7

C+:r (rv. 15(-J~ , 2-D L l/ ~ f.nffiffi tR \'l\!fi 1J($p ~ <Tff qft 1 VRCfft 'fit ~ ~ qn fclcRvT I ~----------~

(~ : ljftI. 3lTiffiI. ~ 3R{ ~~)statement showing details of immovable property on first appointment and also on 15\ January of each calendar year(e.g. Lands. House. Shop. other Buildings etc.)

1m! "ft. 1Form No.1

2. tlCAT'l

Designation

fhy'/1. ~Name

3. ~Organisation

PAwhl di4-NS JrGUw,8'R,S L'i,DI e ::rUN 020104. ~qft~

Date of JOining

5. ~mBasic Salary

6. ~Location

w.~. ~ o\!fi ~ qn fclcRuT ~3I1A~tR"fi.fft ~$q;or ~ifiT~ ~~'¥l \CUl1Jt1

S.No. Mm (;fftf ~ 1'f'Q';flc~. 1 ot~~~'{fm 3Ifuffl qft ~ (~~1'f'Q' crrftcI; 31m Remarks

~ 5 ~ ~/'llCR/ljftI ~.) u.rn ~<!fI~ (~~1'f'Q' ;flc~. 3~) Total annual

Details/Description of ~~~~I "IR "ft. 2 '\Pi Value of the income from

property and its location. If not in own name. 6~) property the property

(see notes 1&5 below state in whose name How and (see note 3house/Building/Land No.) held and his/her when below)

relationship. if any to acquiredthe employee (See notes .

2&6 below)

I . 3)( PLOfS ~,'?~f)$n!/; f'JA fiJiUJ1~G fJ.s I '1 . NIL-,6/5.20/.GAS! «rrv C t;E("F) I C; CfOI

/JuCL.'"

N M-NG eS7A-TtE f'JML~E DevP€/tl/Vf'r4A1Z C!;.rMES 01Afl.ctc~

h,(pEIUl-i.Ai) rv-t lAD" ,

(U"'~(si(rf(, F- ~/'J, It) Ef.;c..LAr~g[WN~zi'"

113)-'

~. fLMND ~-/~q (VA (JU(i..01iH,l' e. 'S,qo,SJ'f/r:: NILLDJt1..I PktrJ

, '" I1V~G.JfttIny P:t.,4-'i3 SELl If C~af) (q't' ~6V7~I APJ'n'1' _1IIA-tv.£Al>BVI f;.rmPIb (i) t'L-FItf.i

INi)11J-. •

fJ~01/c UUJ., Illf/oq JWvSirJC,~#JI.s.Mi.;" .N~ .J>nHl

.-

,.:" ,

(JR.,7

-.rrc 1. ~ ~ 'l,uf '{ill:f ~ 3"I"'R "'fTIl 'l'{ ~ t m ~"lf'{ ql1 ~ Cf>l ~ I

Note 1. If the property is not wholly owned the extent of share may also be indicated.

11c2. =e=r4 ~ ~ "$ ~ ~ ~ emam ~ ~ o/P <fit ~ ~ ~ ~ ~ ~ 3fiffi~em~rnft<p~mrrr I~, ~~~qlt~~~~q;nf~~ ~ C2lfcffi ~ ~ qlt 'Gffift -g- ill ~ ..~ q;) ~"lIT ~ ~ ~ lit ~ ~ em~ =e=r "4 am ~ ~ wm -;fflf tWIT 3i'R am 3i'R ~ ~ 'TffiA' qll 3lCl"fu~ ~ wm <rtft tWIT 'I

Note 2. For the purpose of Col. 4 the term lease would mean a lease of immovable property fromyear to year or for any term exceeding one year of reserve yearly rent. When, however,the lease of immovable property is obtained from a person having official dealings withthe employee, such a lease should in this column irrespective of the term of the leasewhether it is short term or long term, and the periodicity of the payment of rent.

-;fie 3. ~ 5 "4 f.'p•..,fc;j ftld ~ VIRT ~ :

Note 3. In col.5 should shown.

