INDIA NON JUDICIAL
Government of Karnataka e-Stamp
Certificate No. Certificate Issued Date Account Reference
IN-KA62852804231480L : 27-Mar-2013 03:55 PM SHCIL (FI)/ ka-shcil/ SRO CHAMRAJPET/ KA-BN
Unique Doc. Reference
: SUBIN-KAKA-SHCIL91627148021607L
Purchased by
: B Z ZAMEER AHMED KHAN
Description of Document
: Article 4 Affidavit
Description
: AFFIDAVIT
Consideration Price (Rs.)
: 0
First Party
(Zero) : B Z ZAMEER AHMED KHAN
Second Party
: BBMP
Stamp Duty Paid By
: B Z ZAMEER AHMED KHAN
Stamp Duty Amount(Rs.) : 20 (Twenty only)
Please write or type below this line
\NO FORM .26 (See rule 4A) Affidavit to be furnished by the candidate before the returning Officer for the election to Legislative Assembly (Name of the house) from Chamarajpet Constituency-168 PART --A I, B.Z. Zameer Ahmed Khan son of Late Ziaulla Khan aged about 48 years resident of No.34 Benson Cross Road, Benson Town, Bangalore- 560046 candidate at the General Election, do hereby solemnly affirm and State on oath as under :1. I am a candidate set up by the JANATA DAL (SECULAR) PARTY I am contesting as a candidate. 2. My name is enrolled in 162 -SHAVAJI NAGAR Assembly Constituency ,Karnataka at Serial No 1028 in Part No.31 3. MY Contact No's is are 9844025075--9740311111 and my e-mail Id is iqbalalikhangyahoo.com tails of Permanent Account No (PAN) and Status of filing of Income Tax Return.
7/1"fiffi/t/te Statuatory Alert:
SI No
NAMES
-2PAN
Self
B.Z.ZAMEER AHMED KAHN
AEXPK9930J
The financial year for which the last income tax return has been filed 2011-12
Spouse Dependent-1 Dependent-2 Dependent-3
BIBI JAWHARA SUGHARA KHANUM ZAHARA FATH1MA ZAID KHAN
BDRPB2563G ADHPK6812G NA NA
NA NA NA NA
Total income shown in Income Tax return( in Rupees) Rs.2497070/(Rupees Twenty four lacks ninety seven thousand and seventy only0 NA NA NA NA
4. I am not accused of any offence (s) punished imprisonment for two years of more in a pending case (s) in which a charge (s) has /have been framed by the court (s) of competent jurisdiction. If the deponent is accused or any such offences (s) he shall furnish the following information:
(a)
(b) (c) (d) (e) (f)
(i) The following case (s)is / are pending against me in which charges have been framed by the court for an n unishable with imprisonment for two years or more: CR No 339/2002, Koramangala Police Station, Case/ first information report No/Nos. together Bangalore , karnataka with complete details of concerned Police station/Distinct/ Sate U/S ,468,471,420 R/W 34 IPC Section of the concerned Act (s) and short description of the offence (s) for which charged Name of the court, Case No. and date of order 8th ACMM Bangalore taking cognizance CC NO-15036/2002. Dt 27.03.2004 Charge Not Yet Framed Court (s) which framed the charge(s) Date (s) on which the charge (s) was /were -NAframed Whether all or any of the proceeding(s) have No Stay in force been stayed by any court (s) of competent Jurisdiction
(ii) The Following cases (s) is / are pending against me in which cognizance has been taken by the Court (other than the Cases mentioned in item (i) above : (a) (b)
(c)
Name of the court, Case No. and date of order taken cognizance : The Details cases were the court has taken cognizance, section (s) of the Act(s) and description of the offence (s) for which cognizance taken Details of Appeal(s)/ Application(s) for Revision (if any) filed against the above order(s)
NA NA
NA
5. I have been/ I have not been convicted of any offences(s) other than any offences(s) re (1), or Sub section (2),or covered in subsection (3) of section 8 of the Representation 1951{43of 1951} And sentenced to imprisonment for one year or more NA
_.... 0 ..r....., ---; n sub Sectio eopleiNtgle pawv R. NPs-1
tArea. ,3 G1\1401---,KRegOs
