UT ADMINISTRATION OF DAMAN & DIU OFFICE OF THE COLLECTOR-CUM-DEO-RETURING OFFICER COLLECTORATE,

DAMAN.

No. 13/07/Special Summary Revision/2013-14 Dated 15/05/2013

Subject: - Affidavit to be filed by the candidates with their nominations paper- medication of format –regarding

Sir,

With reference to above cited subject, please find enclosed herewith a copy of

letter No. 3/4/2012/SDR dated 24/08/2012 along with its enclosure i.e. Notification of

amendment of Form -26 received from the Election Commission of India. New Delhi for

your information.

Kindly acknowledge the receipt of the same

(Asha Chaudhary) Dy.Collector(HQ)/ARO,

Encl :- As above 1-Daman & Diu Parliamentary Constituency Daman.

To,

1. The President, Bhartiya Janta Party, Daman. 2. The President, Indian National Congress, Daman. 3. The President of NCP Party, Daman. 4. The President Samajwadi Party Daman 5. The President Janta Dal (U),Daman

By Speed Post

ELECTION COMMISSION OF INDIA Nirvachan Sadan, Ashoka Road, New Delhi-110001

No. 3/4/2012/SDR Dated:-24thAugust, 2012

To, Chief Electoral officers of all State and Union Territories

Sub:- Affidavit to be filed by the candidates with their nomination paper-modification of format - regarding.

Sir/Madam,

The candidates at elections to the Parliament and the State Legislatures hitherto wererequired to file two affidavits: one, in Form -26 appended to Conduct of Elections Rules 1961 and the other, in the Form prescribed by the Commission, vide its Order No. 3/ER/2003 dated 27.03.2003, as subsequently modified by the letter of even number dated 25.02.2011. In the affidavits, the candidates are required to declare information about their criminal background, if any, assets, liabilities and educational qualifications.

2. On a proposal moved by the Commission for amalgamating the two affidavits into one format, the Govt. has amended Form 26 so as to include in it all the information that was sought in the two separate affidavits. The Ministry of Law and Justice have notified the revised format of Form 26 in the Gazette of India on 01.08.2012. A copy of the said notification dated 1st August, 2012 is enclosed herewith.

3. In view of the amendment to Form-26, all candidatesshall, hereafter, file only oneaffidavit in the revised Form 26 notified on 01.08.2012(at elections to the Parliament and State Legislatures). The requirements to be followed while filing the affidavit have been mentioned in the notes given at the end of the format. Further, as already directed in the Commission’s letter No. 3/ER/2011/SDR, dated 1st September, 2011, the affidavit should be on stamp paper of such denomination as prescribed under the State Act on the subject.

4. The Commission has directed that the revised format of the affidavit should be brought to the notice of the Returning Officers for all elections conducted by the Commission, including elections to RajyaSabhaand Legislative Councils ( in the States having Legislative Council) with instructions to ensure that this is brought to the notice of all concerned.You may kindly ensure that all the Returning Officers, including Returning Officers for elections to Council of States and Legislative Councils, receive a copy of this letter along with the notification of amended Form-26 and acknowledgement of receipt be obtained from every Returning Officer in the State. A consolidated

certificate that all the Returning Officers have received the instructions may be forwarded to the Commission within one month of receipt of this letter,

5. You are also requested to furnish a copy of this letter along with copy of the enclosed notification to every political party (including registered unrecognized parties) having headquarters in your State/UT, including the State Units of recognized National and State political parties.

Yours faithfully,

(Ashish Chakraborty) Secretary

---

- -- - - --

• REGD.NO. D. L.-33004199 - . ---·~---.

