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isBiMj!aBiiaiiai®i«tfi S R ^ I W WEST BENGAL

AFFIDAVIT

4 5 A A 5 7 2 7 0 0 ,

^M^fidavit to be Furnished by the candidate along with Nomination Paper £ Before the Returning Officer _

For election to West Bengal Legislative Assembly (Name of the House) 'J ^ From 230 - Daspur Assembly Constituency (Name of the Constituency) % jz>

Ajit Bhunia, son/daughter/wife of Late Kalipada Bhunia Aged 57 years, —£ ^ j I resident of Vill.- Kismat-Narajole, P.O.- Harirajpur, P.S.- Daspur, Dist. -«^S ^ 11_ Paschim Medinipur, (mention full postal address), a candidate at the above X ~^ts Election, do hereby solemnly affirm and state on oath as under:- 1L* i > (strike out whichever is not applicable) ~ o j:

"•UJI1* H A S I N A - (1) I am a candidate set up by All India Trinamul Congress (name of the Acfv©cat», political party) / am contesting as an Independent candidate.

NOTARY PUBLIC (2) Detail of PAN and status of filling of Income tax return : r**"*—1 Sir No.

Names Permanent Account Number (PAN)

The financial year for which the last Income-tax return has been filed

Total income shown Income Tax Return (in Rupees)

1. Self N.A. N A

2. Spouse - N A N A N A

3. Dependent 1 N A N.A N.A

4. Dependent 2 N A N.A N.A

5. Dependent 3 N A N A N.A

(3) The following case(s) is / are pending against me in which cognizance has been taken by the court:-

SI. No. Offence Description (a) The details of case where the court has taken

cognizance, Sections of the Act and description of the offence for which cognizance takes :

FIR NO. 143/08 Date - 29/10/08 P.S. - Daspur, Section - 147/148 / 149/325/326/379/427 IPC

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

ACGM Ghatal. Charge Sheet No. 157108 Date-08/12/08

(c) Details of Appeal(s) / Applications(s) for revision (if any) filed against the above order(s):

Not Applicable

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

Not Applicable

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

Not Applicable

(c) Punishment imposed : Not Applicable

(5) That I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all

SI. No.

Description Self Spouse Dependent -1

Dependent -2

Dependent -3

i) Cash in hand Rs. 550.00 N.A N.A N.A N.A

ii)

( O T A

Details of Deposits in Bank accounts (FDRs), Term Deposits and all other types of Deposits including savings accounts), Deposits

Bfcith Financial Institutions, .^O^Banking Financial ^CpftJOTBies and - i ^ p ^ f t v e societies and " h e amoSnt in each such ^ ^ p o s i i a i

Pension as Ex- MLA at Daspur UBI A/c No. 3494 Rs. 9,075.00 Savings A/c at Daspur UBI A/c No. 15946 Rs.

30,000.00

N.A N.A N.A N.A

^53

»DefcfflMPinvestment in rfBSMyDebenture / share iftjprnits in companies / •mutual Funds and others and the amount

N.A N.A N.A N.A

iv) Details of investment in NSS, Postal Savings, Insurance Policies and investment in any Financial Instrument in Post Office or Insurance Company and the amount

N.A N.A N.A N.A

v) Personal loans/advance given to any person or entity including firm,

N.A N.A N.A N.A

Adv©cat«, NOTARY PUBLIC

Var GTteaa) Su i> r> l V n ! , t o n )

atatal. Pactum Msdmipur

1/(1

Company, Trust etc and other receivable from debtors and the amount

vi) Motor Vehicles. Aircrafts/Y achts/Ships (details of Make, Registration No. etc, Year of Purchase and amount)

N.A N.A N.A N.A

•

vii) Jewelry, bullion and valuable thing (give details of weight and value)

N.A. 60 grams. (Jewelry) Rs. 1,20,000.00

N.A. N.A. N.A.

viii) Any other assets such as value of Claims/interest

N.A N.A N.A N.A N.A

ix) Gross Total value Rs. 39,625.00

Rs. 1,20,000.00

NIL NIL NIL

B. Details of Immovable assets : SI. No.

i)

Description

Agricultural Land Location(s) Survey number(s)

Area (Total measurement in acres)

inherited es or

hase in

of Land (in case of purchase) at the time of purchase Any Investment on the land by way of development, construction etc. Approximate Current market value

Self

Mouza Kismat-Narajole, J.L. No. 16

70 dec.

