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INDIA NON JUDICIAL
Government of National CaP ital Territory of Delhi
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qiqt-{ qqeCertificate No.
Certificate lssued Date
Account Reference
Unique Doc. Feference
Purchased by
Description of Document
Property Description
Consideration Price (Rs.)
First Party
Second Party
Stamp Duty Paid By
Stamp Duty Amount(Rs.)
""1', ,,,, |N-DL10585672077837S , i: " : :
,:' 16-Jan-2020 11:36 AM
rr\4pAcc (rv)/ dr71340s/ DELHI/ DL-DLH
suBt N-DLDL71 34032990531 54261 865
SAHIBAM
Article 4 Affidavit
Not Applicable
0(Zero)
SAHIRAI\,4
Not Applicable
SAHIRAI\,1
1oo(One Hundred only)
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- Form 26(See rule 4A)
AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITHPAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO LEGISLATIYEASSEMBLY OF NCT oF DELHI (NAIvfE oF THE HOUSE) FROM AC-52TUGIILAKABAD (NAME OF THE CONSTITUENCY)
PART A
I SAHTRAM **sor/deughter*xife-of Late Shri Suraj MaI Aged 59 years, resident ofH' No' 321 churiya Mohalla, Tekhand village, New Delhi-110020 (mention full postaladdress), a candidate at the above election, do hereby solemnly affrrm and state on oath asunder:-
(1) I am a candidate set up byAAM AADMI pARTy
(*xname of the political party) / ** .
(**strike out whichever is not applicable)
name ls eprolled in AC- 52, TUGLAKABAD, NCT oF DJLHI (Nq{ne of the
and the state), at Serial No. l00S in part No. g6.+
telephone number(s) is/are 99r004g7g7 and my e-mail id (if any) is
@gmail.com and my social media account(s) (if any) is/arell'J
(i) Facebook: www.facebook.com/pehalwansahiram
(ii) Twitter: www.twitter.com/pehalwansahiram
(iii) Instagram: www.instagram. com/sahiram.tuglakabad
nor.o
zo
,Is.
gr/"*
v(4) Details of Permanent Account Number (pAIg* and status of firing of rncometax return:
E
l1tl
Names [rnehinancialfear forwhich thelastIncome-Taxreturnhas beenEled
five Financial Yearson 31st March)
lncomein Income Tax
Rupees) for the
(i) : Rs.3,75,580/-
(ii) 2018-19: Rs.3117,170/-
(iii) 01 7-18: Rs. 3,1I,530/:
F
a Ils
ofi
NoLDC!
Zo
29^ o.
(iv) 6-17: Rs.2,84,0901-
SelfRam) AACPR3838B 2019-20
(v) 5-16: Rs. 2,69,970/-
(i) NOT APPLICABLE
(ii) NOT APPLICABLE
(iii) NOT APPLICABLE
(iv) NOT APPLICABLE
2Spouse
(Smt Balesh) No PAN allotted ApprrcaernNOT
(v) NOT APPLICABLE
(0 NOT APPLICABLE
(ii) NOT APPLICABLE
(iii) NOTAPPLICABLE
(iv) NOT APPLICABLE
3HUF (If Candidate
Karta/Coparcener)ls NOT
APPLICABLE APPLICABNOT
LE
(v) NOT APPLICABLE
(i) NOT APPUCABLE(ii)
(iii) NOT APPLICABLE
(lv) NOT APPUCABLE
Fe
I NOTAPPLICABLE APPLICAB
LE
NOr
(v) NOT APPLICABLE
(i) NOT APPLICABLE5
il2
NOTAPPLICABLE
I NorAPPLICAB
LE (ii)NOT APPLICABLE
77
PAN
NOT APPLICABLT '
5*?,rL
!t
LJglJ.
a: i,
Eg7
tJo
2'_()i
.jIt is mandatory for PAN holder to mention PAN and in case of no PAN, it
should be clearly stated "No PAN allotted".
(5) Pending criminal cases
Q) lrdeclare that there is no pending criminal case against me.
