INDIA NON JUDICIAL

Certificate No.
Certificate lssued Date
Account Reference
Unrque Doc. Reference
Purchased by
Description of Document
Property Description
Consideration Price (Rs.)
Frrst Party
Second Party
Stamp Duty Paid By
Stamp Duty Amount(Rs.)
Government of Nationa! Capital Territory of Delhi
e-Stamp
tN-D1880538232995401
16-Nov-201311:48AM
TMPACC (tvy dlB06B03/ DELHr/ DL-DLH
s u B I N-D LDL806803740905008546371
MANOJ
Article 4 Affidavit
Not Applicable
0
(Zero)
: MANOJ
: Not Applicable
: MANOJ
: 10
(Ten only)
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FORM 26
(See rule 4,A)
AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION
PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO DELHI
LEGISLATIVE ASSEMBLY FROM AC-07, BAWANA, DELHI. CONSTITUENCY
PART.A
I, MANOJ, S/O SH. INDER PAL SINGH Aged about 21Year, R/o 0-291, GALI
NO. 14, PHASE-4, PUSHKAR VIHAR, SHMIHAR, DELHI, a candidate at the above
election, do hereby solemnly affirm/state on oath as under:-
1 I am a candidate set up by AAM AADMI PARTY (**name of the political party)l**
am contesting as an Independent candidate.
(**strike out whichever is not applicable)
My name is enrolled in Assembly constituency No. AC-69, MUSTAFABAD, at SI.
No. 122 in part No.32.
My contact telephone number is/are 9015631082 and my e-mail id is
mrmanoj 90 I 5
@
gmai l.com and my facebook a./c mrmanoj 90 1 5
@gmai
l, com
Detail of PAN and status of filing on Income Tax return:
I am lam not accused of any offence(s) punishable with imprisonment for two years
or more in a pending case( s) in which a charge( s) has/have been framed by
the court( s) of competentjurisdiction.
If the deponent is accused of any such offence(s) he shall furnish the following
information: -
(s) is/are pending against me in which charges have been
imprisonment for two years or
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5.
S.No. Name Permanent
Account Number
(PAN)
The financial year
for which the last
Income tax return
has been filed
Totallncome
shown in
income tax
return
(in
Rs.)
Self AOXPMOTOOE NA NA
2 Snouse NA NA NA
., Dependent I NA NA NA
4. Dependent 2 NA NA NA
(i)
an offence punishable with
A Case/First Information Report No.A'{o.s
together whit complete details of
concerned Police Stations/ Distract /state.
Not Applicable
B Section(s) of the concerned Act(s) and
short description of the offence(s) for
which charse
Not Applicable
C Name of the Court, Case no. and date of
order taking cognizance:
Not Applicable
D Court(s) which was framed the charge(s) Not Annlicable
E Date(s) on which the charge(s) was/were
framed
Not Applicable
F Whether all or any of the proceedings(s)
have been stayed by any Court(s) of
comDetent
Not Applicable
(ii) The following case(s) is/are pending against me in which cognizance has been
taken by the court
[other
than the cases mentioned in item (i) above]:-
I have been/have not been convicted of an offence(s)
[other
than any offence(s)
referred to in sub- section (l) or sub-section (2), or cover in sub-section (3), of
section 8 of the Representation of the People Act, 1951 (43 of 1951)l and
sentenced to imprisonment for one year or more.
If the deponent is convicted and punished as aforesaid, he shall fumish the
following information: In the following cases, I have been convicted and
sentenced to imprisonment by a court of law:
t-
A Name of the Court, Case no. and date of
order taking cognizance:
Not Applicable
B The details of cases where the court has
taken cogni zance, sections of the Act and
description of the offence for which
cosnizance taken:
Not Applicable
C Detail of Appeal(s)/application(s) for
Revision (if any) filed against the above
order(s)
Not Applicable
S.No. Offence Description
A The details of cases, sections of the Act
and description of the offence for which
convicted:
Not Applicable
B
H:.:l
tne cgL;fi_ffiffi ate(s) Not Applicable
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C Punishment imposed: Not Annlicable
D Whether any appeal was/has been filed
against the conviction order. If so, details
and the nresent status ofthe apoeal.
