40AA 544567qjinod 7(u:~arSaoSri l~otory Public at Purulia.

Manb~~2r 243 5T Constitutency., " / • ~-';"l11J. ::..•~o. ~_"')_~I~?sh,:._ .••_.!j::~.;Jl: L::._··~, •.: Singh Sardar son of -late Muchiram Singh Sardar ~ged

~ onrr,ent for tvvo years or IEOH? in a pending case( s) in which a char-

i ge(s) lias/have been framed by the court(s) of c01Tlpetent jurisdic-

\. ,i. 'i \' ;,

(i)Case/First information reports No.INos. Nil.(ii) Police stetion(s) Nil, District(s) Nil.

vi) Whether all or any of the proceedi.ng( s) have beenstayed by any court(s) of competent jurisdiction Nil.

of section 8 of the Representation of the People Act,1951 (43 of 1951) and sentenced to imprisonment for one

(vi) Whether the sentence(s) has/have been stayed byany court(s) of competent jurisdiction Nil.

I,the above-named deponent, do hereby verify and dec-lare that the contents of this affidavit are true and

.J+:\yc--dit,,- N~A-&:'Advocate.

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?\'.'I.\\\\C\ ~S~~.i .oJ The N'ota:r:y ::Public. • ••• • • • • • • • :~ •• • • • • •• • • ••• •~. '.. r:::'~'J'~\)"~2\}~~~~:. Govt. of West Bengal, llist. Pu:r:ulia(W. B.) •

>. ". • ...1< <:</ Affidc"vi t', ....~.. "_,~~::e-~be Ft1.rnished by the candidate alO:(lgl'lith lTomination Paper

51. No. f{r3 L Before the Returning Officer,Oat) /..1,of ..f./ For election to West Bengal Legislative Assembly(name of the

~ House, From Manbazar-243 (S.T.) Constitu~ncy (Name of the~ Constituency).

I, Kartik Singh Sardar, son of Late r,~uchiramSingh Sardar,m

Aged 46 years, resident of ViII. Kadma, P.O. 32~i, P.S.-

9 Nanbazar, Dist. Purulia (.vl.B. )(mention full postal address),

~

d

J(1) I am a candidate set up by Party for Decocratic SOci2~ism

(P.D.S.)(name of the political party.

(2) Details of PAN and status of filing of Income tax returnSl.No. Names Permanent The financial year Total inoome

AccolUlt for which the last shown InNumber<P AN) bwomeo tax Income Tax

return has been ReturnCinfiled Rupees)

1. Self Nil lJil Nil Nilti

2. SpouseUilnil Nil

3. Dependent 1 Nil Nil Nil

4. Dependent 2 tiil Nil Nil

5. Dependent 3....... Nil Uil nil

-

(3) The following~) is! are pending against me in which copiZ8DCO hIlS becmtaken by the coUl't :

BI.No. Oft'enoe DellCription

W Tho dAtnili of CBaU wJuu09 thQ court has takancogniztUtctl, Sections of the Act and description of

Nilthe offeIWefor which oognizance token:

(b) Name of the court , Case No. and Date of order~ cognizance: Uil

(0) DQtlirlli of Appu1W/ApplWationW for RavUrlon Ofmy) filed o.gainst the above order(s) : Nil

(4) Cases in which IlmYe been comicted by a court orb.• (other those Mailed toinForm 26):

(a) The details of cases, Sections of the Act anddescription of the offence for which convicted :

Nil

(b) Name of the Court(s), Case No. and Date(s) oforoer(s) : Nil

(C) Pwrislunent imposed :I?i1

I(5) That I giTe herein below the details of the assets (movable and immovableete.) of myself, my spouse and all dependents:

(Note:i.Assets in joint name indicating the extent of joint ownership will also have to~~. .2. In case of deposit! Investment ,the details including Serial Number, AmOlmt,Date of Deposit, the Scheme, Name of Bank I Institution and Brench are to begiven3.Value of Bonds I Sharel Debentures as per the current market value in StockExchange in respect of listed companies and as per books in case of non' listedcompanies should be given.4. Dependent, here IIlelU15a peI"l!lon,substantially dependent on the income ofthe candidate.5. Details including amo\mt is to be given separately in respect of e~.chinvestment)