(Tick this alternative if there is no criminal case pending against the Candidate and
write NOT APPLICABLE against alternative (ii) below)
OR
(ii) The following criminal cases are pending against me: NOT APPLICABLE
are pending criminal cases,against the candidate, thenitick this alternative
off alternative (i) above, and give details of all pending cases in the Table
Table
II
(iii) NOT APPLICABLE
(iv) NOT APPLICABLE
(v) NOT APPLICABLE
(i) NOT APPLICABLE
(iDNOT APPLICABLE
(iii) NOT APPLICABLE6
\TD(iv) NOT APPLICABLE
Dependent 3NOT
APPLICABLE
NOTAPPLICAB
LE
(v) NOT APPLICABLE
C,-{il./
Ci
cr
z onc;
aCzt-'lm
aroiJ-l}.o'(Dz=O=.
with name andof Police Stationt-r
NOT APPLICABLE
l-NOT APPLICABLE
APPLICABLE
iCase No. with Name of thelco,r.t
(b) NOT APPLICABLE NOTAPPLICABLE INoT
APPLICABLE
7
(c) Section(s) of concernedActs/Codes involved(give no. of the Section,
e.g. Section.......of IPC,etc).
NOT APPUCABLE NOTAPPLICABLE
NOT APPLICABLE
(d) Brief description ofoffence
NOT APPLICABLE NOTAPPLICABLE
NOT APPLICABLE
(e) Whether charges havebeen framed(mention YES or NO)
NOT APPLICABLE NOTAPPLICABLE
NOT APPLICABLE
(0
4If answer against (e)above is YES, thengive the date onwhich charges wereframed
NOT APPLICABLE NOTAPPLICABLE
NOT APPLICABLE
(g)
YES or NO)
beenthe
NOT APPLICABLE NOTAPPLICABLE
NOT APPLICABLE+
a".t'i
TH f;.
Sd,{-
7
(6) Cases of conviction
(i) .
('fiek tlds alternafive; iFthe eandidate has not been eonvieted and rvrite NOT
TPPLI€ \3r E *gainsFarternative (ii) belew)
OR
Gi\t{havebeen convicted for the offences mentioned below:,
Qf the candidate has been convicted, then tick this alternative and score off alternative
(i) above, and give details in the Table below)
FrR NO. 379t99
PS.: OIAState Vs. Bahadur &Ors"
FrR NO.127l97
PS:OIAState Vs. Sahi
Ram Pehalwan &Ors.
(a) Case No. FrRNO.534116Cr. Cases 1262812018
PS.: OIAState Vs. Sahi Ram Pehalwan &Ors.
Ms. Gurmohina Kaur,Ld" MM. Saket, ND
Order on Quantum ofSentence passed by Sh.
Anubhav Jain,Ld. MM,Saket, ND
Sh. DharmeshSharma, Ld. MM
(b)
./-
Name of the
Court
Sh. Samar Vishal, Ld"ACMIWPHCAID
Under Section| 47 / | 48/ 149 I 186133213
53 IPC
U/s 3 ofThe West BengalPrevention ofDefacement ofProperty Act,1976.
(c)
, '.;L!t
Under Section 3241341 I 506/34of IPC
Alleged involvement inan altercation at thetime of incident whendemolition drive was
being conducted byDDA with the help ofPolice.
Pasting of poster(d) Brief description
of offence for
which convicted
Wrongfully restrained andassault upon complainant byaccused for an issue ofconstruction of road by MCD inthe area.
(e)
*!
/ .'.
Order of Conviction:0s/07/2017
Order on Quantum ofFine:15/12/2017
30.07.1998& Lok Adalatorder dated02.08.1998
Dates of orders
of conviction
Order of Conviction:3r/a7/2018
Order on Quantum of Fine:06109/2018
Fine of Rs.3000/- andbenefit of section 428Cr.P.C.
Fine of Rs.1,000/-.[0.
?)r
Fine of Rs.2,00,50ry-.
NO NO(e) Whether any
Appeal has been
rES
Table
+
ZR:.