Not Applicable
7. That I give herein below the details of the assets (immovable, movable, bank balance,
etc.) of my self, my spouse and dependants:-
A. Details of movable assets.
Note: l: Assets in
joint
name indicating the extent ofjoint ownership will also have to be
given.
Note: 2. In case of deposit/Investment, the details including Serial Number, Amount, date
of deposit, the scheme, Name of the Bank/Institution and Branch are to be given
Note: 3. Value of Bonds/Share Debentures as per current market value in Stock exchange in
respect of listed companies and as per books in case of non-listed companies should
be given.
Note: 4. Dependent here has the same meaning as assigned in Explanation (v) under section
75A of the Representation of the People Act. 1951. .
Note: 5. Details including amount is to be given separately in respect of each investment
I
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+
S.No Description Self Spouse(s)
Name(s)
Dependent
-l
Dependent
-2
(i) Cash in hand Rs. 1,000/- NA Not
Applicable
Not
Applicable
(ii) Details of Deposits in
Bank accounts (FDRs,
Term Deposits and all
other t1,pes of Deposits
including saving
accounts), Deposits
rvith Financial
Institutions, Non
Banking Financial
Companies and
Cooperative societies
and the amount in each
such deposit
(l) sBI, LONI, GZB,
A/C NO.
302465885 I I
Rs. 11,000/- (apprx)
NA Not
Applicable
Not
Applicable
(iii) Details of investment in
Bonds, debentures/
shares and units in
CompaniesAvlutual
Funds and others and
the amount.
Not Applicable Not Applicable Not
Applicable
Not
Applicable
ri\ I Details of investment in
NSS, Postal Savings,
Insurance Policies and
investment in any
Financial Instrument in
Post office or Insurance
Company and the
Amount
Not Applicable Not Applicable Not
Applicable
Not
Applicable
(v) Personal loans/
advance given to
any person or entity
including firm,
Company, Trust etc.
And other receivables
from debtors and the
amount.
Not Applicable Not Applicable Not
Applicable
Not
Applicable
(vi) Motor Vehicles/
Aircrafts/ Yachts/
Ships (details of Make,
Registration No. etc,
Year of
Purchase and amount)
HONDA (M.
CYCLE) REGN.
DL5SAC7566
MAKE- 2OI I,
RS.40,000/- (APPX)
MARUTI ALTO
MAKE- 2OO9
RS. 1,50,000/-
(APPx)
MAHINDRA
CHAMPION,
MAKE
_2OII,
1,50,000/-
Not Applicable Not
Applicable
Not
Applicable
(r ii) Jervellery, bullion and
valuable
thing (give details of
weight and
value)
NIL NA Not
Applicable
Not
Applicable
(viii) Any other assets such
as value of Claims
/interest
NIL Not Applicable Not
Applicable
Not
Applicable
(ix) Gross Total value Rs 3,52,000/- NA Not
Applicable
Not
Applicable
I
I
=
=
=
=
ing the extent ofjoint ownership will also
'lz-l
B. Details of Immovable a
2.Each land or building or apartment should be mentioned separately in this format.)
S.No. Description Self Spouse(s) Name(s)
Not Applicable
Dependent-1
Not Applicable
(i) Agricultural Land
Location(s)
Survey number(s)
NA NIL Not Applicable
Area (Total
measurement in
acres)
NA
Not Applicable Not Applicable
Whether inherited
prooerty (Yes
or NO)
NA Not Applicable Not Applicable
Date of purchase in
case of self acquired
property
Not Applicable Not Applicable Not Applicable
Cost of Land (in case
ofpurchase)at the
time of
purchase
Not Applicable Not Applicable Not Applicable
Any Investment on
the land by way of
development,
construction etc.