(en) \ifil'f ~ ifRT, ~ ~ ~ qx ~ ~ lit,'~ 3lvR em 'lfTIlR f$m 1flIT ~ 3T2fClT

~(A) Where, the property has been acquired by purchase, mortgage or lease, the price or

premium paid for such acquisition.('~) Ufl5l ~ ~ '!R ftmr 1flIT -g- cfflf ~ ~ fcml<rr '4T I(B) Where it has been acquired by lease the total annual rent there of also and(TJ') Ufl5l ~ q;r 3T$r Gi'NI~CfiI,(, ~ ~ ~ ~ 3TFureqlt ~ lit cfflf 3TFure~ em

~~I(C) Where the acquisition is by inheritance, gift or exchange the approximate value of the

property so acquired.

~ 4. 1 ~~m~em~fcrcRoT'4T~VIRT~ INote 4. The annual return in respect of immovable property may also be submitted in this form

as on 1st January.

"Ilc 5. ~ Rim \iI"'I'QG, ~, ~ ;MR TiJq "4 ~ t \ffiCIj'f fcfflur ~ ~ ~ 'fRwr ~ 2;1 1ft \jjFfi ~ I

Note 5. Name of District, Division Taluka & Village in which the property is situated and also itsdistinctive number etc. will be given in Col.No. 2.

"Ilc 6. ifRT, ~, ~, ~, ~ ~ ~ II"CfiR em ~ 3i'R C2lfcffi / ~ em Ofm ~~<13TFureqlt~t I ~~"4~~/~em1:fffi3i'R~~em'4T~fcnm VIRT ~ I

Note 6. Whether by purchase. mortgage. lease. inheritance. gift or otherwise & name with detailsof person/persons from whom acquired Address & connection, if any with theperson/persons concerned are also to be given in Column.

6mf1l'R / Signature ~~'-:::=-_==___ f~ / Date : __ $~l.urr1-==Ii.A~lp~(.&..., ...:-..

~u~Assets Liabilities

(<p) ~ Q~'t1~R1 q ~ (Vf11T ~ ~'~' ~ ~)(A) Liquid Assets & Investments (including deposits & LIe Policies)~ m~~ ~ "f1lf tR ~ ~ ~ ffi6 3lFvRr ~3WT 1.~/~~Description AmounV ~ How acquired Annual cm~l

Original Held in the name income 1. Liabilities to thePrice of & relationship derived Bank/Financial

1 2 3 4 5 institution

. L.le ftJULY A 1072e/~I'q ~ELf g:41/''''tiS NIL- •

NO 112S741t1tfllMv"" ;-'I(4 ',6", t...f1S'V IJ.et '" D2-'f I~g. 1'1/10/10/2..

£..1 C (1tlL/CY lf :l.br.34~ ~e-Zl; . gltrJl~S NIL-NO 332,27trZJ" /J'e,.. . Sum/MvW) ,~r .11t-N~olo (TbtJ..Ittt fl/J1l#) ih to t.MC.H.J .. 2. firif ~ ft~1-v<- (ls Cj 71tJ)~ p. 4- ~(i).j

f:::11fM IUINJ cm~1L.I c. PtfUCY ~/Nt,.$ .l'J/L131.:5 2.S13 !hp(t1Meum ItA-Nlrv HANM 2. Liabilities toIn ;;t~paUlfp t.I I,~e,~"DIz, ...•.• r: <!"'.f'u.' ."or-I e: .1&. l(}£Jz- friends & relatives'UIrn v€j)i!lli i.t 1., C~,evp/~ (~) ~C' o..pp~ ,7M~/n.JffU 'Vlt/~· (B) Movable Properties1 2 3 4 , 5"

. (Ul..-O ~~,6\),tm/l, £~; fllP...CJtAf.E3.3RT~~~6Dao.pp~ ~/~(J) .NfL

,', ap/W).· . q,~ ~ I

('A1L (,v~t~K. f!.s 3,'t"t."li~)1., gaf -do-- ~IL 3. Other liabilities, if~q, anyC# 'ZD111a< f'S !,jc,tJV1)/z. St~;' ~d-t? ........ ~/L

Aj(l"fV)t (.$ C(. ~11~j)

/2m-I~BLA1fit f..t '12, tlb"DJz. . ~Cvi -d~- ~/l-,

jt I7MHI Cut?}R-••..3z, t'~z.