-3— If the deponent is convicted and punished as aforesaid, he shall furnish the following information: In the following cases , I have been convicted and sentenced to imprisonment by a court of law : (a)
(b) (c) (d)
The Details of cases, Section (s) of the concerned Act(s) and description of the offence(s) for which convicted : Name of court (s), case No. and Date(s) of order(s) : Punishment imposed : Whether any appeal was/ has been filed against the conviction order. If so, details and the present status of the appeal :
-NA-
-NA_ -NA-NA-
(7) That I give herein below the details assets (movable, immovable, bank balance etc.) of my self, my spouse and all depended. A,. Details of movable assts. SI No (I)
(ii)
(iii)
(iv)
(v)
(vi)
Description
Self
Cash in Hand
1, 75,000.00
Details of deposits in bank Accounts (FDRs, Terms Deposits and all other types of deposits including saving account),Deposits with Financial, institutions ,Non Banking financial Companies and CoOperative Societies and the amount Details of investment in Bonds, debentures / Shares and units in Companies/ Mutual Funds and others and the amount : Details of investment in NSS„ Postal, Savings, LIC policies and investment in any financial instruments in post office or Insurance co, and the amount. Personal loans/ advance given to any person or entity including firm ,Company, Trust etc and other receivable from debtors and the amount Motor vehicles/ Air crafts/ yachts/ ships( (details of make, Regn No etc. year of purchased and amount)
Spouse (s)
Mrs. BiBi Jawhara15,000
NIL SBI Fort Branch A/c No 1030912135, Rs 28000 Apex Bank, Vidhana Vedi 39000/- tz,. S-ig. AP /3,1/ Pl,
Dependent-1 Name Mother) Rs 2000/-
Vijaya Bank Basavanagudi Brach SB A/c No26049 65,000.00
Dependent2 Name Miss.Zahara Fathima Daughter Nil
Dependent3 Name Mr.Zaid (Son)
Nil
NIL
NIL
NIL
Nil
NIL
Nil
Nil
NIL
Nil
Nil
Nil
Nil
Nil
Nil
NII
NIl
NI1
1.Car,MercBenz, Regn No KA01MG9945Dt 2011 Rs.49,24,912
Nil
Nil
Nil
. 41 . Ii In
1
arne R. N►K Area.
am.lapo,0R.r..
No. of Corrections60 .2(zfiixi.c
-41( 1 \Reg. NO, 9 \ 0
- 4- -
(vii)
Jewellery,bullion ang valuable thing(s) ( Give details of weight and value)
2. Toyota Fortuner No KA01 Mh 9945 Dt 2012Rs2572804/45 grams Gold (1,26,000.00) 47.90 (1,34,120.00)
Silver 250 grams (127,500.00)
NIL
NIL
NIL
NIL
NIL
NIL
712704.00
191500.00
Nil
Nil
234 grams and 15.180 grams Gold (6,9,7704.00)
(viii) (ix)
Any Other assets such as values of Claims\interest Gross Total Valve
NIL
_
7999836.00
B. Details of Immovable assets ote: properties in joint ownership indicate the extent of joint ownership will also have to be indicated) Si. Description Self Spou Dependent Depende Dependent No. -1 nt -3 se -2 (s) (i) Agricultural Land Nil Nil Nil Nil Nil -Location(s) -Survey number(s)
(ii)
Area(total measurement in Acres)
Nil
Nil
Nil
Nil
Nil
Whether inherited property (Yes or No) Date of purchase in case of self acquired property Cost of land (in case of purchase) at the time of purchased Any investment on the land by way of development, construction etc. Approximate current market Valve Non-Agricultural Land/Location (s) Survey number(s)
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
(1)No 38 & 39 Serpent ant Street Richmond Town Bangalore- 25 Dt.03.07.2009
Nil
Nil
Nil
Nil
Nil
Nil
Nil
No
No
No
Area (total measurement in Sq ft. Whether inherited property rt (Yes or No)
(2)Sale Agreement holder of Property No.2, Station Road, Shivaji nagar, Bangalore —52 The title of this property is under dispute (1)14924Sqft. (2)33479 Sqft. NO
7 )1 /
I arne
i ic.'r( R. NMI( * 1 p. N ALORE \ - r$ \ rlo•
/I
- 5 -
Date of purchase in case of self acquired property
(1)03.07.2009 (2)03.04.2008
Nil
Nil
Nil
Nil
Cost of land (in case of purchase) at the time of purchased
(1)3,0500000/Rs Three crores and five lakhs only (2)1,00,00,000.00(one crore.( The title of this property is under dispute