Yes

N.A

N.A.

N.A

Rs. 1,05,000.00

Spouse

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

NIL

Dependent 1 N.A.

N.A.

N.A.

In the year 2010-14 dec. land was purchased. Mouza NijNarajole, J.L. No 16 Rs. 15,000.00

N.A.

Rs. 15,000.00

Dependent 2 N.A

N.A

N.A

N.A

N.A

NIL

A (kujir H A Z R * /

Advecat*, NOTARY PUBLIC

|Por Gfcaal Sub-^viBton) OlttUl, Ptsobim Madiuipur

Dependent 3 N.A

N.A

N.A

N.A

N.A

NIL

ii) Non-Agricultural Land Location(s) Survey number(s) Area (Total measurement in acres)

Mouza -NijNarajole, J.L.No 16

26 dec.

Whether inherited property (Yes or No) Date of purchase in case of self acquired property Cost of Land (in case of purchase) at the time of purchase

Yes

N.A

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

N.A

iii)

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

Approximate Current market value Commercial Buildings (including apartments)

ion(s) ,umber(s)

ea urement

N.A

Rs. 60,000.00

N.A.

N.A.

N.A.

NIL

N.A.

N.A.

N.A.

NIL

N.A

N.A

urchase in self

acquired property Cost of Land (in case of purchase) at the time o f purchase Any Investment on the land by way of development, construction etc. Approximate Current market value

N.A

N.A

N.A

N.A

N.A

N.A

N.A

N.A

N.A

N.A

N.A

N.A

•NIL

N.A

N.A

NIL

N.A

N.A

NIL

Adv»cat», NOTARY PUBLIC

(For Gmrtal Sub*e><v.aio&) Ofeataii Pasd&ini Madmipur

N.A

N.A

N.A

N.A

N.A

N.A

NIL

N.A

N.A

N.A

N.A

N.A

N.A

NIL

N.A

N.A

N.A

N.A

N.A

N.A

NIL

N.A

N.A

N.A

N.A

N.A

N.A

NIL

K

iv) Residential Buildings (including apartments) Locations(s) Survey number(s)

Mouza -NijNarajole, J.L. No. 16 residing in the party office (A.I.T.C)

N.A N.A. N.A N.A

Area (Total measurement in sq. ft) - .

N.A. N.A N.A. N.A N.A

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

N.A N.A N.A. N.A N.A

Whether inherited property (Yes or No)


Date of purchase in case of self acquired property


Cost of Land (in case of purchase) at the time of purchase


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


£ 2 ft4fjrjroximate t(2ijrre1^narket v&ne^ *\


I A X,.

Other's (|ti&i as mterSst ifcftroperty)


W of$in-ent j ^ r k e t Value of r'c$ to irffomove

Rs. 1,65,000.00

NIL Rs. 15,000.00 NIL NIL

lve 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 for each item)

SI. No.