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[:he <!3aLett~ of ~ndia EXmAORDINAR'r'

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{1) ~c:p Cf)l.3fT.728(3l'), nR'R9 8 ~. 2007 I

(2) ~ Cf)T.3li.425(3l). ~ 23 ~. 2011

MINISTRY OF LAW A~U JUSTICE

(Legislative.Department)

· NOTIFICATION

New Delhi. the 1st •\ugust, 20 I :2

fc)',-~T 7fm-­

s.o . 17J2(E).- In exercise of the powers conferred by section I69 of the Representation of the People A.ci. 195 I (43 Of 1951). the Central Government, after consulting the Election Commission, hereby makes the following rules further to amend the Conduct of Elections Rules. 1961, namely: ­

l. (/)These rules may be c~lled the Conduct ofElections (Amendment) Rules, 2012.

(2) They shall come into force on the date of their publication in the Official Gazette.

2. In the Conduct of Electio~s Rules. 1961 , for Form 26 and the entries relating thereto, ~ the followi~ Form and entries shall be substituted, namely:­

"FORM 26 (See rule 4A) Please affix your

. recent passport size photograph here .

Affidavit to be filed b)· the candidate alongwith nomination paper before the returning officer for eleetion to .....•.................•.•.••. (name of the House)

from.... . ....•.... . •.. ......... ... . ....•constituency (Name ofthe constituency)

PART-A

I. ............ ... .. .. ................ **sonldaughter/v<ifc of ...... . .. ..... . ........... ... ...... . .. . Aged....... ........ .years, resident of ........................ . ..... . .. ... ...... (mention full

12 THE GAZETIE OF INDIA : EXTRAORDINARY [PART 11-Sl:l:. 3{ii)J

postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under:­

(1) I am a candidate set up by - ....... ... . .. . .. . .. :( ..name of the political" partv)/**arn contesting as an Independent candidate. ~

(**strike out whichever is not applicable)

(2) My name · is enrolled in............ .... .. ........ ...................(Name of the constituency and the State), at Serial No .... .in Part No..... .

·(3) My contact telephone number(s) is/are ............................... . .. and my e-mail id (ifany) is ........ . ........................ .... ... ........ ... . ... . ·:: . ... . .. . .. . ......... . ....... ..

(4) Details of Permanent Account- Number (PAN) and status of filing of Income Tax return:

Sl. No.

l. 2. 3. 4. 5.

Names .

Self Spouse Dependent-l D~ndent-2 Dependent-3 .......

PAN IThe financial yearIfor which the last Income-tax return

Ih_as been filed I

Total income sho\\-n in

Income-tax return (in Ru_pees} I

!

(5) l am/am not accused ofany offence(s) punishable with imprisonment for two years or more in a pending case(s) in which a charge(s) has/have been framed by the court(s) ofcompetent jurisdiction.

If the deponent is accused of any such offence(s) he shall furnish the following information:­

(i) The following case (s) is/are pending against me irt whi~h charges have been framed by the court for an offence punishable with imprisonment for two years or more:­

I

(a) Case/First Infom1ation Report I No./Nos. together with complete ~etails of concemed Police Station/District/State.

(b) Section(s) of the concerned Act(s) and short description

I of the_ offence(s) for which charged

(c) Nan1e of the Court, Case No. and date of order taking cognizance:

(d) Court(s) v.t.ich framed the charge(s)

(e) Date(s) on which the chan?.e(s) was/were framed - - ·­ .. - ·­ . -

I I

I

~------ ~

... nl'TTTl II- ~ 3(ii) I . . _.

en rWileiher a11 or any or the .I proceedings(s) have been stayed .bY any Court(s) of competent jurisdiction

(ii)The following case(s) is/are pending against me in which cognizance has been taken b); the court father than the cases mentioned in item {i) above):- ~

I(a) Name of the Court, Case No. and date of order ~ing

I cognizance: .,

I (b) The details ofcases where the i court has taken cognizance,I I section(s) of the Act(s) and !

description of the offence(s) for which cognizance taken

(c) Details of

l 1 Appeal(s)/Application(s) forIrevision (if any) filed against the above order(s) . I

{6) · I have been/have not bt..>-en convicted of an otTence(s) {other than any ofience(s) referred to in sub-section (1) or sub-section (2). or covered in sub-section(3), of section 8 of the Representation of the Peopk Acl, 1951 ( 43 of 1951)J and sentenced to imprisonment for one year or more.

