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Wry *gC ASSAM

{

10AA 281937

Afrdavit to bc lilcd by the candidatc along\

.a$' ased t[ yesrs, rcsidenr of Vill- Rolqmonqwe. p0&p/$ Dlpbu. Wrrd NFS Ditt-if,o" -^_.1 ^^-, (mention full postal address), 8 csrdidatc ar the

do hcrcby solcmnly affirm and strte on cth as urder:

I caodidate sct up by Indh! Nrtiorl Conqrc$ flNCt prrty (..nsme of

returdng ofrcer for el€ctiod to troulc of the people flrk $bhr) (n8me ofthc Hous€)from SA|ttonopour Dirtrict .(STt pdi|pctrbrv consttu€rrcy (Namc of the

/,A coDsdoencl)

J/- \ '^$

bxq),.$^f. 1 ,*r-^

"u$.;!t*t Tff@iff_Elt *nn t g$x , y,( or r.rtc xrl'rhcr Erlri

,rTg-Itlltfun vtV y "sm contcsting ss an Indep€ndent candidatc. (.. Strike out

2 f *hi#ver rs not spplicrbl€)

tY- ,t

^'!!.t(!.tt ^'l!

w*

-7-

(2) My name is enrolled in l9-Diph|| (ST) Lcsithtiv€ A$cmblv CooltitueN% Ars|o(N8mc of the constituency and th€ Sta!e), at Serial Nor 425 in psrl No!,!!E

(3) My contact telcphone numbe(s) is / are C!4!Z!!4!!(BL-9!5!!!S!E(M) and my e-nail id (if any) is ...... .................. NIL ...........andmysocialmedia accourts (ifsny) sre ... .........N&

(5) t fl6 / 8ln not accused ofany offenc{s) P||nishsble with irnprisonmcnt for two ycars or more

in a pending case(s) in which a charge(s) has / have been fiamed by the cout(s) of aomp€tcnt

jurisdiction.

Ifrhe deponent is ac{used ofany such offenc{s) he shall fimish th€ following informstion:-

(i) The following cis{s) is / arc pending against me in $tich charge hrve been framed by rhe

for an offcnce punishable with impri for

(ii) The following cas€(s) is / ar€ p€nding sgainst me in which cognizance has been taken bythe coun.

(The details of atl pending cases in which cognizanc€ have been tEken by th€ Coun,

<"\G

3\pa

aA

e;-

4 Details ofPermancnt Account Number (PAN) and status offillinc of income trx reitm.sl.No

Names PAN The financial yearfor which the lastrncome I8x rcum

has been filed

Total income shownin income Tax rctum

(in Rs.)

l. SelfShri Biren Sircb Encti AALPE 3{IE!'E asts- aoL4 F-. c rstu.hs

2.Spouse NIL .b('/ .\\ 1-z

3. D€pcndent - IMilr Kriok EtrcaiDi

ABAPE 482'C N'2-.t J..$12

4.Depend€nt - 2 .IO'S N\T NJ"2

5.Dependent - 3 C\rU N?, Nd

court tor an two yea$ or more:-

Case / First information Rcpon No. / with complete

details of concemed Policc Station / N1g

BS€ction(s) of the conc€med A9(9 and short description of the

offenc{s) for which charg/ rs'tP

Name ofthe Court, C96 No. and date oforder taking cognrzance: JslgD Coun(s) which qllled the charg{s) Ni4.E Dat{s) on wltfch the charge(s) was /were fi'amed N1,t

Whethe;zfll or any of the Foc€eding($ h8ve b€€n stayed by 8ny

co)f(s) of competeot j urisdiction.N1.0

ive ofthe ishme ot inc of should be m€ntioned.

d;*i*::T"'**

Name ofthe Cou4 Cas€ No. and

The &tails of cascs wlpre

section(s) ofthe Ac(s)

has ta&en cognizance,

.* \\2,l<Vtw

Applican(s) for revision (ifany) field

Sikha B

RegO t{o..Dpil

(6) I ffii/have not b€en convicted of an offenc{s) [other thsn any ofence(s) referred

!o in sutr's€ction (l ) or sub-s€ction (2), or cover in suLsection (3), of section 8 ofthe

Representation ofthe People Act, l95l (43 of l95l )land sentenced to imprisonment for one year

or more.