Description Self Spouse Dependent -1

Dependent -2

Dependent -3

i) Loan or dues to Bank / Financial Institution(s) Name of Bank or FI Amount outstanding Nature of loan

UBI Daspur Branch, Personal Loan A/c No. 611012243 Rs. 30,000.00

N.A. N.A. N.A N.A

Loan or dues to any individual / Entity

Crop Loan at Deshapran

N.A. N.A. N.A N.A

Advecata/ NOTARY PUBLIC

fat (jfn>fa.\ Sub-E^v^lon) - ftail. Ptaeium Modiaipui

other than mentioned in ( i ) above. Name(s) Amount outstanding Nature of loan

SKUS at Narajole Rs. 5,000.00

Any other liability N.A. N.A. N.A. N.A N.A Grand total of liabilities

Rs. 35,000.00

NIL NIL NIL NIL

ii)

\m

Government Dues

Dues to departments dealing with government accommodation

N.A N.A. N.A. N.A N.A ii)

\m

Dues to departments dealing with supply of water

NIL N.A. N.A. N.A N.A

ii)

\m

Dues to departments dealing with supply of electricity


ii)

\m

Dues to department jjealing with supply jpf^&kphone / ^ a ^ b ^ e ^


ii)

\m DuSsJKsfepartment

transport (-including ^taafcjtfijff , (Kelicp?tW

N.A. N.A. N.A. N.A N.A

.^J&JftjfcPax Dues N.A. N.A. N.A. N.A N.A gj&jfiln*fTax Dues NIL N.A. N.A. N.A N.A service Tax Dues N.A. N.A. N.A. N.A N.A Municipal / Property Tax Dues


Sales Tax Dues N.A N.A. N.A. N.A N.A Any other dues NIL N.A. N.A. N.A N.A Grand total of all Govt, dues


I

Acivecate,

NOTARY PUBLIC fat GfttmaJ Sub-ghvision) in

Details of profession or occupation : a. Self: Agriculture, Political worker and pensioner as Ex-MLA. b. Spouse : House wife.

Educational qualification is as under : Details of highest school / University education with full form of the certificate / diploma / degree course) Name of School / College / University and the year in which the course was completed) Passed Higher Secondary Examination in the year 1971, from Narajole Mahendra Academy under West Bengal Board of Secondary Education.

i. 2.

3.

4.

5.

6.

ABSTRACT OF THE DETAILS GIVEN (1) TO (8) ABOVE ; Name of the candidate Full postal address

Number and Name of the constituency and state Name of the Political party which set up the candidate (otherwise write 'Independent') (a) Number of cases in which conviction order passed (other than those referred to in Form 26) (b) Total number of Pending cases where the court(s) have taken cognizance PAN of

(a) Candidate ) Spouse

Dependents

Sh. Smt. Kum. Ajit Bhunia Vill. - Kismat-Narajole, P.O.- Harirajpur, P.S.-Daspur, Dist.- Paschim Medinipur, West Bengal. 230 Daspur Assembly Constituency. West Bengal All India Trinamual Congress (A.I.T.C)

NIL

One

Year for which last Income Tax Return filed N.A N.A N.A

Total Income Shown

N.A N.A N.A

Asset

TjPurchase Price and Development Cost of Immovable Property (Total Value) ii) Approximate Current Market Price of Asset (Total Value) Liabilities i)Government Due (Total) ii)Loans from Bank, Financial Institutions and others (Total)

Details of Assets and Liabilities in rupees Self

Rs. 39,625.00

Rs. 1,65,000.00 N.A

Rs. 1,30,000.00

Rs. 35,000.00 NIL

Rs. 35,000.00

Spouse

Rs. 1,20,000.00 NIL

N.A

NIL

NIL N A

N.A

Dependent - 1

NIL

Rs. 15,000.00

Rs. 15,000.00

Rs. 15,000.00

NIL N.A

N.A

Dependent -2 NIL

NIL

N.A

NIL

NIL N.A

N A

Dependent 3 NIL

NIL

N.A

NIL

NIL N.A

N.A

Advecato, NOTARY PUBLIC

ffot Grmtal Sub-ighvisloS)

9. Highest educational qualification :

Passed Higher Secondary Examination in the year 1970, from Narajole Mahendra Academy under West Bengal Board of Secondary Education. (Give details of School / University education with full form of the certificate /. Diploma / degree court) (Name of the School / College / University and the year in which the course was completed.)

