonof JoeMonserrate,ged 9years,esident f HouseNo.167,Galli,Taleigao, oa, candidatet heaboveElection,o hereby olemnlyffirm ndstate noathasunder$(1) ama candidateetupby ndian at ionalongressarty,

I

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df PAN and status of f i l inq of Income ta x return :

rS I .N Names

Permanent ccountNumberPAN)

Th e inancialear or

which he ast ncome-

tax returnhas been

filed

Total ncoshown n

IncomeReturn ir

RuDees)

ne

1 Self Mr.Atanasio onserrate AEOPM8398H 2010-11 512,50002 Soouse l\4rs. enniferMonserrate AFGPM4451G 2010-11 116,00.00

3 Deoendent- NA - NotApplicable

4 Deoendent - NA - NoiApplicable

5 Deoendent - NA - NotApplicable

(3 )Th e ollowingcase(s)s/arependingagainstme n which cognizance as been akenby

court:

143.1 7 4A 49.1 3,324,325,326,332,333'427nd

nd Sec.3 of the Preventiono PublicPropertyAct

It is alleged hatthe accused ed a morcha o Panali

stationon accountof the failureon thepartof the police

inspectoro arrestcertainanti-social lements.t ls

alleged that the crowd led by Ata.nasioMonserrate

violenvunlawfulndattackedhepolice tation ,

ll . Caseno .92/10/C JMFCat Panaji /s35 3 /w34 IPC  . u a s c l l o . J z t t v t v - J t v t f I a t . d r r d l t u r . ! r . , , w v a , , v

It is allegedhat hedeponent mongst thers ftercomi[lg

know about the afrest of his wife forcibly ried to entef t

The detailsof caseswhere he coun

has aken ognizance.ections f

Act andDescription f the offencewhich ognizanceaken

cc No.92/10/c14.07010

Petit ion o.8'1/2010.

Petil ion riminal o.2/201 &

WritPetit ion riminal o.421201 iledbefore he

HighCourt f Bombay t Panaji, oa .

Details f Appeal s) Applications)

for evisionif any) iledagainsihe

4. Casesn which havebeenconvicted y a courtqf !!q

{ a )

The detailsof cases,sectionsot the

Acl anddescription f the offence or

whichconvicted -------NrL------

( b )Name f heCourl(s), as eNo .an d

Date(s) f orde(s):

c ) Punishmentmposed

other hose eferredo n Form26):

(5)That lgive hereinbelow he detailsofthe assets movable nd mmovable tc')of myself,

my sPousean dall dePendents:

A. Details f movable ssets(Note:l Assetsn ointnamendicatinghe extent f ownership il lalsohave o beglven l

2Incaseofdeposiulnvestment,thedetailsincludingserialumbef, mount, aieof Deposit,he scheme,

Name f Bank/lnstitutionnd Branch re o be given

3. Value f Bonds/share/Debenturess pe r hecurrentmarket alue n stockExchangen respect

companiesndas pe rbooks n caseof non-listedompanieshould egaven.

4. Deoendenf.er emeans person, ubstantiallyependent n he ncome f hecandidate'

5. Detailsncludingmounts to be given epefatelyn respect f each nvestment)

ofl l isted

SrN o Degc ription Self Spouse

Depsnddnt1 l

Dependent Dependent3

r) Cash n Hand IN R 2 472.857 tNR 2.472,451 - No tApplicable

( i i)

( i i i)

(FDRs, er mDepositsnd allother

types f Depositsncluding avingaccounts), eposits it hFinancial

lnstitutions,onBanking inancial

CompaniesndCooperative

societies nd he amount n eachsuchdeposit

Details f nvestmentn Bonds,Debentures/sharesndunlts n

companies/Mutualuods ndotheF

and heamount

tNR 6 452993

(A soe rAnnexure)

tNR 6.452,993

{A soerAnnexure)