Ifthe deponent is corvicted and punished as aforesai4 b€ shall fumish the following

infornation : ln the following cases, I have been convicted and s€ntenc€d to imprisonmenl by a

coud of law.

(7\ That I give hercin below the details of the assets (movable and immovable etc.) ofmys€lf, my spous€ and all dependents :

A. Deteils of movable ass€ts:

Note : l. Ass€ts in joint name indicating the extent ofjoint ownership will also hsve to be given.Note : 2. In case of deposit/lnvestmen! the details iocluding Serial Number, Amourt, dale of

deposit the scheme, Name ofthe BanMnstitutioo and Branch are to be givenNote :3. Value of Bonds /Share Debenhles as pe. curlent rDarket value in stosk exchange itl

rcspert of listed companics and as per books in case of nonlisted comDsnies should begrven.

Note ;4. Dependent h€re has the sam€ meaning as assigned in Explamtion (v) under section 75 Aofthe Repres€ntation ofthe peopl€ Act l95l.

Note :5. Details includiog amourt is to be given separalcly in respect ofeach invesunent.

L."

\.

F\-

(\

a-.d

ffi;"tJ"''

The d€tails ofcas€s, Section(s) ofAc(s) and description of the N ?.2

B Name ofthe cour(s), case

'd and date (s) oforder (s) : N.r.e

Punishment inW*n ,,2 Ni.{

DwaVhas been filcd agaiDst the conviction

and tbe pres€nt stltus ofthc appeal :

Whether any$r1,t-

Sikha BrrtlahAlea'Karb Arrgrorg

ReCd i{o.-0PU

#!\tl,+lli',',UA

-4-

ffi

? z

E-af,<9g6f

EAl>-tsE<ZBil='q!9a, €.*:Ei,9" 'i

3.C;q€gEEL!9-qF5800 i+F&cE5t8 8x!E.tE5Ea'e'. 5eiPo 6€

9n

+FFEEFE t'l

S3 r'

si fl5E=5!'? =.2e7aE Hei EgE3 -FsE

?irFE*E.;Eq6

E6E.:9F;AFErAEaa29qe

ela9E.

zz*?

95

OP

<-a !l6 E.F

-o I9tr'.uE!FUPs, :;

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r :-g3.a5!rtig E F.q-i

F EFe, ss

zr zr zF

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tfI'F56E;tFEt

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xF

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z zF

z z zF

7l|z,a

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Fi&xiE. l--- E !':EE;-k -dR.faz

zF

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oag!.gJc

E$

,

F3t!.lIx=FFFI

Ftl

''{(^":Ft

G\"G*

€

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B. Details oflrnmovable Ass€ts :

Not€: l Prcp€rti€s injoint owne$hip indicating the cxtent ofjoint ownership willb€ indiclted

Note 2. Each land or building or alrarunent should be maintaircd s€parstely in this'N

MEs.*:ffli-JlSl

Agricultural ls6d

locsion G)

Survcy numbcr

(s)

Mit X.jokEtrgdpl

P.t.| Dorl6t

A€a (totdl

meEsutcmcnt m

aarcs)

l hcthcr ilherit€d

prop€rty (Yes or

to.)

Ddc of puchasc

rtr oas€ of sclf-

&quncd popcrty

Cost of l,rdd (in

cas€ of purcftss€)

at |hetime ofpurchasa

R!,r2r4&(xw-

Any invcsurcrr

o! fte land by

w'Y ofdcvcloprtr€ot,

con$ruction ctc.

Rubb.r

Pbtrnfirn for

frainiclr|tce ch.R!.20,m,m0/-

A!'proximafe

q|Ircnt msr*ct

rduc

Notr-Agricdtural

t^.trd :

Locatiotr (s)

S*v"y

Tcr Grrdan

owncd jobdy by

L.lj. Moh.n

EDgri & f rDilyat

Rongbolgghra,

Krrbi Arybr8md Sclf &

F.EIly of ViInoDgDontw..

Diphu

€/rr^ aj-fl, W

whather inhcritrd

Fopcrty (ycgno)NO NIL NIL NIL I'IL

Darr ofplrchrs.

i! oas€ ofsclf

acquircd prop€rty

I{IL NIL NTL NIL NIL

Cost of l.nd (ir

c.sa of purchrsc)

d thc tiDc of

Rr.l l.4qm0/-n.IL NIL NIL NIL

A[y mvcstncrlt

on thc l.trd by

wry of

dcvoloFrcnt

constuation etc.