VERIFICATION

I, The deponent, above named, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed there from. I further declare that: (a) there is no case of conviction or pending case against me other than those mentioned in item 3 and 4 above : (b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 5 and 6 above.

Verified at Ghatal this the eleventh day of April 2011.

W f e i a / Sob ffl

_ J^j/S0^ *toimi!y agragd b/ £

before me on this d n y g « ~

fcho is du!yjde|tified SrL,.., ^

•* 1 ^ . ^ . . . ] ™ $ ^ * ^ ' Ld. Advocate / P B̂ rtmrifr-

/7SUJIT HAZRA I V / ^ / h N O T A R Y ( 7 '

GOVT. OF INDlll

?JWm WEST BENGAL

AFFIDAVIT

ANNEXURE XIII C

(CHAPTER, PARA 9.3)

FORM 26

( SEE RULE 4A )

45AA 5 7 2 9 2 3

I Affidavit to be fursished by the candidate before the returning officer for election to

1 West Bengal Legislative Assembly For election to West Bengal Legislative Assembly (Name of the House)

I From 230 - Daspur Assembly Constituency (Name of the Constituency)

MUJIT H A % " A j i t Bhunia, son / daughter / wife of Late Kalipada Bhunia Aged 57 years, A d v „ & t « b s i d e n t o f V i n _ Kismat-Narajole, P.O.- Harirajpur, P.S.- Daspur, Dist. -

N9IAR,Yc w U r? L ^J?aschim Medinipur, 1« andidate at the above Election, do hereby solemnly affirm and state on oath

.., • / a o U ' - - ' -y- / • ^ « c e ( s ) ^ h ; h a b j c > , ; ,j ;•.-„•>-• ;••> i pendingeai.;-is)in whiaj • c h a r g e ) ••• •

j.. . . . v -rs iH, c«inpcjXftijur-:>diction.

(ii)

(iii)

(iv) (v) (vi)

2.

If the deponent is accused of any such offence(s) he shall furnished the following information: (i) Case/First information report No./Nos : 143/8 Date - 29/10/08

Police Station(s): Daspur , District(s): Paschim Medinipur, State(s): West Bengal. Section^) of the concerned Act(s) and short description of the offence(s) for which the candidate has been charged : 147/148/149/325/326/379/427 I.P.C Court(s) which framed the charge(s): A.C.J.M, Ghatal. ' T J 1 " '*' u

Date(s) on which the charge(s): 157/8 Date - 08/12/08 "Whether all or any of the proceeding(s) have stayed by any court(s) of competent jurisdiction : N.A. 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 covered in sub-section(3), of section 8 of the Representation of the People Act. 1954 (43 of 1951) and sentenced to imprisonment for one year or more.

If the deponent is convicted and punished as aforesaid, he shall furnished the following information: i) Case/First information report No./Nos : N.A. ii) Court(s) which punished: N.A.

.StationCs): N.A. District(s): N.A.

f the concerned Act(s) and short description of the offence(s) for which the candi-arged: N.A. ich the sentence(s) was/were pronounced: N.A. sentence(s) have been stayed by any court(s) of competent jurisdiction : N.A.

latal Date : 11/04/2011 Signature of Deponent

VERIFICATION

I, above named deponent, do hereby verify and declare that the correct to the best of my knowledge and belief, no part of it is concealed therein*

.ww N(^jfiedai.GhAfa.l fhfo.^leventh day of April 2011.

fcefore me on this da I I U

«ho is duly id ulyic T '

ntif!ed 3

«•».•« Ld. Advocate / PoieoaaUf Rlown to me.

Mop-

^jfsUJlT H A Z R A / l / ^ / l j NOTARY I

G O V T . O F INDIA Cbatal, Pswcium Medinlpw

contents of this affidavit are true and false and no other material has been

Signature of Deponent

R | % | t l

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