- No t Applicable

tNR 3,240.349

{As De rAnnexurel)

rNR 3.240.349

fA soe rAnnexurel)

- NotApplicable

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rN R 2,875,263

(vii)

vi i i)

rNR 2,875,263

rNR 16,647,743NR 16,647,743

rNR '11,796,891INR 11,796,891

1765.5 ergram=

tN R 2,634.9561765.5 ergram=

IN R .1,089,973

(A sperAnnexure l)

tNR _ 1,089,973

(Aspe rAnnexurel)

lNR 47 211 lNR 47 211

INR 2]77sA0 INR 2,177,600

rNR 5,022,500I NR 9 . 7

Details f nvestmentn NSS,postal

Savings,nsurance oliciesan dinvestmentnanyFinancialnstfumentn Postoffice or

Company nd heamount

Personaloans/advanceiven o anyor entityncludingirm,

, Tfustetc andotherreceivablesromdebtorsand theamount.

MotorVehicles/Aircraftsachts/Shipsdetails f vlake,

Registrationo.etc,YearofPurchasendamount)

Jewellery,ull ion ndvaluablehjng(9ive etails f weight nd value)

other ssets uc has valueoF

(Noter

2 .Properliesn ointownershipndicatingheextent f ointownership il lalsohave o be ndicatedEach an dor buiiding r apartmenthould e mentionedeperatelyn his ormat.)

W

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7,{'Built pArea Totalmeasurementnsq. t.) As DerAnnexure Vll Aspe rAnnexureVl l - No tAoglicableWhether nherited rooertv (Yesor No NO - No tApplicableuate ot purchasencaseot sell

acouired rooertv Aspe rAnnexureVll As oe rAnnexure Vll - No tADD|icableCostof Land incase f purchase) t

the timeof purchase INR INR - No tAoolrcableAny Investment n the and by way oldevelooment, onstruction tc. tNR 8,974.058 tNR 8 ,974,058 - No tADDlicable

ooroximateurrent a rket alue r NR 38,128.750NR 38,128,750 - No tAoolicable

Others such s nterestn prooedv) INR INR - Not Ao0licable

(vi)lotal of uurrentMarl(et alue ot (lto (v)above INR 68. ' t81 .850NR 68.18 '1 .850 - Not Applicable

(5) givehereinbelow he detailsof l iabil it ies/ ues o public inancial nstitutions ndgovernment - (Not6:Please iv eseparate etailsof nameof Bank, nstitution, ntityor individUal

ABSTRACT F THEDETAI.SGIVENN 1)TO 8)ABOVE:1

Name of the candidateShri.lsrauKurF.AtanasioMonserrate

2 Fullpostaladdress l!9!s9 No '167,Galh. aleiqao, oeNumbef an d Name of th€constrtuencyand state

From13St .Cruz,Goa.

Nameot the Polltical artywhichset

up the candidate otherwisewrite'lndependent')INDIANNATIONAL ONGRESS

b.Spouse Business

(8) My educational ualif ications as unoer:Shri AtanasioMonserrate eniorSecondary xamination( ouncil ofSecondaryEducationMohali) ntheyear2009

(Give etails f highest chool Universityducation ith ull or mof thecertif icate/iptoma/ egree ourse)(Name f he SchoolCollege/ niversitynd he year nwhich hecoursewascomoleted.)

and amount or each tem

S. N(Descript ion Self SpouseDependent - Dependent - Dependent -

I 3

( i ) Loanor dues o Bank/FinancialtN R 2.636,430

As perAnnexure Vlll

As pe rAnnexure Vlll

As pe rAnnexure Vlll

INR 2,636.430

As pe fAnnexure Vll l

As pe rAnnexure Vll l

As pe rAnnexure Vll l

- No tApolicablenstitution(s)