R!.r,m,00,000/-

NIL NIL NIL NIL

Approxin&

curlrirt maket

vsluc

Rrl,llr49,(m/-NIL NIL NIL NIL

I <;

|lt

:']'-.

8-l

Cotrutr€fcial

builditrgs

(irchditrg

apdtsnents)

loc*ion(s)

NIL NIL

l. Ear.r Pctrol

Pudp.tKhcronl W6tXrrbi Aqlotr&P.rln.r|hip wllh

Mk r<rjok

Eogipi lxpbu

ard Mr. DharaD

N.lh Pr.!.d of

lrn}l' Dbt-Nogrotr

2. Otr FLt.tB.!.at Vihrr'

Ncr Dclhi'

6..t!ring 130{)

Sq. ft wtrh s

Iroor* vll. Fbt

nor- Il

I

Ulo(Groud

l*'l| 3- onc SD'I n rI

I 3 B.dd.d Rooo

I rt GuwrtrtlI

I Hi.d rb. trtr A

I Ho.t L ltirpur,

IlA.&taD.

NIL NIL/i.\/sI

6)

lioz

\)//'7r^J'"'fi\Regoa.\

o,$

Un s

o*

l"g{P'

1r-

Ofi''r'[olo.$i-r''

-, O(AlEa (tot ldaaswemcnt in

sq.fl)

<t"H', fctZ1. I Elahr

z l3lxt tq.ft.3. 3 B.d.d noom

}f2u f{d

I

]s->

\^\

+-id\

{

-aro

-e-

Built{p !r.a

(total

drcasuramc in

sq.ft)

NIL NIL NIL NIL NIL

Wt€ih€r inherit€d

Fopany o/es or

no)

NTL NIL NIL NIL rtaL

\,I.55

\r'J

3--f

^

c.,

{PN"rush\teHjlti

-.4t

D$e of purclasG

in csse of s€lf

sc4uned propqty

I\IIL NTL NIL NIL I{IL

Co$ of prop€tty

(in c!s. of

puchasc) !t thc

time of

r\ilL NIL

1. ns.l||',tll,(m/-2. Rt.25,O,0qt/-3. R .2a|x),m/- rt[|L NIL

Ary ltrvestmcnt

on $c propctty hy

wcy of

NIL NIL NIL NIL NIL

Approxilnatc

current (ral(ct

valuo

NIL ITIL1. Rt.5o,m,00/-2. Ri.3O,OO,odr/-

3. Rt.2s,qr,0qr/-

NIL FIIL

z&,iv

lncndcntiat

I butldinc

I (hcludins

.

I ap.rments)

I r"""ti-Cl

I Survcy numbe(s)

2 Ass.n TWC Ibulldlnara I

Enlnrbnot I

Rcc b||lldln3.t IRoqnoqxr., I

Dlphu, f..ru I

Andon&vldc I

P.tt t{o-368 I

e93:l1 Assam lYPc

bulldlng n.CMI Ho3pltal,

dphu, f.6lAnllon3; Vldc

P.tt l{0-311

rY6: /sixra t

WNILNIL NIL NIL

\Y

NIL rtm- NILBuih up ar.a (totd

mlsgtrcnent io

sc fr)

NIL NIL

I),l!

t'l^o.;1*

'l

NIL NIL NIL n.|LWhcthd hhcrit d

propcrty (Yes or

!o)

NIL

fho of ptdase

m cas. of 5.lf

acquir€d propcrry

NTL NIL

ItlL

NIL NIL NIL

NIL NIL NlLaost of propcrtY (in

c5rc of Pu!6hrs€) al

rh€ tim€ of

NIL

-n-

-j;Z

it-$,>

\.r-J-l

1

-eor)

Ary itrvlcbaot

o! lic led by

w8y

dq/clopo.d,

coiafuc'loll !tc.

IIIL N'IL NIL fatl, NIL

ApptoxiEdc

a||lltat ortct\d|r

r ir a!,gtm/-r. l& aPC,0/- flt|, NIL tvl, NIL

Oth.ri (so.h rs

itrE* in

Fop€(ty)

NTL NIL nflL nflL NTL

Tdl of cdtlotDltct valuc of(i) to (v) rbovc

rr, r,55,||,m/-$1L

*"t37,4,n1--$$?f J,.c'tA,

f"*"r--*t'-".*w;::L'",3"d,r$iii".'oe'l-01 w

- lo-

(t) I give hereir bclow the deteils of lisbi[ties /dues ofpublic./financial instittdions

Sovemmc :

(Note: pleas€ give s€psrate daails ofname ofbenl institutiorl entity or individual and

before each item)

*

rO

1b8

r!{_E}->

I

.€

l\Ft-:t\-ts| -,n

i:x{;$R€S.