~: tR'illW

'rt;4UICltfN ~W~ -Ju~ NIL- Date SignatureJJ"r't c4~'7) ~ ~fflo/l-- ~£ILf- -rl>, -t'.''jv,}/'iI.m.-::t ,0/ L-.

e» ~~:~~v

2ct>.;-'Ur>.7

2.

3.

4.

5.

f1""',6.

~.

>;rq::! ~t.2Form No.2

tm'I1 f.rifcffi 1R qRfl"'llfldl ~ ~ (3J"i.l'M ~ i!>T ~) ow ~ ~ q!f 11ft 1 ~ <fiTft't'l t; ~l1J Cf>1 fQq~ J

Statement showing details of assets (other than immovable property) & Liabilities on first appointment and alsosubmission of return on 1'1 January of each calendar year.

ga...f..L.i}rv If., N riNM (ili7/).)1. 1Jl1

Name

trcr"fTll'Designation

W'r<R'- Organisation

flfW AN d111N..rheLl cdfJEt-l t5i D

16 :JVN :2...vlO~1Ift~

Date of Joining

¥f<l<ABasic Salary I I

~Location

~ ~ UTR ~ :- ;::;nn <mft' ~ iTI ~ q;;) ~ I

N.B. Additional sheets may be attached where necessary.7. £-&/1<-6 t4 2-.tcr6Vlz ~Q.f -do .-

'2.c!>~

11c 1.mR,~, ~ ~ em fcrcRur M <it ~ ~ ~ ~ <rrVTR fG<rr ulT~Note 1. In the case of share, securities, debentures etc. face value and approximate

market value as on the date of statement may be mentioned.

-.rrc 2~ \~ <ft+rr 41R1;ffjq) -m 3Rflfu M '4T<fi 'Gf(-;ft ~ INote 2. In the case of Life Insurance Policies the date of maturity may also be stated.

-.nc: 3. "{5l -m 3Rf1fd" (Cfil~ / m-=r -m 7Ji0 qft ~ qft ~ -m ~ -4 ~ ~ -m fC1~~~ qupf, ("{5l) t'.!l<fi elm m ~ ~ qupf (1T) 3RT ~ ~, ~, ~~~ \il1 ~ "$ "f)q -ii t ~ em fclcffuT ~ fcnm VIRT ~ I.(i) <m (ii) ~/~~ (iii) ~RhJl~c;'1/ '!<R <f>~'tI'1'1I ~ / ~~ql~I'i / eJ~~\Jj'1 ~ m.rr 3R1 ~~fGm<m~~~15~~3lfmptem~~~VIRT~ I

Note 3. Under B information may be given regarding items like (a) gold/gold ornamentsapproximate weight only be stated. (b) Silver including ornaments etc.(approximate weight) (c) Other precious metais, items of jewellery, preciousstones forming part of jewellery etc. Approximate value to be stated (i) car (H)Scooter/Motor Cycles (W) Refrigerator/Air Conditioners, Radio/Radiogram/Television. sets and _any other articles, the value of which individually is more thanRs. 15,000/-.

-.nc: 4. ~ 4 -4 <:ffi ~ f$m '\ilA1 ~ fm qm ~ <fi1 3f\if;:{ Wtr, ~ ~ ~ V<mX~ fct<fr <r<rr en em ~ ~ \;fAT ~ I

Note 4. In column 4, may be indicated whether the property was acquired by purchase,gift, or otherwise.

-.nc: 6. ~3it -m 3kPfu ~ ~ ~ '\ilA1 ~ INote 6. Under liabilities, brief details should be given.

6«ITaR / Signature o-_do:::.!...· _ .~ / Date; _ .•.••Su...(...!...fII..!o!IM:;:..··"",'2£~'-'r..J,I _

~fi. 3ForrnNo- S

~ ~ mf ~ 1 ~ em ~ / <filt~ $- <m-cr $- 3R'f'Ifu .:lIftr-mttm .~ ~ "'fTt! Q"'I "'?~( 1.1fc1 I tWit 3fi~ 31!1~o iF::.il"$"'f(111R~l'TI:~/~~ cmfcfiR1I'f IDetailed statement in respect of shares debentures purchased under promoters/employees quota as on 1" Januaryof each calendar year in officers own name and also those held the names of spouse' and dependent children.