S, DSlOription Selt Spouse Dependen Dependent- Dependent-No. t-I 2 3(j) Cash in hand lls.15,OOO/- Nil Nil lil"il l~il

(;ii) Details of Deposits Rs.500/-in Bank aooounts at E.G. V.CFDRs,Term Bank,SindrDeposit, and all Branchotluil' ~!l of S/ B A/C.Deposits i.'l,eluding No.4916

savina aooOWltS),Depolilits withFinMci.alInstitutiOIUJ, NonBlUlkina FinancialCompanies andCooperative I I I I Isocieties and the- J~_

(ill) Details ofinvestment in Nil Nil Nil Uil NilBonds ,Debentures/sharesand units incompaniesl Mutual IFunds and others Iand the mnount.

I!

(jv) Details of.-

investment inNil Hil Nil lir.il Nil

NSS, Postal.Saving , InsurancePolicies andinvestment in anyFinancialInstrument in Postoffice or InsuranceCompany and theamount.

(v) Personal loans/advance given to Nil Nil Nil Nil Uilany person orentity includingfirm, Company J

Trust etc. andother l'eCeivablesfrom debtors andthe amount.

(vi) MotorVehicleslAiIwafts/ I'f-il Nil Nil lIil NilYachtslShipI(datsiIs of Make,Registration No.etc, Year ofPurohaseandamount) .

(vii) Jewelry ,bullionand valuable thing Nil Nil Nil ~Til Nil(give detaiJ.s ofweumt and value)

viii) other assets MUCh Hilas value of

Nil Hil Nil UilolainullinteN!rt

(ix) Gross Total value Rs.15,500/- Nil Nil Nil Nil

.6: ;-;::i ~~ I ) ::3 ~ ~~. <)~1r\. \?3rL4JFJ.J>.<.G.-fit. mB...· .

~-~.'-A¥,.

l.Properties in joint ownership indicating the extent of joint ownership will alsohave to be indicated .

2. Each land or building or apartment should be mentioned separately in thisformat.)

S.No. Description Self Spouse Dependent- Dependent- Dependent-1 2 3

(i) AWcultura! Lmd Nil Ihl Nil l;il UilLocation(s> Surveynumber(s>

I

Area (Total Nil Nil Nil Nil Nilmeasurement inac:res)Whether inherited ...N.o Nil Nil IHI Nilproperty (Yes orNo),Date of purchase Nil Uil Nil Nil Nilin case of self .acquired propel'ty

Cost of Land( in Nil Nil Nil Nilcase of purohase>a~ Nilthe time ofpurchase.

Any Invemnent on Nil Nil Nil Nil NilthQ land by way ofdevelopmentconstruction etc.Appl'UXimatQCu1Tent market Nil lIil Nil Jiil nilvalue

ill) Non- Ag:rignlturaJ l'iil Nil Nil NilL!YYI NilLocation(s) Surveynumber<.>Area (Total Nil Nil Nil IUl NillUQUW'QDlQut insct.f\)Whethor inherited Nil Nil Nil Nil Nilproperty (yas orNo)

00 ' \R·C::Il,O r:(/6/ J3~~ Y~y r0I'yY\T<j'BIN

~. __ .

. NQ1ARY

1 3 APR 20l/

,

Date of purchase --in esse of self Nil Nil Nil Nil IUlacquired propertyCost of Land( incase of purchase)at lEl. Nil. Nil Nil IUl.the time of

I

purchase.Any Investment on Nil Nil nil lifil .Nil. Ithe land by way ofdevelopmentconstruction etcApproximate Nil. Uil Nil. Nil HilCurrent marketvalue