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
5,22,34000.00 +(Sale agreement amount (RS.1,00,00,000,.00) Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Area(Total measurement in Sq.ft.) Built-up area (Total measurement in Sq.ft.) Whether inherited property (Yes or No)
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
No
Nil
Nil
Nil
Nil
Date of purchase in case of self acquired property Cost of land (in case of purchase) at the time of purchased Any investment on the land by way of development, construction etc. Approximate current market Valve (iv) Residential Buildings (Including Appartments) Location (s) Survey number(s)
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
1.G-2, Ground Floor, Ranka Enclave, # 3/1, Old Tumkur Road, Rajmahal vilas extn., Sada shivnagar, Division no. 82 Bangalore — 006
Nil
Nil
Nil
Nil
4618 Sqft.
Nil
Nil
Nil
Nil
3250Sqft.
Nil
Nil
Nil
NO
Nil
Nil
Nil
17.09.2004
Nil
Nil
Any investment on the land by way of development, construction etc. Approximate current market Valve (iii)
Commercials Buildings (includes apartments)Location (s)Survey number (s)
Area(Total measurement in Sq.ft.) Built-up area (Total measurement in Sq.ft.) Whether inherited property (Yes or No) Date of purchase in case
.
'.r I:11 41. as(NituN R. NAIK Nil i
BANGA.L ea0 .
C;,1\ Reg,. No. of . f ‘'"
-6 --
r--
(v)
(vi)
of self acquired property Cost of property (in case cost of property of purchase) at the time of purchased Any investment on the land by way of development, construction etc. Approximate current market Valve Others (Such as interest in property) Total of Current Market Valve (i) to (v)
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
2,34,00,000.00
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Rs.7,56,34,000.00+ (Sale agreement amount (RS.1,00,00,000,.00)
Nil
Nil
Nil
Nil
Nil
(8) I gave herein below the details of liabilities / dues to public financial institutions and Government.
SI No (i)
Rs,2,00,00,000/(Two crores Only) U. Mallikarjuna 2 Crores Hand Loan Ref : DD No162399,162398 A62400, Dt 29.06.2009 Nil Rs 200,00,000 ( Two Crores Only) Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
NIL
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil (.0....)1i.
Nil
Nil
Nil
Nil / 44----
Self
Spouse (s)
Loan or dues to Bank /Financial institution(s Name of the Bank or financial institution, amount outstanding, nature of loan Loan or dues to any other individual/entity other than mention above Name (s), amount out standing, nature of loan
Nil
Any other liability Grand Total of Liabilites (ii)
Dependent2 Name Nil
Dependent-3 Name
Nil
Dependen t-1 Name Nil
Description
Government dues : Dues to Department dealing with Govt. Accommodation Dues to department dealing with supply of water dues to department dealing with supply Of electricity dues to department dealing telephones/Mobiles dues to departments dealing with Government transport (including aircraft and helicopters)
Nil
.- T
/1' --,./ i az li '41 ARUN A II * i A
472-A{/0 ?1
.\\
— -1 -
(iii) (iv)
Income Tax dues Wealth Tax dues Service Tax dues Municipal or property Tax Dues Sales Tax Dues Any other dues Grand Total Of all Govt. Dues Whether any other liabilities are in dispute, if so, mention the amount involved and the authority before which it is pending
Nil Nil Nil Nil Nil Nil Nil -NA-
Nil Nil Nil Nil Nil Nil Nil NA
Nil Nil Nil Nil Nil Nil Nil NA
Nil Nil Nil Nil Nil Nil Nil NA
Nil Nil Nil Nil Nil Nil Nil NA
(9) Details of Profession or occupation: (a) Self, Managing Partner, M/s.N.T.Zameer Ahmed Khan Associates (b) Spouse---- Partner. N.T.Zameer Ahmed Khan Associates (10) . My Educational qualification as are under –SSLC discontinued. At Siddhartha High School Kunigal. Tumkur Dist. In the year 1982-83 Part B 11. ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART –A 1.