PUnishmbnti ;rri,' .--- l J
1*g:* ,: ..,:,.1i'
:'.--- -. .-.. . . - ', '. -
'-'i,'.-;.,'.-'u'
filed against
conviction order
(Mention YES
or No)
(h) lf answer to (g)
above is YES,
give details and
present status of
appeal
CA.No.13612018Patiala House CourtSahi Ram Pehalwan & Ors Vs.StateDisposed off on 15.12.2018
APPLICABLE NOTAPPLICABLE
(64) I have given full and up-to-date information to mypolitical party about all pending criminal
cases against me and about all cases of conviction as given in paragraphs (5) and (6).
lHtwhom this Item is not applicable should clearly write NOT APPLICABLE
IN 5(i) and 6(i), abovel
be entered clearly and legibly in BOLD letters.
to be given separately for each case under different columns against each
3. Details should be given in reverse chronological order, i.e., the latest case to be
mentioned first and backwards in the order of dates for the other cases.
4. Additional sheet may be added if required.
5. Candidate is responsible for supplying all information in compliance of Hon'ble
Supreme Court's judgment in W. P (C) No.536 of 2011.
in joint name indicating the extent ofjoint ownership will also have to be given.
. ,, 17).,,,Ttat I giv. herciq h]o, * the:details of the assets (movqpfe and immovable etc.) of myself, my
of deposit/Investment, the details including Serial Number, Amount, date ofthe scheme, Name of Bank/Institution and Branch are to be given.
Bonds/Share Debentures as per the current market value in Stock Exchange incase of non-listed companies should befid
glveLof listed companies and as per books in
-{*/--
Note: 4. 'Dependent' means parents, son(s), daughter(s) of the candidate or spouse and any otherperson related to the candidate whether by blood or marriage, who have no separatemeans of income and who are dependent on the candidate for their livelihood.
Note: 5. Details including amount isto be given separately in respect of each investment
Note: 6. Details should include the interest in or ownership of offshore assets.
Explanationr- For the purpose of this Form, the expression "offshore assets"
includes, details of all deposits or investments in Foreign banks and
any other body or institution abroad, and details of all assets and
liabilities in foreign countries' ;
Spouse(Smt. Balesh)
HUF Denendefit-r
Depe4de Denendeit-rS.
No.Description Self
(Sahi Ram)
-tr,--'
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
ffirin hand- \'r"\.:,- iir\. , \\*-\f;\1.
\\ ,\Rs.25,0004 Rs.25,000/-
(ir)
.
4pPoJ(O a900lz9o=.
h
a)Indian OverseasBank,Okhla Phase-lNcNo.1 58601 000001829Balance as ont5.01.2020
Rs.4,91,952.00
b) Bank of India,OkhlaPhase- 1,
A/c No.602910100009203Balance as on
T5:01.2070
Rs.8,580.54
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE ABLE
APPLICNOT
deposits includingsaving accounts),
Deposits withFinancial Institutions,
Non-Banking
Financial Companiesand Cooperative
societies and the
amount in each such
deposit
{
t-)
ln
of
/t Iil t
(FDRs,
and all
Bank of India,Okhla Phase-1
A/c No.
602910100013260
Balance as on
15.41.2020
Rs.8,850.70
b) HDFC Bank,
Okhla Phase-II,
A/c. No.
59109910049797
Balance as on
15.01.2020
Rs.3,93,743.00
c) Bank of India.Okhla Phase-l(Election Account)A/c.No.6029rc|W0r3264Balance as on
15.0r.2420Rs.5,10,000.00
NILNOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(ui) Details of investment
in Bonds,
Debentures/SharesNIL
:
<^iln/-*
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNIL
of investment
NSS, Postal
instruments
Post office or
the amount
in any
Company
Insurance
and
.-
EH
EOf*JDYG, .,+'./
o{
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
APPLICANOT
BLE
NILNIL
and the
tn
or
grven
Trust etc.
firm,
NOTAPPLICABLE
NIL
Motor Vehicles:
a) Maruti Swift VDIRegistration No.DLSCDTOOOTPurchase in 2015 forfi.s.6,80,000/-
Maruti BrezzaZDI
in 2018 fort0,24,783/-
ehicles/Aircrafts/
Make, registration
;oP
U)(:
-l
o
(Details
etc. year ofand amount
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
a) Gold-350gmValue approx.Rs. 13,45,000/-b) Silver-500gmValue approx.Rs. 27,000/-
alue alrprox"200gm
7,69,000/-thing(s)
details ofand value)
-"i"
md units in;ompanies/ Mutual
Funds and others and
the amount.
