D€cla.

ation of Ass€ts and Liabllities

Ye.r 20lA-19
I, BII{ Y l(Ull,ltR llAll.llc S/O DlcAi{BER pD. titALLItC Aged 54 (FIFTY FOURTY) years. betonging to
DISTRIGT I DUSTRIES CEiTER sedice and presenuy working as cE ERAL ,]i{A]{AGER. give heretn
below the detalls of the assets (lmmovable, movable, bank balance, etc.) of mysetf, my spouse and
dependants* :

L D.trlf. ot moveble..E tr
(Assets in joint name indlcaung the extent ofiotnt ownership willalso have to be gtven)

st. Descrlption self Spouse Name Dependant-2 Dependant-2 Dependant-

(s) Name Name 3 Name
No.
RAVI SAHAY CHHAVT
SHRISTY
0) Cash 50,000 MIL 25,mO 30,000 NIL
( ) Deposit in Banks, RS- 3,00,000 NIL NIL NIL NTL
Flnancial Institutions
And Non-Banklng
Financial Companles
(iiD Eonds, Debentures RS 19,00,000 NTL NIL NIL NIL
ard Shares in
companies
(iv) Other financial uc NIL NIL NIL NIL
lndltutlons, NSS, 3,0o,000

Postal Savings, LIC

Policies, dc.
(v) Motor vehldes HONDA ML NIL NIL NTL
MOTERRCYCLE
(details of make,
MARUT]
etc.) WAGANOR
(vi) Jewellery (give NIL NIL NIL GOLD NIL
details of weight and lOOGM

value)
(vll) Other assets. such NIL NIL NIL NIL NIL
as values of clalms/
interest
Note :
Value of Bonds/shares/Debentures as per the latest market value ln Stock
Exchange in respect of listed companies and as per books in the case of non listed
companies should be glven.
*Dependant here means a person substantially dependant on the income of the
employee,

6e
 B. Detials of Immovablc a3slets as on 31.12.21118
[Note : Properties in joint ownership indicating the extent of joint ownership will
also have to be indicatedl
sl. Descrlption Self Spouse Name Dependant- Dependant- Dependant-
No. (s) 2 Name 2 Name 3 Name

(D Agricultural Land NIL NIL NIL NIL NIL

- Location (S)
- Survey Number(s)
- Extent (Total
measurement )
-Current market value
(iD Non-Agricultural Land NIL NIL NIL NIL NIL
- Locatlon (S)
- Survey Numbe(s) .
- Extent (Total
measurement )
-Current market value
(iri) Buildlngs (commerclal NIL NIL NIL NIL NIf
and residential)
- Locatlon (S)
- Survey/door
Number(s)
- Extent (Total
measurement )
-Current market value
( ) Houses/Apartments, NIL NIL NIL NIL NIL
etc.
- Location (S)
- Survey/door
Numbe(s)
- Extent (Total
measurement )
-Current market value
(v) Others (such as NIL NTL NTL NIL NIL
lnterest ln DroDerty)
(2) I glve herein below the details of my llabllltles/overdues to publlc financlal
institutions and govemment dues:
lNote : Please give separate details for each item]
sl. Description Name & address of Amount outstanding
No Bank/Financial Institution(s)/ as on 31.12.2018
Department(s)
(a) (i) Loans from bank HDFC DARBHANCA 50,000
(ii) Loans from financial NIL NIL
institutions
(iii) Government Dues : NIL NIL
(a)Dues to departments
dealing with government
accommodation
(b)dues to departments NIL NIL
dealing with supply of
water
(c)dues to departments NIL NIL
dealing with supply of
electricity
(d) dues to departments NIL NIL

dr,,
C-
 dealinq with telephones
(e)dues to departments NIL NIL
dealing with govemment
transport (including
aircraft and helicoDters)
(0 Other dues if, any NIL NIL
( b ) (i) Income Tax including NIL
surcharge [Also indicate PAN NO.-ABFPN 76541
the assessment year upto
which Income Tax Retum
filed, Give also permanent
Account Number (PAN)l
(li) Wealth Tax fAlso NIL NIL
indicate the assessment
year upto which Wealth
Tax return filed.l
(iii) Sales Tax [Only in case NIL NIL
of DroDrietary businessl
(iv) ProDerW Tax NTL NIL

C. PeEonal Detail
GPF/CFPIPRAN No. tNDlMOB|t4T
Gender M (M/F)

Date of Birth (DD/MM/YYYY)

1 1 0 9 1 9 6 4

Class/Group B (NBtc)
Cadre B.I.s
(Full Name e.g. B,A.S- - Blhar Administr_atve Servlce

B.S.S.- Bihar Secrdartat Se.vice dc,

Home District DARBHANGA

rhercby declare that the above details al€ true to the best of my
knowledge and beli€f'
sisn.tu,. hiagy hdq.,A q7 al 4
Name of Employee: LJ*^t *rro" *-*
P|ace:SITAMARHI Designation : GENERAL MANAGER
tY\ q Department tNDusrRrEs DEPART|E T
l-'"l\
Date:
-
Note: Pleise sign each page of the declaration. Ass€t declaration fomr
must be in A4 size white paper with computer typed (single sidc) in
pr€scribed format.l