Name of the candidate
: B. Z. Zameer Ahmed Khan
2.
.Full Postal Address
: No 34, Benson Cross Road, Benson Town Bangalore-560064
3.
Number and Name of Constituency and state
168 Chamrajpet, ,Karnataka
4.
Name of Political Party which setup The candidate (otherwise : Independent)
: JANATA DAL SECULAR
5.
. (i)Total No of pending cases where Charges have been farmed by the court By the court for offences punishable with imprisonment for two years or more:
-NA-
(ii) Total no of pending cases where the court (s) have Taken cognizance (other than the cases mention in Item (i) above
-NA-
Total Number of cases in which convicted and sentenced to Imprisonment for one year or more (expect for offences referred to in sub-section (1) ,(2) or (3) of section 8 of Representation of the people Act,1951
-NA-
6.
'
A i.ame
ZARUN. R. NAIL
.4
7.
PAN (a) Candidate (b)Spouse : (c)Dependents-1 (d)Dependents-2 (e)Dependents-3 8.
AEXPK9930J BDRPB2563G ADHPK6812G NA NA
Total Income Shown
24,97,070 Nil Nil Nil NIL
Details of Assets and Liabilities in Rupees
DISCRIPTION
SELF
SPOUSE
DEPENDEN T-1
DEPEND ENT-2
DEPENDE NT-3
Movable assets(Total Valve)
7999836.00
7,12,704.00
1,28,400.00
Nil
Nil
3,40,00,000.00 (Rupees crore forty lakhs only)+ 1,00,00,000.00( one crore.( The title of this property is under dispute
Nil
Nil
ND
Nil
Development/ Nil Construction cost of immovable property after purchase( if applicable (iii) Approximate current Market price of (a) Self7,56,34000.00 acquired (Rupees Seven assets (total crore fifty six Valve) lakhs thirty four thousand only) +1,00,00,000.00 (one crore.( The title of this property is under dispute
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
A
B (i)
Immovable assets Purchase price of self acquired immovable property
(ii)
9
Year for which last Income Tax return 2011-12 NA NA NA NA
(b) Inherited Assets(Total Valve) Liabilities (i) Government Dues (total (ii) Loans from Banks from
Nil Nil
Nil
Nil
/- #1 , Hand Loan sum of Rs 2,00,00000
Nil
Nil
Nil
, -- 1: m a e
-3
It A1K R. Z(ARU N *
F ANG AL612.E
R eg. NO.96° .
nV
10. (i) (ii)
11
financial ( Two Crores ) instituti from U ons and Mallikarjuna other via DD. Liabilities that are under dispute: Government Dues Nil (total Loans from banks Nil from financial institutions and other
Highest Education Qualification::
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
SSLC discontinued. At Siddhartha High School Kunigal. Tumkur Dist. In the year 1982-83
Note; Enclosed IT returns of financial year 2011-12 Individual And our firm M/s.N.T. Zameer Ahmed Khan Associates
VERIFICATION 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, and no part of it is false and nothing material has been Concealed there from, I Further declare that:. (a) There is no Case of conviction or pending case against me other than those mentioned in items Sand 6 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 items 7 and 8 of part –A and items 8,9 and 10 of Part-B above.
DEPONENT
Verified at...Bangalore...this..! of.
...1..2013. SWORN TO SPORE ME R. NAIK, B A , LL. ADVOCATE & NOTARY BANGALORE,.
.RUN.
(too. of Corrections (2---'
12 APR 2013 14, 6 r 6-1)
Yi. ivo. /
Year
44) (.3