(iv)
APPLICABLE
NOTNOTAPPLICABLE
APPLICABLE
NOT
riirI
-
B. Details of Immovable assets:
Note: 1. Properties in joint ownership indicating the extent ofjoint ownership willalso have to be indicated
Note: 2. Each land or building or apartment should be mentioned separately in this
format
Note: 3. Details should include the interest in or ownership of offshore assets'
1[
I'
(YIurl other assets such
value ofNIL NIL
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
lix) Gross Total value Rs.34,1L,376.70 Rs.18,97,632,54 NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
Denenderit-s
DeneldeHUFSpouse(Smt. Balesh)Self
(Sahi Ram)DescriptionS.
No.
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILGram Dabas,
Ieh.HasanpuaP Nagar
(i) Apricultural Land
Location(s)Survey nurnber(s)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL0.315 acreArea (totalmeasurement in acres)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPTICABLE
NOinherited
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL24-05-2011
lnacquired
rrlq'iptNng
,LJNOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILRs. 1,60,ffi0/-WibrI-ana (in case
ofpurchase) at thetime of purchase
',tl-
I
NOTAPPLICABLE
Denenderit-r
NOTAPPLICABLE ,..,"
l'+
t{
H
r*
f-;
CNOTAPPLICABLE
NOTAPPLICABLENILNIL
Any Investment on the
land hy way ofdevelopment,construction etc.
NOTAPPLICABLE
NILRS.9,00,0001-Approximate Currentmarket value
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNO
(iD Non-AsriculturalLand
Location(s)Survey number(s)
NOTAPPLICABLE
NOTAPPLICABLE
CANILN/AArea (totalmeasurementin sq. ft.)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILN/Aes or
inherited
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILN/Aof purchase inofself- acquired
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNILCost of Land (in case
ofpurchase) at thetirne of purchase,.:i
a)
s
npoo,,,* * ryct [.- <
o=:a-J
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNIL
(.t)
Zr__l
J-I.:
.;J
Investment on the
land by way ofdevelopment,construction etc.
Any
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNOTAPPLICABLE
NILApproximate currentmarket value
NOTAPPLICABLE
NOTi{PPtICegrB ABLE
NOTAPPLICABI,ENIL
s)uding
NIL
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNILo
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNIABfrtt-lrp-$fea (total
moasuierir'ent in sq. ft .)---"", "i': /
|.- '-l
s
/_^
'1
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
iiiroperty
(iii)
-/::1tj
NOJAPPLIC
apartments)
ffi-ryt,
in sq. ft.)
I . :':.. j ::. :::
i
-
1
1),iirl;a
oai)i.J
d
I
NOTAPPLICABLE
NOTAPPLICABLE
CANILN/AWhether inheritedproperty(Yes or No)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILN/Aofpurchase inofself- acquired
NOTAPPLICABLE
CANILNILCost of propertY (incase ofpurchase) at
the time of purchase
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLENILNIL
Any Investment on theproperty by way ofdevelopment,construction etc.
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILNILApproximate currentmarket value
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL
a) H.NO 321
Churria MohallaVill. TehkandNew Delhi
b) T-56 TekhandExtn Delhi
s)(s)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLENIL
a) 7200 sq. ft.
b) 900 sq.ft.
I lu_ Area (Totalmeasurementin sq. ft)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL
a'57200 sq.ft.
b) 900 sq. ft.Built up Area (Totalmeasurementin sq. ft.)
NO.T, ,.:
APPLIC ]
ABLE
\Qf, .
APPLICABLE
APPLICABLENIL
Whether inherited
K*,NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLENIL
NOT
NOTCABLEself- acquired
purchase in
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NILofproperty (inofpurchase) at
NOTCABLE
time of purchase
nd
ri
\IOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(iv1
RLE
$6J:.,,:APPLICA
{YPS . ,
bIYES
-
"*'--)
BaoZ
fr(i:al
f\ d
herein below the details of liabilities/dues to public financial
and government:-
(Note: Please give separate details of name of bank, institution, entity or
individual and amount before each item)
l) rb
r..l O"
b)NorAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLENIL
NOTAPPLICABLE
a) NIL
b) NrL
Any Investment on thetand by way ofdevelopment,construction etc.