If the deponent is convicted and punished as aforesaid, he shaH furnish the follo....,ing . information: In the following cases, I have been convicted and sentenced lo imprisonment by a court of law:

{a) 'The details of cases, Section(s) of the concerned ·Act(s) and description of the offence(s) for which convicted I

(b) N.ame of the Court(s), Case j ·No. and date(s.) of order(s): · ·

(c) . Punishment imposed (d) . Whether any appeal was/has

been filed against the conviction order. If so. details

I and the present status of the I appeal:

I

I (7) TI1at I give herein below the details of the assets (movable and immovable etc.) of myself, my spouse and all dependents:

A. Details of movable assets:

Note: l. Assets in joint name indicating the extent ofjoint ·oy,nership will also have to be given.

Note: 2. In case of deposilflnvestment, the detail ~ including Serial Number, Amount, date of deposit, the scheme. Name of the Bank/Institution and Branch ate to be given

14 .. lHE GAZETTE Of INDIA : EXTRAORDINARY fPART 11-Sa:. 3(ii))

Note: 3. Value of Bonds/Share Debentures as per current market value in Stock exchange in respect-of listed companies and as per books in case of non-listed companies should be given.

Note: 4. Dependent here has the same meaning _as assigned in Explanation (v) under section 75A of the Representation of the People Act, 1951.

Note: S. Details i~luding amount is to be given separately in respect ofeach investment

Sl. No. (i) (ii}

(iii)

I .. ! i !

(iv)

I

(v)

(vi)

Description

Casbinhand Details of deposit in Bank accounts(FDRs, Term Deposits and all other types of deposits including accoun~).

• with Institutions, Banking Companies Cooperative

saving Deposits

Financial i Non- 1

Financial I. I

and ' societies I

and the amount tn each such deposit Details of investment in Bonds, debentures/shares and units in companies/Mutual j funds and others and the amount Details of investment in NSS, Postal Saving, Insurance policies and investment in · · any Financial instruments m Post office or Insurance Company and the amount Personal advance given person or inCluding

loans/ to any entity firm,

company, Trust etc., and other receivables from debtors and the amount

Motor Vehicles/ I Aircrafts/Y achts/Ships (Details of Make, I registration number etc. year of purchase i

SpouseSelf Dependent-! Dependent-2

I

'

.

I I I

I I

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Dependent-3

.

I

I I I

I I I

!

. I

I

l "il'l 11-"IS~ 3(iiJ1 • 15 • and amount)

I(vii) !Jewellery, bullion and ' valuable thing(s) (give

details of weight and

(viii)

(ix)

value) _Any other assets such

1 as value of

Iclaims/interest Gross Total Value

,

B. Details of Immovable Assets:

Note: 1. Properties in joint ownership indicating the extent of j oint ownership will also have to be indicated

N.ote: 2. Each land or building or apartment should be mentioned separately in this format

fs. No.

Description Self Spouse Dependent-1 Dependent-2 Dependent-3 l I

(i) 1 Agricultural Land I Ii 1 ILocation(s) I

I I Survey number(s) I i

Area (total ! I

measurement in acres) l Whether inherited J I I property (Yes or No) Date of purchase in! ' I !I

· case of self-acquired I i !I I I ipro~rty i i

Cost of Land (in easy

I I Iof purchase) at the

! time of purchase. 1 I Any investment on the l !I I

land by way of ~ Idevelopment, construction etc. Approximate current market value

(ii) Non-Agricultural 1 Land: Location(s)

ISw:vey number(s} Area (total I measurement in sq.ft.) i I

I 1 \Vhether . inhe~ted ! I ! • 1"v1"-:'•.' {Yes or No) 1 i i

I I I

I Date of purchase in 1

I I I

case of self-acquired l Ij>I'O_Q_e1"1)' I

Cost of Land (in case I ! I

16 THE GAZETfE OF INDIA : tXTRAORDINARY . ... ,..--··­

of purchase) •at the time ofpurchase Any investment on the I~ land by way of ~

development, .