Sp

Sl.No. Description S€lf Spous€ Dependsntl Depodcnt2 Dependent3

I Losn or dues 1o

BanUfinancial

institution(s) Name of

th€ bank or finmcid

institution, ADouDl

outstanding Nature

NIL NIL NIL nal|, NIL

lran or ducs to any

other individualdcntitY

other tban m€ntioned

above Nam{s) amount

outstsnding Nstute

NIL NIL NIL^m,

NIL

NIL NIL NILAny other liabilry NIL taIL

NTL MLC'aa"d totat of

LiEbilitiesNIL NIL fm

NIL NIL riarl, NIL

ll Govemment dues :

dues to depsrtnents

rbaling with

gov€mment

o".nmrnodetion

NIL

I

NIL NTLlSues-to-a"P"tt*t

I dealins with sundv of

I WAt€r

NIL NIL NIL

NIL NIL NILDues to deporunent

dealing with suPPlY of

electricity

Du€s o deportmcm

dealing wilh

Telephonesltlobiles

NIL NIL

NILNIL NIL NIL NlL

NIL NIL

.dtlC to-Cparttrtent

l-* with

lBovemment transpon

I (includinc sircrafts 8nd

I helicogeal

NIL NIL NIL

NIL

-"t" llry NIL NIL NIL NIL

- -

t-

N\S

at\

Iq

Af

(9) Details of profession or occupstion

(a) selfgg!_g!!f,&(IaLsru). (b) spouse.............. NrL(10) My educatioDl qualificalion is as und€r :

l. P$!ed Mrtric Eram h the y€rr from Borhrppurc Eish School

2. Pr$cd B.A. Errm ir the ycrr 1967 from Nowtrot Coll€qe

(Give d€tails of higbcs Schoolruniversity education mentioning thc full form of thec€rtificatddiplomr/d€g€e course, name ofthe SchooVCollege,/Univenity and the ycar in whichth€ clurse wss completed)

.'-

We8lth tsx dues I'IL A{IL NIL NIL NIL

Servic€ l8x dues NIL NIL NTL NIL NIL

MunicipaYproperty

Tax duesI{IL I'IL NIL NIL fatl,

Sales Tax dues NIL NIL NIL NIL NIL

Any other dues^lIL

tul, NL I\tIL NIL

lll Gland total of all

Gov€mmetrt duesNIL NIL NTL taL IL

Whether any other

lisbilities arc in

dispute, if so, mention

lhe smount involved

and the sdhority

before which it is

pendiqg

I\IlL ML NIL NIL ML

'sikna goruanrAle€-I. sati Anglrtlg

n"io nu.'oe'''oz

PART-B

(t l) ABSTRACT OF THE DE-IAILS GMN IN (l) TO (l0) OF PART -A

Sl.No N&!. of 6c candidtlcsShrt Blrcr slnrd Enld

\:_

CIf)

d

'd

Full posol rd&rsr vllL lotrrmdr.. W.rd No-5

P/O&P/SI Diphu

Irirt- Krrbi Alrlo'rt lirrnl* md trdc of thc ootrsitu.oca strd sttdc lAcEssi!--Plsdt{SD

P.dLd.trnrY Cootdluancv. As.p

Noc of thc political pdty which sct up thc

codidne (otherwisc rnite lndlp.od€nt)

lodLn N.liord Cotrllt . t INC)