Name f Bank

Amount utstanding

Nature f oan

- No tAoolicable

- No tApplicable

- No tApplicable

Loanor dues o anv ndividua ls/

rNR 33,922,769AsperAnnexurelXAsperAnnexurelXAsperAnnexurelXAspe rAnnexurelX

INR 33,922,769As pe rAnnexure lXAs pe rAnnexure lXAs pe rAnnexure lXAs pe rAnnexufe lX

- NotAoplicable

Entitvother han mentioned n (i )

above.Name(s)Amount utstandingAmount utstandingNature f oan

- No tAoolicable- No tApplicable-

NotADDIicable- NotAoDlicable

rNR 692,351Aspe rAnnexurelXtNR 37,25 '1.550.00

NR 692,351As per Annexure lX

- NotApplicable

Grand otalof l iabil it ies IN R 37.251.550.00(ii) Governmentues:

Duesodepartmentsealing it hgovernmentccomodation N I L NIL - NotAoolicableDues o departmentsealing ithsuPPly f water NIL NIL - Not Applicable -Dues o departmentsealing ithsupplyof electricity NIL NIL - No t ApplicableDues o departmentsealing it hsupply f elephones/mobiles NIL NIL - No tApplicable

Dues o departments ealingwithgovernmentransport,ncludingarrcrafts nd helicopters) NIL NIL - No tApplicableIncome ax Dues 4,823.00 41.607.00 - Not ApDlicable -WealthTax Dues NIL NIL - No tAoolicableServiceTax Dues NIL NIL - No tAoolicableMunrcrpal/Prope(Vax Dues NIL NIL - No tApplicableSales axDues NIL NIL - NotApplicable,n yother ue s NIL NIL - NotAoolicable

Grand otalof all Govt,dues 2.994,823.00 3,641.6070 - NotApplicable

Details f profession r occupation:a. Self Business

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Name f the bank A/c Tvpe Amount inRs.)CorporationBank-Tonca

AxisBank td .4 l854Bankoflndia 15921 Jennifer

Bankof India Atanasio A/c 9870

Canara ank23169 Jennfe f )Corpora t ionank l7 l7 ( Jenn i fe r

Corporation ank 1323

Corporationank I458

Corporationan k1558

Corparation an k1586

Corporation ank9699

Corporatior'ran k SB/01/00q407

Corporation ank Tonca i00

Dena ank 103

HDFC00591000046740JenniferHDFCBank76528

HDFCBank 372

ICICIBank 1708

l c l c l B a n k 0 1 5 0 1 0 11 9 0

lDBl Bank i i 2 l4 Jenn i fe f

KotakBank20000304 Atanasio

KotakMahindra /c No. 1000! 03

Mapusa rbanBank CD/ 25803Mapusa rbanBank SB/ I i754.

OBC/CTB

oBc/cTB 3 69OBC/GTBA/c No. l3 17 0

SBI 103 588 i68Jenn i fe f

SBIA/cNo. I 1031602179

Syndicate ankA/c 13893

Uco Bank2578

UTI Bar rk / cNo.39224

Coryoration ank1595

ICICIBank 493

50 % share undercommunionof assetsShri.Atanasio \4onserrate

Smt. ennifer onserrate

Total

FixedDeposit

SavingsSa vng s

Savings

Savings

Savings

Current /c

Savings

Savings

Savings

Savings

Savings

Savings

Savings

SavingsSavings

Savings

Savngs

Savings

Savirrgs

Savings

Savings

Current /c

Savings

Savings

Savings

Savings

Savings

Savings

Savings

Savings

Savings

CurrertA/ c

Current /c

| 37 46744'