Not Applicable Not Applicable Not Applicable
Approximate Current
market Value
NA Not Applicable Not Applicable
(II) Non-Agricultural
Land
Location(s)
Survey number(s)
NIL NA
Not Applicable
Area (Total
measurement in
sq.ft.)
Not Applicable NA
Not Applicable
Whether inherited
propertY (Yes
or NO)
Not Applicable NA
Not Applicable
Date of purchase in
case of self acquired
property
Not Applicable NA
Not Applicable
Cost of Land (in case
ofpurchase) at the
time of
purchase
Not Applicable NA
Not Applicable
Any Investment on
the land by way of
development,
construction etc.
Not Applicable Not Applicable
Not Applicable
Approximate Current
market Value
Not Applicable NA
Not Applicable
(m) Commercial
Buildings
.,X7 t
(includine
,/rl)):
NIL
R>\
NIL
Not Applicable
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apartments)
-Location(s)
-Survev number(s)
Area (Total measu-
rement in sq. ft.)
Not Applicable Not Applicable Not Applicable
Built up Area (Total
measurement in sq.
ft.)
Not Applicable Not Applicable Not Applicable
Whether inherited
orooertv(Yes or NO)
Not Applicable Not Applicable Not Applicable
Date of purchase in
case ofself
acouired orooertv
Not Applicable Not Applicable Not Applicable
Cost of property (in
case ofpurchase) at
the time of
purchase
Not Applicable Not Applicable Not Applicable
Any Investment on
the property by way
of development,
construction etc.
Not Applicable Not Applicable Not Applicable
Approximate Current
market Value
Not Applicable Not Applicable Not Applicable
IV)
A
Residential
Buildings (including
apartments,)
-Location(s)
- Survev number(s)
NA NA Not Applicable
Area (Total measu-
rement in sq. ft.)
NA NA Not Applicable
Built up Area (Total
measurement in sq.
ft)
NA NA
Not Applicable
Whether inherited
property
Yes or NO)
NA NA Not Applicable
Date of purchase in
case of self acquired
orooertv
Not Applicable NA Not Applicable
Cost of property (in
case ofpurchase) at
the time of ourchase
Not Applicable NA Not Applicable
Any Investment on
the land by way of
development,
construction etc.
Not Applicable NA
Not Applicable
Approximate Current
market Value
NA NA Not Applicable
v) Others (such as
interest in properfy)
NIL Not Applicable Not Applicable
ffi
Total of Current
Market Value of (i)
Not Applicable
(8) I give herein below the details of liabilities/ dues to public financial institutions
and government:-
(Note: please give separate details of name of bank, institution, entity or individual and
amount before each item)
S.No. Description Self Spouse(s) Name(s) Dependent-l
Not Applicable
(i) Loan or dues to
Bank/ Financial
Institution(s)
Name of Bank or FI
Amount outstanding
Nature of loan
NA NIL Not Applicable
Loan or dues to any
individuals/ Entity
other than
mentioned in (i)
above. Name(s)
Amount outstanding
Nature of loan
NIL NIL Not Applicable
Any other liability NIL NIL Not Applicable
Grand total of
liabilities
NA NIL Not Applicable
(ii) Government Dues:
Dues to departments
dealing with
government
Accommodation
NIL NIL
Not Applicable
Dues to departments
dealing with supply
of water
NIL NIL Not Applicable
Dues to departments
dealing with supply
of electriciW
NIL NA
Not Applicable
Dues to departments
dealing rvith supply
of telephones/mobiles
NIL NIL
Not Applicable
Dues to departments
dealing lvith
government transport
(including aircrafts
and helicopters)
NIL
r i{G;-..
NIL
Not Applicable
iffiffi
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(9) Details of profession or occupation:
a. Seli L.{\\'\'ER AT DELHI HIGH COLRT SOCIAL WORKER
b. Spc:se \ r
(10) lIr educ:rti,--ri.il ,.rualification is as under:-
F::
"I
CCS UIil!ERSITY IN YLAR 2011
C i e ;e:".-s i: :,-.nest School L nirer>in education mentioning the fuil form of the
'5-
-:-:'5
j'^'-,-,
r:sree
course. name of the School Colleee L'nirersin and the !!1..-.ve-! u.l .!.r.4 v\
!
lear
in uhich the course rras completed.)