construction etc. Approximate current market value

(iii) • 1

Commercial Buildings .. i (including apartments)

I II •

-Location(s) , I ~-Survey number(s) '

Area (total I

I measurement in sq.ft.) I I

i IBuilt-up Area (total ! I

ii !

measurement in sq .ft.) II I Whether inherited I I property (Yes or No) I IDate of purchase ini case of self-acquired

I [ property !Cost · Of property (in

IIcase of purchase) at I

Ithe time of purchase

I IAny investment on the

! l1 property by way of II I II

1development. II construction etc.

l l Approximate current I

I I

! j market value I -­- ·I(iv) I~eside~tial Buildings I(mcludmg· ' :

I I I I apartments) : II

I' l I -Location(s) I 1 -surv~y number(s) iI i Area· . . (total I

I .

I ! ' j measurement in sq.ft.) J I!

I II Built up area (Total 1 II measurement in sq.ft.) I iI

I Whether inherited I. I

property (Yes or No) I j_

Date of purchase m i I

case of self-acquired

I property I Cost of property (in I .

I I case of purchase) at 1

i ! I

~t: time ofpurchase l I _l-1 !

--I . Anv investment on the I

II j tand by way of I I

iI l

1development, j i

\

I

•

f 'Wi 11- --T&~Ul!; J(ii ) I • 11

I '

IApproximate current ~. construction etc.

! marker value I (v) ~Others (such as

"interest in property) ! (vi) .

I Total of current

rmarket value of (i) to I(v) above

(8) I give 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 before each item)

! s . . I Description Self Spouse Dependent-! D~pendent-2 Oependent-3 : No .

(i)

(ii)

I Loan or dues to Bank!fmancial institution(s) Name of the Bank or

I.financial Institution,

IAmount outstanding. Nature of Loan

'! Loan or dues to any qther individuals/entity other than mentioned I I ~~ . I Name(s), AmoWlt I I outstanding, nature of lI loan ~o--th·e--r~li-a~bl-.II-. ~-----+---------r--------1------------r---------~,r---------~

I Id total of i liabilities ! i Government dues: I Dues to departments j dealing with I

1 government 1

~ accommodation i -I

I I Dues to department ! 1 j dealing \\ith supply of 1

f-__J electricity I

I IDues to department

I j dealing with supply of I telephones/mobiles

I

I

18

I THE GAZETTE OF lNDIA : EXTRAORDINARY (PART li-SEC. 3(ii))

(iii)

(iv)

Dues to department dealing with government transport (including aircrafts and helicopters) Income tax dues Wealth tax dues Service tax dues Municipal/Property Tax dues Sales Tax dues Any other dues Grand total of all Government dues Whether any other liabilities are in dispute, if so, mention the amount involved and the authority before which it is pending.

I

I I

(9) Details ofprofession or occupation:

(a) Self. .. ..... . ...... . ... . ... ... .... .. . . . . .... . . .. .. . . . . . (b) Spouse....... .. ... .... .. ... . .. . .. . .... .... .... . ... . . . .

(10) My educational qualification is as under:­

(Give details of hi~est School/University education mentioning the full form of the certificate/diploma/degree course, name of the SchooiJCollege/University-and the year in which the course was completed.)

PART-B (II) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART-A:

1. Name of the candidate Sh./Smt./Kum. 2. Full postal address I

3. Number and name of the constituency and State

4. Name of the political party which set up the candidate · (otherwise ·write 'Inde~nd.en!')

5. (i) Total number o f pending cases where charges have been framed by the Court for offences punishable with

iimprisonment for twoyears or more !