39,643.00,20,76'7.00

r,278,s84.10' t,684.15

't6,97 .00

5 43 ,1304224,494.00

. 1 7 . 0 0257.89

r5,962.00

65i .984.00

t5,402.0021,829.01

78,220.085t ,322.59r0,356.94r0,000.00

I6,60.00795,68.i2

4,332.3428,902.088,988.00

2 5 , 5 5 1 . 0 5t 75 .87 . 1 77 . 1 7

83,684.96s1 714.31

2.48't698,490.60

60,070.001,058,457.-571.045.065.86

12 , 905 , 985 . 13

6,452,993.006,452,993.00

ANNEXUREIInvestmentn Shares& M utual un ds as at 31/03/2011

Name f the und/Company Cost inRs. )a) Mutual undKotakMahindra utual undDS PMerryl ynch Mututalund

a) Shares

ln RajHospitalityvt .Ltd.(1997Shares t Rs .304492 pershare)Total

50%share nder ommunionf assetsShri.Atanasio onserrateSmt.Jennifervlonserrate

200,000 0200,000.00

6,080,698.71

6.480.698.71

3,240,349.003,240,349.00

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eatoup iildaEin

LI CPoticy o.LI CPolicyNo.

Torat a)

930912470930755903

Public rovidentFund

Total b)

GrandTotat a+b)

5mt.Jennifer onserrate

1,250,000.001,500,000.00

Valueas on 3113t2011

2,875,263.0O2 875 263 OO

Names f the panies AmountRiiEin3113t2011duanceo*ardspiilrasibi proiiE

Advanceorpurchaseof Flar

ClaraPholomena ia sMariaRitaDiasRitaAntonefta ia sVelhoConstructionVerner elho

Devidas alyekar

EdwinMascarenhasCroupCorstruction

Curudas ayekarlnacioPereira

.iayesh

MichealViegas

Ru iPinto

VernerZacquaris onteiroSharayu utomobilesAdvalpalkarConstructionsCaetano SouzaDigirech

FlorieViegas

CoodEarthDevelopersMudhirCupra

Uday \4adkaikar

Ra jHospiraliryvt Lt dRohitMonserratePriority utomobilesKalaMotersRentReceivableTD SReceivable(NinadLaud)TD SReceivabte(Edithde )Kotal Securit ies

2,400,000.00

| 47 ,479OO666,666.00

666.666.00

666.666.00r.i0.000.00

t50,000.00250,000.00t09,500.00800,000.00250,000.00

t00,000.00

I5 ,666.00250,000.00

436,000.00849.000.00r00,000.00

230,678.009.000.000.00

500,000.00

500,000.00600,000.00

l ] 8 , 012 . 00r,400,000.00

500.000.008.-r21.668.002 , t 7 t , 900 . 91

78,445.0040,003.00t0,000.0056,500.00

261.400.00

3J.295,485.96

16,641.74?.c)8

t6 ,647,712.98

ANNEXUREIV

?ers9!.ellq3rs&dv.""

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FourWheelersToyotaprado

Mercedes enzC 23 0Mercedes enzE CD I350ruercedes enzG 655AM GlataXenonMarutiOmniMarutiOmnifMaruti mn iMarutiOmniHyundaii0

SkodaSuperbToyotaFortunerToyotaCaptiva

Two WheetersRoyalEnfield u etKinetic ondaKinetic ondaTVS ScootyTVSScootyKinetic ondaKinetic ondaKineticHondaKinetic ondaKinetic ondaKineiicHondaKinetic ondaTVS ScootyKineticHondaryS ScootyHondaDioKineticHondaKinetic onda

ANNEXUREVI

Total alue

ffi

cA_08-F_0001cA_o7_E_010.1GA_07_L-0026cA_07_L_OOO1

cA_07-c_7178cA-07_E_3129cA-07-C_6932

cA_07-c_6933

cA_07_C_6934cA_07-E_0380

cA-07_L_0333cA-09_E_0333

cA_09_D_0s33

cA-07-H-3162

GA-01_H-2500

GA-01_H-7376

cA-01-Y-2753cA-07-B-2995cA-?1_Y_1249GA-01_Y_6330cA-01_Y_0650GA-01-Y_6221

GA-o1-Y_6218

GA-01_Y_0674

cA-01-H-6560

GA-07-8_2627GA-01-Y-6247GA-07-H_8708GA-07_J_3634

GA-01-Y_6247GA-01-Y-2862

23,593,781.00

11 796,891.0011,796,89100

12t09t200626/05/200927t06/2011

04t07t200s20t07t2010

24/01t2011

29t12/2009Q1/07/2009

25/07t2ao513/'10t199901t06/200112/08t1999

11t05t2001

14t05t200116/08/1999

06/04/199824t03/200516t05t2001

Business ssets(Hearine)uusrness ssets(RajConstructions)