(ill) Commercial Nil Nil Nil Nil NilBuildjpp<mcludingapartments)Location(s) Surveynumber(.>Built up Area Nil Nil Nil Nil Nil(Totalmeasurement inSQ.ft) -Whether inherited Nil N" Nil. Nil. Nil~-property (Yes orNo)Date of pUl'Chase Nil Nil Nil Nil Nilincase of selfacauired proPertyCost of property Nil. Nil Nil Nil Nil(incase ofplU'Chase)at thetime of purchase.Any Investment on Nil Nil Nil Nil Nilthe property byway ofdavalopmantcoIUJtruction eteApproximate Nil Nil Nil Nil NilCurnmt marketvwa'

uv) RHidAmtialBgiJdjna (including Nil Nil Nil Nil NilapartUl6Jlt.)Location<J) BUl'Veymunber(s)

:2l~1f~o 'r" .I' 0{'Y'1"Y d

81NODKU~n ~A.O~\. N01ARY

Area (Total lUl Nil Nil Nil Nilmeasurem6Ilt insq.ft)

Built up Area(Total rTll Uil '!\ril :£,Ti1 Uilmeasurement insa.ft)Whether inheritedproperty (Yas or Nil Nil Nil Nil !'TilNo)Date of purchasein case of self Nil Nil Nil Nil Nilacquired property.Cost of property Nil Nil Nil I Nil Nil IIGncase ofpurchase)nt thetime of purchase.Any Investment onthe land by way of IHI Nil Nil Nil NildevelopID6Iltconstroction eteApproximate -Current market Nil Nil Nil Nil Nilvalue

(v) Oilien(lJUCh as Nil Nil Nil Nil Nilinterest inproperty )

(vi> To~al of CurrentMarket Value of Nil Nil Nil Nil Nil(j)to (v) above

BINOO I5~SAO

'. ~~...•••. N01AAY

(6) I IiTc herein bclow the details of liabilitiesl dues to public fiUllucialinJrtitutions and govemment.:-(Note: Please give 8eparate detail. of name of Bank ,iJurtitution, entity orindividual and amount lor each item)

.?r-:/ Y::'''-- (l /" /'"---,b 13 <Jf) ,,5:-j5' - "-lYJrt"Y<!!

1r1x)it;b.'~-tyt. me- \~~. va-J-, (~y)

S.No. Description Self SpoUse Dependent- Dependent- Dependent1 2 -3

(j) Loan or dues to NilBank I Financial Hli lTilI i\Fil I lril

InstitutionCs>Name of Bank orFIAmountoutstandingNature of loan.Loan or due. toany lUl Nil Nil UilindividualslEntity

.Nilother thanmentioned in (j)above _Name(s)AmountoutstandingNature of loan.Other liability tifil Ul Nil Nil NilGrand total ofliabilities. Nil Nil Nil Nil Til

Govpmwepl Dues: Nil NilDues to Nil Nil NildGpartmQIltdealing withgov6l1UIlentaocommodationDues todepartments Nil Ii11 Nil Nildealing with Hilsupply of waterDues todepartments Nil Nil Nil Nil Nildealing withsupply ofelectricity /'

*I(~ -. f'-

INOO KUf\1LfV:;A.O"-..:u:\l\

.. . ~uTARY

1 3 APR 2011

(]d <ffi( s Rh\~

,l'4I(.i.M( ')'ll€--

~~'-~ 0C'N.-l~.f\¥,

Dues todepartments Uil Nil Nil Nil Nildealing withsupply oftelephone/mobiles

III

---Dues to Nil nil Nil Hil rIlldepartmentsdealing withgovernmenttransport(includingaircrafts andhelicopters)Income T8I Dues Nil Nil nil Nil Nil

Wealth Tax Dues

INil Nil Nil nil Nil

Service Till[ DuesHil Nil - Nil Nil Nil

Municipal!Property Tax Dues Nil Nil Nil Nil Nil

Sales Tax Dues Nil Nil Nil Nil Nil

Any oilier dues .Nil Nil Nil Nil 'NilOrand total of allGovt. dues. Nil Nil Nil ~Til Nil

(7) Details of prolession or occupation:

a. Self ?~~~.~.':.::~~.?~.b. SpouIl8 ..fl.C?':t.§l.~~~g.~.~ .