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLENIL
NOTAPPLICABLE
a) Rs.60,00,000/-
b) Rs. 14,00,000/-
Approximate currentmarket value
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL(v) Others (such as
interest inproperty)
NIL
(Yi)
-: r.
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
RS. 83,00,000/- NILTotal of currentmarket value of (i) to(v)3bove
Denendefit-r
Def,ende DependenSnouse(Smt'. Balesh)
HTIF
(Sahiram)Self
S. No. Description
l
rl(NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
I\[ILr-i
lz-r€ ,>XCz
Loan or dues toBank/Financiallnstitution(s)
loan
tution,
-{NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NIL
dues to any
Name(s), Amountoutstanding, nature ofIoan
other thanabove. I\{IL
n
zo
,*r",, , ,
a
HE1
Any other liabilit-vNIL NIL
NOTAPPLICABLE
Grand total oftiabilities NIL NIL
NOTAPPLICABLE
H
A:lro
df .-5o. cl<cct-.za--i
-{
to departments (A)Has the Deponent been in occupation ofaccommodation provided by the Govemment at anytime during the last ten years before the date ofnotification of the current election ? NO
with
(B) If answer to (A) above is YES, the followingdeclaration may be furnished namely:-
(i) The address of the Government accommodation:
x
aCzUxl
(ii) There is no dues payable in respect of aboveGovernment accommodation, towards-
(a) rent; NOT APPLCABLE
(b) electricity charges; NOT APPLCABLE
(c) water charges; and NOT APPLCBLE
(d) telephone charges as on ...NOT APPLCABLE..(daIe)
fthe date should be the last date of the third month prior tothe month in which the election is notified or any datethereafter].
Note-' 'Nol Dues Certificatet... ,..:
fromthe' agenclesrespect of rent, electricity charges, water chargestelephone charges for the above Governmentaccommodation should be submitted.
to departmentwith
transportaircrafts
)NIL
NIL
and
.ir o(1")aa:n:4.O=.
-D\)
C\>:C)
iifi?:{].
' ..i
NOT [.lOT lNorAPPLTCA lePPuca lar nr,rcalBLE Ftr PENOr Nor NorAPPLTCA larrlrca laPPrrcenBLE FLE PE
/rzEs.aig/!1. tick tkrnnrnnriqfp
(ii)
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
cJ
a
profession or occupation:
Social Worker/ Political Activist/Farmer
: Housewife
A) Details of source(s) of income:
(a) Self :l. Income from Salary2- lncome from House Property (for rental income from the owned properties)3. Income from other sources (for interest income from saving u""orrrtg.
Contracts with appropriate Government and anypublic company or companies
of conhacts entered by the candidate... ...ML... ....
of contracts entered into by q)ouse .... . .NIL. . . . . . . ..
of conkacts entered intobydependents ... lVL..
of contracts entered into byHindu undivided Family or trust in which the
/
I
{ s
(iv) Income Tax duesNIL NIL
NOTAPPLICABLE
NOTAPPLICABLENOTAPPLICABLE
(v) GST duesNIL ML
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(vi) Municipal/Property taxdues NIL NIL
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(vii) Any other duesNIL NIL
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(viii) Grand total of allGovernment dues NIL NIL
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
)
if so, mentionamount involvedthe authority
any other
which it is
NIL NIL
INOTlapprrcahr-e
Norhpprrcabr-B
Norlappucatsrp
APPLICABNor
LE
o"
i
\*,
(c) Source of income, if any, of dependentS,...... NOT
NOTAPPLICABLE
NOTAPPLICABLE
I
afe rn
3,8c- =rfIl:
*,a- .:' ia(r'lJ ft-ft' ):
a',.t
a:,
lgfi
,fcandidate or spouse or dependents have interest ... NIL
(e) details of contracts, entered into by Partnership Firms in which candidate or spouse ordependents are partners ... NIL
(f) details.of contracts, entered into by private companies in which candidate or spouse ordependents have share ... NIL ...:. :...