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(iii)
Income Tax Dues NIL NIL Not Applicable
Wealth Tax Dues NIL NIL Not Applicable
Service Tax Dues NIL NIL Not Applicable
Municipal /Property
Tax Dues
NIL NIL Not Applicable
Sales Tax Dues NIL NIL Not Applicable
Any other dues NIL NIL Not Applicable
Grand total of all
Govt. dues
NIL NA Not Applicable
(iv) Whether any other
liabilities are in
dispute, if so,
mention the amount
involved
,
and the
authoritl before
ri'hich it is pending.
NIL NIL Not Applicable
PART-B
(11). ABSTRACT OF THE DETATLS GIVEN rN (1) TO (10) OF PART-A:
Details of Asst'ts and Liabilities in ru
,\sscl
''
,tal value)
Purchase Price and
Develolnrent Cost of
1 Name of the candidate MANOJ
2 Full postal address 0-291, GALI NO. 14, PHASE-4, PUSHKAR VIHAR,
SHIV VIHAR.
a
J Number and Name of the
constituencv and State
AC. 07, BAWANA, DELHI
4 Name of the Political party which set
up the candidete (otherwise write
'Indeoendent')
AAM AADMI PARTY
5 (a) Number ol-cases in which
conviction order passed (other than
those referred to in Form 26)
No
(b) Total nur.nbcr of Pending cases
where the court (s) have taken
cognizancc
No
6 Total numbcr of cases in which
convicted aurl scntenced to
imprisonment 1br one
)'ear
or more
[except
for o1'1in--.'s rcl]rred to in
subsections t I
'
:'
-1
r .-rf section 8
of Represe::r , -:':1,,' People Act.
195
'
No
PAN of Year for rvhich
last Income Tax
Return filed
Total Income
Shown
a) Candidatt AOXPMOTOOE NA NA
(b) Sp.rusc NA Not aoolicable Not applicable
,
(c)
Detrencle nt I Not applicable Not app cable Not applicable
d Dcnendent I Not applicable Not app cable Not applicable
Spouse(s) Name(s) Dependent-l
Not Applicable
Not Applicable
Not Applicable
Inrrtovl,r.le P
Deve I o prnent / construction
cost of irtmovable property
Approrirnate Current
N'lalket i'rice of Asset
(Total Value)
(rr) s.' I r'
-acquired
assets
i I
.rl
Value)
(i
,
',r
lited assets
Higi (ll)
rent dues (Total)
,rrn Bank, Financial
.rrrs &nd others
irre under dispute:
rent dues (Total)
r:rtio n el qualification :
:
:=
:
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::S
-:.IVERSITY
IN YEAR 2011
-f hishest s.hooltniversitl education mentioning the full form of tfie
:loma" degree course, name of the School/college/universiry, and the'
DEPONENT
'r'e named, do hereby verify and declare that the contents of this affidavit
ro the lbest of my knowledge and belief, no part of it is false and nothing
,ncealed
there from. I further declare that:
.:ase of conviction or pending case against me other than those mentioned
rd6ofPartAandBabove;
-', or my dependents do not have any asset or liability, other than those
r items 7 and 8 of Part A and items 8,9 and l0 of
part
B above.
\TRIFICT\'
I. the depon
are true and
material has
(a) ther,
in ite
(b) I, m)'
menl
Verified at I
\J
\ ear
'-rvrrroulsrrr vvutr!r lrorllL (Jl
lrrs JUlluul/uUllgBg/Unlvcrslt)'anO
Ine
f
; the course u'as completed.)
!.=C_L.O:f
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Nofery
Delhi{
Not Applicable
Not Applicable
Not Applicable
Not applicable Not Applicable
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DEPONENT