Total

::rT"';.c:':d;::"*llry5mt.Jennrfer onserrate

varueas on 311312011

642,580.00438,165.00

'1,099,200.00

z,tzg.gqsno

1,089,973.001,089,973.00

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Field,Corlim iswadi-Goa36/55)

Dhavem ield,Corlim iswadi_Goa(surveyNo 35/40)Dhavem ield,Corlim iswadi_Goa(surveyNo 37120)Dhavem ield,Corlim iswadi-Goa(survey o3S/23)Dhavem ield,Corlim iswadi_Goa(surveyNo 34/30)Dhavem teld, orlim iswadi_coa(surveyNo 34/SO)Dhavem ield,Corlim iswadi_Goa(surveyNo 36/53)

CasaMonserrate)

KamatMansion latNo.2KamatMansion latNo.3Kamat \/ansion la tNo.4KamatMansion latNo.5FlatatCruzApts,La Campala, iramarFlatNo5-5(26), t KamatClassic, onca

flat No .501,5t hFloor,Central ark,St.paulRoad,Bandra W)

FlatNo.307,Rahe.ia esidency, angatore

Property t near hurch SurveyNo. 17011)propertyat TaleigaoSurvey o.167/7)

::::^1'o:1 schootreased)ptotNo 6&10),aleis

Hroperty t Tateigao SurveyNo . i6715)(attached "o

KamatMansion hopNo 1, 2. 3, 4 MnamarKamatMansjon hopNo.5,MiramarKamatMansjon hopNo.7, iramar

llopat Pooja pts.,Opp.KamatMansion, onca

Snopat KamatClassic. onca

:hopNo.FF3 tVelhoTradeCentre, anajj

KamatMansion, hop.No.6,MiramarKamatMansion hoppremises(Nog), MiramarKamatMansion hoppremises(Nog) ,MiramarKamatMansion hopNo.10,Mirarnar

flf;: "tniruiSadanoffice o. 01202,302,03),

House tTaljegaoSurveyNo. 167/6)Bungalow t TateigaoSurvey o. 169/3)SmallHouse t TaleigaoSurvey o. 167i2)

.Umattouse t Cazacho ccor,TaleigaoSurveyNo .

186t2)

andDetails f lmmovable

Builtup Area Totalmeasurementn

065.d1

182.00

1,540.00

1 414.00

112 . 20

165.00

240.00213.00

474.00't12.00

94.0010700108.00140.00126.00

83.33159.70

1

18/09/1985'i8lp9/1995

12tO3/2010

30t07t1997

2

2st11/1999

Q4/10/199912t07t2000

13t07t1992

21t04t1999

02103/1999

09/06/2000

18/09/199506/08/199904t10t1999

21t04t1995,

19/06/1995,28/0711997.