(10) My educational qualification is as under:
1lft class from Govt. Boys. Sr. secondary School Badarpur, New Delhi, 19g0
(Give details of highest School / University education mentioning the full form of the certificate/diploma/ degree course, name of the School lCollege/University and the year in which the coursewas completed.)
T
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Iil
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d:
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! PART _ B
(11) ABSTRACT OF TIIE DETAILS GIYEN IN (1) TO (10) oF PART - A:
SAHI RAMof the candidate
Mohalla, Tekhand Village, NewH. No.321 ChuriyaI 10020
postal address
AC-52 Tuglakabad, NCT of Delhiconstituency andand name of the
AamAadmi PartYof the political PartYcandidate (otherwise write
which set uP
Independent')
NILotal number ofpending criminal cases
03 (Three)Number of cases in which convicted
Total Income ShownYear for which last Income TaxReturn filedPAN of
Rs.3,75,580/-2019-20AACPR38388
NILNILNo PANallotted(Smt. Balesh)
NOT APPLICABLENOTAPPLICABLE
HUF
NOT APPLICABLENOT APPLICABLENOTAPPLICABLE
Dependent
-31Spouse
(Smt.Balesh)
Not NotNotb
Notoxfrlt"Rs.18,97,632.54Rs.34,11,376.70
Moveable Assets(Iotal value)
NotNot NotAnnlic
dEte
NotAonlicitite
NIL,60,000/-
I
ame
and tiabilities.: (inctuding !,,ff,{ory assets) in
LLrP1es, :',
flonendl)pnendent'-2
SelfDescription
A.
B.
Annflicab ApplicableI
-
!
II
(a) Self-acquiredassets(Iotal Value)
(b) Inherited assets(Total Value)
NIL
IU
&
{_)
d
NIL NotAnnlic
dEIe
NotApplica
bIe
Not
fotl"
RS.9,00,000/-
RS.74,00,000/
NIL
NIL
*#X"Not Not
Applica-6IeNot
TdX"Not
bilities
duesotal) NIL NIL
OT
NIL NILLE
dues
NIL NILfrom Bank,al Institutions
others (Total) NIL NILLE
1 I e class from Govt. Boys Sr. Secondary Schoor, Badarpur, New Derhi, I9g0
highestVE
course,details of
educational qualification
)
x.t
/
Not
\ ->',; .*- ^
(l'.t
that are under dispute
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
(IIJ NOTAPPLICABLE
NOTAPPLICABLE
NOTAPPLICABLE
['.lOTAPPLIC
Schoolnanoe
,,4
!
VERIFICATION
- ---: :-.::,ilt. 3bo\,e named, do hereby verify and declare that the contents of this affidavit
-: :-: 1-.,: .::rilr to the best of my knowledge and belief and no part of it is false and nothing
::,:-=:.'-: -; 'reen concealed there from' I further declare that:-
: , -i:ere rs no case of conviction or pending case against me other than those mentioned in items 5
=d 5 of Part A and B above;
(b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in
it..ni Z una S of Part A at a items 8, 9 and 10 of Part B above'
Verified at...New Delhi.. this the. ..20th...day of...... January, 2020""'
DEPONENT
ru Y ptlBx,tr{-
ll rAN zoza
Note: 1. Affidavit should be frled latest by 3.00 PM on the last day of filing nominations'
Note: 2. Affidavit should be sworn before an oath commissioner or $agistrate of the First-
Ciass oib"for" a NotarY Public'
Note: 3.All columns should be filled up and no column to be left blank' If there is no
information to fumish in respect of any item, either "Nil" or "Not applicable", as the
case may be, should be mentioned.,
Note: 4. The affrdavjt should be either t}'ped or writtenlegibly and neatly'
Note: 5. Each page of the Affidavit should be signed by the deponent and the Affrdavit should
bear on each page the stamp of the Notary or oath commissioner or Magistrate before
hom the Affidavit is sworn.
1.J,?
H
7
I
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