(i)Totsl nmbcr ofp€trdirg cas€s whcr. ch{ges

havc bccn framcd by rhe coun fol offanoes

punishsblc wilh irnFisomcor fG two y.as or

mone

NO

(ii) rotal numuct of pqdirg clgcs whcrc

cour(s) iavc rakcn coSrizalc€ (otiol thsn thc

oascs m€dtiotrcd in itan (i) abov€ I

NO lffilfotat nunUct of casd fu which convic{€d rod

scnta{cad to iDprisoDnant for on€ yc{ or 6ore

NO

//17{d($riilP\L;o n"n

R"Ei6 PAN of Ycd of s/iich l&st

tncomt tat( nclum

filcd

Total incoma showtr

a. Candidatc AALPE 3$58 20lrl4 R!. 6.00.000/-

b. Spousc fm NIL ML

o. Drp€nd€r s ABAPE 4827ClaIL NTL

7 Dctaits .f Asstts atd lilbilitics in Rupces

D.!.riFion Sclf Spo{6a D.p.6dcn

I

Dcpottdadt

2

D.o€od.nt

lD.peod.tn

Morrabla A$cts

(totrl vdu€)NIL tal|- NIL NIL NIL NIL

B Imltrovabl€ NL NIL I'IL NIL NIL NTL

i+o-

I0'

o

I Purcbda priar of

salf ifitrovabl.

proFtyNIL NIL NIL NIL NIL NIL

.,oto{c.rt i r-p

It Dc'ralopbarn /clnltnlcion cost

of idrnovrblc

pmFty sicfpurchllc (ifrpplicrblc)

lv|, NIL NIL NIL NIL NTL

Appoxrmdc

o,'rqtt mlr*ct

pncc

NIL NIL NIL IYIL NIL rrall,

r. Sdf {cquird

u!ct! (tdd

vrluc)

(b) inh.ritd

rllcts (iotd

vilua)

I\tIL NIL NIL NIL NIL NIL

9 Liabiliti.s NIL NIL NIL NIL NIL NIL

CoYGrmcdt

durs (tolal)NIL NIL IIIL NIL ttal|, N'IL

ll Iams fror!

bel, ftrecidinstitutioos edorh63 (total)

NIL NIL t{IL It{IL NIL Ir.lL

l0 Li.bilitic6 tl|d arE und.r disput!

I Gov€rDmcnt

duls (totrl)NIL NIL NIL NTL IYIL NIL

ll l,oes fiotrr

be\6nEcid

i$tinrtions

and othqs

(torrl)

rt[L NIL NIL NIL NTL NIL

u(Giv€ d€tsib of hiShest sohooyu[ivenity cducaion mctrtiodnS thc firll fomr of tlc

c€rtificstc/diplood&gtoc @unF, trf,rc of tha 3chool/collcgc/Eiv"siry @d thc y€d in

whidl th. corrsc wss complcled)

J\^-A r PalJiet ---sz ,

G,u 1C4o Js r-t .tst.e N}? N/

2, LLg Q,U t1?t ,\-\2 -Nc'l, Nt-l? .\tt (-

- l?-

I

].s

q(t

0"i

q

o

ff**;'.:;:lxil'ldiAegO tto'OP

Kntot I

-14-

' 't:e t^;

;u*Jr{ l'"4

$F(

VERIFICATION

I, the deponent, above name4 do hereby veriry and dcclare that

tru€ 8nd correct to the b€st of ny knowledge and belief 8nd no pad of it is false and nothing

matcrial has been concealed there from. I firnher declar€ th81:

(a) There is no cas€ of conviction or pending c{s€ sgainst m€ other than thos€ mentioned in

items 5 and 6 of Psrt A and B above:

(b) l, my spouse, or my dopend€nts do not have any asset or liability, other than those

mcntion€d ir items 7 and 8 ofPart A 8nd items 8. 9 and l0 Pan B above.

-.,%!"#:'"

A","^ S;,16 €,-F-DEFotttENT

v ^ '

25f11/lr

Note: l. Affidavit should be filed latesr by 3.00 PM on the last day offilling nominations.

No&:2. Afidsvii should be swom bcfore an Oath Comrnissioner or Msgistrare ofth€ First Class

or before a Notary Public.

Note3: All column should be filled up and no column !o be left blant. If therc is no infonnation

to frImish in respoct of any it€m, eitlEr 'l lil" or "lvot applicable,', as thc case may be, should be

me ioned-

Note4. The affid8vit should be either typed or written legibly and rratly.,,

[F. No. H-t 1019(6]4012-Lcg-

/ Il Dr. SoNay Siogll Addl,

sccy.

Note: Th€ principol rul€s were publisbed vide rptification number S.O.859, d8ted the l5d April,196l and last amendcd vide notific8tions,

( l) Nunber S.O.728 (E), dared the 86 M8y, 2007.

(2) Nutnb€r S.O. 425 (E) dated 23d Februsry, 201 L

iUl:*r"$1

WE#trc-oi*Fff"mdu"ir *"

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