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&3 MAR

AFFIDAVITfor election to LOKSABHA

from 46 - RATNAGIRI - SINDHUDURG constituency

I, JADHAV, AJAY son of JADHAV, DADA aged 28 years , resident of B-279,

Vaishawada, Sawantwadi, Tal. Sawantwadi, Dist. Sindhudurg, State - Mal--=sgtxat' V

A at the above election , do hereby solemnly affirm and state on oath as under:-

I

MP. D.PARAB

B. A. LL. B.Advocate & Notary

I

(1)(2)

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

i) Section of the Act and description of the offence for which cognizancetaken : - NIL

ii) The Court which has taken cognizance : - NIL

iii) Case No. - NIL

iv) Date of order of the Court taking cognizance : - NIL

v) Details of appeal (s) / application (s) for revision etc.,if any , filed against aboveorder taking cognizance : - NIL

(2) That I give herein below the details of the assets ( immovable, movable, bank balanceetc. ) of spouse, my dependents and myself*:

A. DETAILS OF MOVABLE ASSETS

\NOM

(Assets in joint name indicating the extent of joint ownership will also have to be given )

S. Description Self Spouse Dependent - Dependent-o. Mrs . Alisha Ku.Vignesh

i) Cash Rs. Rs. NIL NIL

i .

30,000/- 10,000/-

ii) Deposits in Banks NIL NIL NIL NILFinancial Institutionsand Non-BankingFinancial Companies

iii) Bonds, Debentures NIL NIL NIL NILand Shares incompanies

iv) Other financial NIL NIL NIL NILinstruments, NSS,Postal Savings, LICPolicies, etc.

v) Motor Vehicles NIL NIL NIL NIL(details of make,etc. )

vi) Jewellery (give 15 gm. worth 30gm. worth 8gm.worthdetails of weight Rs.22 ,500/- Rs .45,000/- Rs.12,000/-and value)

vii) Other assets, such NIL NIL NIL NILas values of claims/interests

Note : Value of Bonds/ Shares / Debentures as per the latest market value in Stock Exchange inrespect of listed companies and as per books in the case of non listed companies should be

given.

* Dependent here means a person substantially dependents on the income o ME

P. D:PARABB. A. LL. B.

Advocate & Notary

(3)B. DETAILS OF IMMOVABLE ASSETS

(Note :- Properties in joint ownership indicating the extent of joint ownership will also have tobe indicated )

S. Description Self Spouse Dependent - Dependent-o. Mrs. Alisha Ku.Vignesh

i) Agricultural Land- 10 Gunta - Kolgaon- Nil Nil Nil

Location(s) Survey Bhomwadi,number(s)-Extent Sur.No.46, H. No.-7(Total measurenment)- Current market value Rs. -1,00,000/-

ii) Non-Agricultural Land- 2 Gunta - Nil Nil NilLocation(s) Survey Sawantwadinumber(s)-Extent City Sur. No.2849,(Total measurenment) Sur. No.92,- Current market value Rs. 2,00,000/-

ii) Buildings(Cornn>e and Nil Nil Nil• residential) -Location(s) -

Survey/door number(s)Extent (Total measurement)-Current market value

iv) Houses/Apartments, etc.- House No. B / 279 Nil Nil NilLocation (s)-Su rvey/doo Vaishawada,number(s)-Extent(Total Sawantwadimeasurement)-Current market value Rs. 3,00,000/-

v) Others (such as Nil Nil Nil Nilinterest in property)

3. I give herein below the details of my liabilities / overdue to public financial institutions andGovernment dues

(Note - Please give separate details for each item )

S. Description Name & Address of Bank/ Amount outstandingN o. Financial Institution (s) as on 31 March 09

Department(s)

(a) (i) Loans from Banks Sneha Nagari Patsanstha

Br. Sawantwadi, Rs. 16,000/-

Loan -A/c No. 495

(ii) Loans from financial institutions Nil Nil

(iii) Government dues Nil Nil

a) Dues to departments dealing with Nil Nilgovernement accommodation

B E

P. D. PARABB. A. LL. B.

Advocate & Notary

(4)

S. Description Name & Address of Bank/ Amount outstandingN o. Financial Institution (s) as on 31 March 09

Department(s)

b) Dues to departments dealing with Nil Nilsupply of water

c) Dues to departments dealing Nil Nilwith supply of electricity

d) Dues to departments dealing Nil Nilwith telephones

e) Dues to departments dealing with Nil Nilgovernment transport (includingaircrafts and helicopters)

f) Other dues, if any Nil Nil

i) Income Tax including surcharge Nil(Also indicate the assessment Nilyear upto which income TaxReturn filed. Give also PermanentAccount Number (PAN)

ii) Wealth Tax (Also indicate the Nil Nilassessment year upto whichWealth Tax return filed.)

iii) Sales Tax (Only in case of Nil Nilproprietary business)

iv) Property Tax Nil Nil

4) My educational qualifications are as under :-

(GIVE DETAILS OF SCHOOL AND UNIVERSITY EDUCATION)

* S. S. C. -

* I. T, I. -

Kalsulkar English School,Sawantwadi

Kolhapur 2002

Industrial Training Institute , Sawantwadi 2001

wd^

Scf t eau n^vu o.cr'

DEPONENT

P. D. PARABB. A. LL. B.

IF2 APR 2009 Advocate & Notary

r

(&)

VERIFICATION

0.i

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 nothingmaterial has been concealed there from.

Verified at Sawantwadi this the24day of APRIL, 2009

DEPONENT

ME

1 o

Regd. No.662/96

P. D. "OARABB. A. LL. B

Advocate & NotarySNEHANKUR New Salaiwada,

Sawantwadi - 416 510.Dist. - Sindhudurg . Ph. 274457

1. 2 APR 2009

Solemnl ff

Noted & Re ist edat Serial No..^

y a irmed / d d forr ^ byr e' gg onent/ t^t Sri

1Clclp1 AY of N '0,n

410 Tai Q0.f^9Q1^1 WV_Dist(( itw+ Today atdIU9c who is iden '

Q) II whom I know nersoaliv