1, "'fTt!

Name

2. ~-fl'I1

Designation

3. Wro-lOrganisation

4. mcfGff.rq;-, ~ if ~ <1ft fufuDate of Joining the PSLJ

5. 'J;<'! <ffi''l

Basic Salary

6. ~~~~P.F. Index No.

7. <WRLocation

SP.t!. <i;q;ft <liT'fIll -mRYCIft 3tfc1m ~<Ift -atl1'lc</~, '$ ~~ 3ivt'l $ Wl<l mfuf trGS.No. Name of the <t&n' ~ <'fTll<! <T>1Z if ~~ 3lk iffll ~ 1:i>'l \ffl

Company No. of Face Cost of Whether promoters! How 'f'T<I q;T-~ '5It"T m 3F1l'

shares value acquisition employees quota acquired ~ffi!?ft IPosition held at thetime of acquision and

. _. if the company hadany borrowing orother facilities al thaitime.

1 2 3 4 5 6 7 8

f\. IL..,

"

~ I Self

~ I llFft'~ Jl1m <fi5fT

Spouse and dependent Children"

8. 1 VRCRl em ~ ~ "RM / mf.f ;f ~ / ~ <fiT~ ~ t IAny additions/deletions to this statement as on 1Sf, January /'tJ A and theprofit/loss incurred by me are given below. D

~ I Place: f/Vt;..>},~) r)1i LHI ~ / Signature: rJ,-,...d--=:=:;;?

~ I Date : __ '3;..-< .;,..1 _(n_A1_rL..:;;.~-.:...l' _ ",/J),~ / Designation: c.;..rr__ r _

ZITTT'

(~ Cj1f 1 ~ emqthl'Q~4Y 'I1'i ~an ~ "fl"m \ffijO lfR'I1 t I )(To be submitted alongwith the assets & Liabilities Statement as on 151 January of every year)

~ <!If ~ GRR 1 ~ q;l ~ 25,000/- ~ 3f1trq;- ~ ;$ WRl, ~~, ~ (f~r ~3fc:! q,~,~ q< f.fcm ~ "f"! <'R.~ qft ~ ~ UtBl I

Form for giving information where total transactions in shares. securities. debentures and investment inmutual fund schemes etc. exceed As. 25,000/· during the calendar year on 1s1 January acLj

4. ~,~ m"2T <'R-~ ftI;m lf4T ~ IParticulars of the partylfirm with whomtransaction is made.(<Il) ~ ~ 3TllrcIft ~ t I(A) Is party related to you?("~) qm 3l'T1l'% rn ~ lfG q< m~~$ m~ <'R-~ ftI;m ~ ~ ~ -q ~ <fiT _

3l1'1:ffi cmt <'R-~ "1Mqft W"'IT<RT t I(B) Did you have dealings with the party inyour official capacity at any time or is theapplicant likely to have any dealings withyou in the near future?

1 . 'WI <f'I.fl 'lG-Wl'

Name & Designation

2. (<p) ~ ~ ~ cffi;j

(A) Scale of pay and present pay(~) ~ r.Jfu ~ ~(8) P.F. Index No.

3. ~ <!If ~ GRR WRl. ~,~,.~3f(; ~, ~ If'( f.t<m~ ~ <'R-~ <fiT i!l'Rl IDetails of each transaction made in shares.Securities. debentures. mutual funds schemeetc. during the calendar year.

5. ~<fiT~Source or sources from which financed?(<Il)~<Im!(A) Personal savings(~) 3RI ~ em • ~(B) Other sources giving details.

6. cmt ~ ~ R;ffi 3fftl" ~ ~ t I

Any other relevant fact, which you maylike to mention.

~ / Declaration :

Nil

"ll ~ ~ <IR<fT I q;-fflt t f1t;~ &RT fc:m >Tm ~ i!l'm "ffi.ft ~1 hereby declare that the particulars given above are true.

<'m1 / Place: N rl<.~ i¥lh (

~ / Date : _'3~/.LfI)..:...If!kJ~.=-::}.c;.::;.;..I/I--_

-t :T

'~Q~ffi / Signature: _

cA.iJ1-~ / Designation: r..,:..r..;...' _