SINOD KUM.·\f~ SAO.-~.~g

1 3 APR b)IJ

(8) My educational qualjfication is as under :(Give details of highest School/ University education with full form of thecertificate I diploma! degree course)<Name of the School/College / University and the year in which the course wascompleted.) Class IX passed in the yeax 1977 under

Secondary Education Board of "1.B. .

~/~ 1N). 0-J~r \\ ' 'Ickl1c,flrd:-SJZ Yl1.e.. J>'

'fF~ti'- ilJ\o,~ Cr1d\.-)

11. Name of the candidate Sh./Smt./Kum. Kart i.k Singn. Sardar .• !I

2. Full polJtal address Ville Kadma, P~O. Eamni,P. S. Manbazar, Dist. Purulia (~I.B.'.

3. Number and Name of Manbazar - 243(S.T.)the constituency and in West Beneal .•State

4. Name of the Politicalparty which set up the Party for Democratic Socialism.candidate (otherwiJlewrite "Independent')(a). Number ofC888II inwhich conviction ordsr Nilpaned (other than -tho.e meITed to inForm 26)(c).Total number ofPending cases where Nilthe courtW have tabu.cognjz'm ••••.

5. PAN of Year for which last Total Income ShownlUl Income Tax Return

filed

(a) Candidate H'il Nil(b) Spouse Nil Nil(c) Dependents Nil lifil

BlNOD I~~AO_

NCJ1ARY

~~CJ Q(~. Y--I~~

1Ide:r(.I{(i~ ,)?1~~

+b~{YW- r{lJ~

*<

6. Details of Asset. and Liabilities in rupees ----. --' "

Description Self Spouse Dependent- Dependf,'lD.t-Dependent-1 .2 3

A. Moveable Uil Nil Nil Nil NilAs.et (Totalvalue)

B. Immoveable nil Nil Nil lJil I :tTilAsset

(j) PurchaseH;,Price and Nil Nil Nil lhl

DevelopmentCost ofImmoveableProperty(Total ValU8)

(jj) ApproximateCurrent Nil Nil Nil Nil NilMarket Priceor A-etcrotalValue)

7. Liabilities Nil Nil N.il Nil Nil,W Government

dues (Total) Nil Nil Nil Nil l~il

(ill Loans fromBank, Nil Nil Nil Nil' NilF:in.eDcialInstitutionsand oth81'S(Total)

8. Highost oduva1ional qualifivation : Class-IX pas~ed in 1977under Board of Secondar,yEducation,West Bengal.

(Give details of School/ University education with full form of the certificate/ diploma/ degree course)(Name of the School/College / University and the year in which the courseww! completed.)

<fi)f f3¢ C; S· y.;~)<1BINOD~O

. . NUlAA'< ,.'

1 J ":DR "I!JH

I ,the deponent, above named, do hereby verify and declare that the contents ofthis affidavit are true and COlTeCtto the best of my knowledge and belief, no partof it is false and nothing material has been concealed there from . I furtherdeclare that :

(a) there is no case of c~mviction or pending case. against me other than thosementioned in items 3 and 4 above .

(b) I, my spouse, or my dependents do not have any asset or liability , otherthan those mentioned in items 5 and6 above.

V rift d Puruli his h 13th d ~1)ril 2011e e at a t t e ay or";.. ... ... . .

!?1'3{r;;;: l7r~.~IVvc<;'DEPONENTIdentified by me J

+f.a:Ht.J:J{v\,tAdvOcate.

1 3 APR 20)1

1. Affidavit should be filed latest hy 3.00 P.M. on the last date of filingnominations.

2. Affidavit should be sworn before an Oath Commissioner or Magistrate ofthe First Class or before a Notary Public.

3. All columns should be filled up and no column to be left blank. If there isno information to furn.ish in respect of any item. either -Nil" -or -Notapplicable"'. as the case may be should be mentioned.

4. The affidavit should be either typed or written legibly and neatly.