23106/1990

't

28t11t1987| 1,OOO,OO0.o0

30t07t1997I 1,OOO,OOO.OO

Dec-98 I 300,000.00Dec-98 I 800,000.002000 | 70o,ooo.oo

23tO9t2O00I 900,000.0016t05t2000I 900,000.0020/01t1986 | 280,000.021t04/1999I 1,000,000.00

22/12t2009| 10,000,000.0019/04/1993I 1.068,16.00

432,000.00l336,000.00

3,203,200.00

384,000.00

5,858,200.001,820,000.00

15,400,000.00

14,140,000.00

37,218,20Q.0Q

4,000,000.001,000,000.00

900,000.00300,000.00500,000.00250,000.00900,000.00100,000.00495,000.00600,000.00

1,000,000.00

5,760,000.001,440,000.00

1,440,000.00

1 184,000.001 180,000.00

480,000.001,440,000.00

1.440,000.001,440,000.001,440,000.00

2 24400000

10,045,000.00

5,775,000.008,400,000.007,455,000.00

16,590,000.003,920,000.003,290,000.003,745,000.003,780.000.004,900,000.004,410,000.00

10,000,000.003,992,500.00

17,948,16.00o t a l 1+ 2 + 3

32,348.316.00 136,363,700.0007"sha eunoeiio mEIn=Eiia-G6i!-Shr i .

Smt.AtanasioMonserrate

68 , 181 , 850 . 0068 , 181 , 8500

Current arketValueRs .

412,500.0

100,000.0

275,000.00

700,000.00

725,000.00

587,500.00

600,000.00

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=Nameof Institution Natureof Loan AmountO/S

-lrsIndBank td .

IFIDUS IndBank td .

tF lt\Lru5 lnd tsank td .INDUS ndBank td.IndusndBank td

Corporation an k

Shri.Atanasto onserraleSmt.JenniferMonserrate

lHousing oan

lCarLoant ^luar

Loan

Car Loan

CarLoan

Ca rLoan

Dr .Ba l n SavingsNc

3,s71,928.00

421,334.12

49.812.18

73,87 .07

48,304.29

1,107,544.54

62.-15 27285939

2,636,430.002.636 430 00

ANNEXUREXLoanor dlrec

Mmesof thepartieson 31t3t2011

Ra jHospiraliriyvt Lt dTarvelAdvanceromRajHospitality vt LtdDeposit owards entAlshaConstruction

AnthonyMendesChaseRealEslateDevelopeersLandscapeevelopersSamrizConstruction

Tanvirnan an powerServiceAdvance wdsSale f KamatMansion hop 2,3,4Advance wdsSale f KarnatMansion Flats Flat

No.5, 6,F-5,S- )AnandBose

AshrayConstruction

Banju l adi l

EssalBuilders

Cracious

JohnPaul

MarioFernandesN coias ernandesPravinEarthMoversRachila Lrpta.velhoRuiPinto

SadikNoorani

Sadiquehaikh

Sira.1haikh

Venrer lex ioVel l roPasa roperties

LandscapeevelopersTotat

@sbnrr.AtanasioMonserrateSmt. ennifer onserrate

3,803,893.609. t24,967.00

I , 75 ,78 . 00700,000.0b

s00.000.00

600,000.00r.s00,000.00

r.000,000.00

r,700,000.00

3,I50.000.002.s00,000.00

r6,000,000.00

r,000,000.002, 60,000.00

169,000.00

s00.000.00

500.000.00t-50.000.001s0,000.00700.000.00

900,000.002.50.000.00

800,000.00600,000.00

r0,050,000.00.

985.000.003,307,500.003,620.000.00

250,000.00

33.922.79.0033,9?2.769.00

718,546.09

606.5s.00

SundryCreditorsProvisions

Total

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Shri. tanasio onserrateSmt.JenniferMonserrate

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8/3/2019 Atanasio Monserrate

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VERIFICATIONl, Atanasio . Monserrate,he Deponent,bovenamed, o herebv erifv nddeclareha t he contents f hisaffidavit nd hecontents f the annexuresnclosed erewith re rueandcorrecto the bestof myknowledgeandbelief, opartof it s alseandnothingmaterial asbeen oncealedhere rom. further eclarehat '

(a) Donothaveanyother onvictionr pending ases gainstme other han hose nentionedn tems3 and4above:(b ) , my spouse, r my dependentso nothaveanyasset r iability,ther han hosementionedn tems5 and6above.

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