I

(ii) Total number of pending cases v.-here the court(s) have taken ~!lgniza._~ce [other than the cases mentioned in item (i) abovel

--- --

·­... r'lflT u--~ 3(ii)J

6.

7.

8.

: A.

Total · Number of cases in which convicted. and sentenced to imprisonment for one year or more (except for offences referred to in sub­sections (J ), (2) or (3) of section 8 of Representation of the People Act,

. }951]. PAN of

(a) Candidate (b) Spouse lc} Dependents Details ofAssets and Liabilities in Rupees

.....

Year for which last Total income shown· income Tax return filed ..;..

: Description Self Sp<>use Dependent-! Dependent­U

Dependent-Ill i Moveable Assets (Total value)

B. Ir:nmovablc Asset ~~~-~~~.~~~~~~-----+----·-- ·----------+---------~---------~

Purchase Price of self-acquired I immovable j . +-1

~-+Lp~lTC~)~~~rt~y-------+----~------r-1------- ~-------· H. Development/ I

1

1

construction cost I of immovable I j I property after ~ j I I ~·

l.

I purchase (if , 1 j applicable) I

,.1

1 III. Approximate I j ~~ j Current market j ~~ :

1 .

r-· 1__ price of- . I 1· IljW self-acquired assets (Total

1 Value) I

I (b) inherited 1 1

assets (Total . 1 Value)

9. Liabilities I.(i) Government dues

(Total) (ii) Loans from Bank,

financial 1Institutions and ! others (Total)

10. Liabilities that are under dispute (i) Government dues

rrotal)

THE GAZElTE OF INDIA : EXTRAORDINARY

• (ii) Loans from Bank, . Financial Institutions and others (Total} 1

11. • 1 Highest educational qualification: . · 1

(Give details of highest School/University. education mentioning the full form of I the -certificate/diploma/degree course, name of the SchooVCollegc!University and

the year in which the course was completed.) '

VERIFICATION

r. 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 and no part of it is false and nothing material has been concealed therefrom. l funher declare that:­

(a) there is no case of conviction or pending case against me other than those mentioned in items 5 and 6 ofPart A and B above;

(b) I. my spouse, or my dependents do not have any asset or -.liability, other than those mentioned in items 7 and 8 of Part A and items 8. 9 and 10 of Part B above.

Verified ar. . . . . .......... . .....this the . . .. ... ... day of. ..................... . . .. ... .. . . .... ......... . .

DEPONENT

Note: I. Affidavit should be filed latest by 3.00 PM on the last day of filing nominations. Note: 2. Atlidavit should be sworn before an Oath Commissioner or Magistrate of the

. First Class or before a Notary Public. Note: 3. All column should be filled up and . no column to be left blank. If there is no

information to furnish in respect of any item; either "Nil'' or "Not applicable''. as the case may be, should be mentioned,

Note: 4. The Aftidavit should be either typed or written legibly and neatly.".

(F. No. H-11 0 19(6~12012-L¢;;. 111

Or. SANJA'r' SINGH. Addl. Sccy

Note: The principal rul.es were published vide notification number S.0.859. dated the 15th April, 1961 and last amended vide notifications­

(I )n~nber S.0.728(E), dated the 8th May, 2007. (2)n~bcr S.O . 425(E) dated 23rd February. 2011.

Pnmc:d hy ltt~o· M;u1at:,!r. ( ilnocrnnu:nt \-.( lndaa Pres!\. T<m~ Roiid. ~ia:-r:tpun. Ne"'" Ddhi·J 1UHh·l

and Publ i>hd by 1hc Colllr.)tl~r r~f i'ubfi,·Aii"n;. 0\-lho-11 0054.

certificate that all the Returning Officers have received the instructions may be forwarded to the Commission within one month of receipt of this letter,

5. You are also requested to furnish a copy of this letter along with copy of the enclosed notification to every political party (including registered unrecognized parties) having headquarters in your State/UT, including the State Units of recognized National and State political parties.

Yours faithfully,

(Ashish Chakraborty) Secretary