DECLERATION OF ASSETS AND LIBALITIES

Year : 2016-17

1. DEO KUMARI wife of DEVENDRA KUMAR Aged-50 Years belonging to DISTRICT

PRIMARY EDUCATION SERVICE and presently working as Assistant Teacher, Primary
School T. N. B Collegiate, Naya Bazar, Bhagalpur, give herein below the details of the
assets (Immoveable/moveable bank balance etc.) of myself, my spouse and dependens.*

A. Details of moveable assets

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

Sr. Description Self Spouse Depende Dependent Dependent

No. Name- nt-1 -2 Name -3 ETC.
Devendra Name Name
Kumar
(i) Cash 14000 NIL NIL NIL NIL
(ii) Deposits in Banks, NIL NIL NIL NIL NIL
Financial
Institutions And
Non Banking
Financial
Companies
(iii) Bonds, Debentures NIL NIL NIL NIL NIL
and Shares in
Companies
(iv) Other financial NIL NIL NIL NIL NIL
Institutions ,NSS,
Savings, LIC Policies
Etc.
(v) Motor Vehicles Self Four NIL NIL NIL NIL
(Details of Make, Wheeler
Etc.) Swift
(vi) Jewellery (give Self NIL NIL NIL NIL
details of weight (200gm)
and value)
(vii) Other assets, such NIL NIL NIL NIL NIL
as values of
claims/interests

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

 Dependent here means a person substantially dependent on the income of the employee.
B. Details of Immoveable Assets
[Properties in joint ownership indicating the extent of joint ownership will also have to be
indicated]

Sr. Description Self Spouse Depe Dependent Dependent

No Name- nden -2 Name -3 ETC.
. Devendra t-1 Name
Kumar Nam
e
(i) Agricultural Land NIL NIL NIL NIL
-Location(s)
-Survey Number(s) Sardarpur
-Extent (Total 00181562
Measurement) &00181567
4 & 13 Katha
-Current Market respectively
Value
(ii) Non-Agricultural NIL NIL NIL NIL NIL
Land
-Location(s)
-Survey Number(s)
-Extent (Total
Measurement)
-Current Market
Value
(iii) Buildings NIL NIL NIL NIL NIL
(Commercial and
residential)
-Location(s)
-Survey Number(s)
-Extent (Total
Measurement)
-Current Market
Value

(iv) Houses/apartments, NIL NIL NIL NIL

Etc.
-Location(s) 1.Sultanganj
(Mirzagaon)
In self name
2.Bhagalpur
in joint name
with spouse
-Survey Number(s) 1.
2.House-94
Ward-18
-Extent (Total 1.2 Katha
Measurement) 2.1 Katha
-Current Market
Value
 (v) Others (Such as NIL NIL NIL NIL NIL
interest in property)

(2) I give hereon below the details of my liabilities/ overdue to the public financial institutions and
government dues:-

[Note : Please give separate details for each item]

Sr. No. Description Name & Amount

address of outstanding
Bank/Financial as on
Institution(s)/d 31.12.2016
epartment(s)
(a) (i) Loans from Banks NIL NIL
(ii) Loans from Financial Institutions NIL NIL

(iii) Government Dues : NIL NIL

(a)Dues to department dealing with
government accommodation
(b)Dues to department dealing with NIL NIL
supply of water
(c)Dues to department dealing with NIL NIL
electricity
(d)Dues to department dealing with NIL NIL
telephones.
(e)Dues to departments dealing with NIL NIL
government transport (including
aircrafts and helicopters)
(f)Other dues, if any NIL NIL

(b) (i)Income Tax including surcharge NIL NIL

[Also indicate the assessment year
up to which Income Tax Return filed.
Give also Permanent Account
Number[Pan])

(ii)Wealth tax [Also indicate the NIL NIL

assessment year up to which
Income Tax Return filed.]
(iii)Sales Tax [Only case of NIL NIL
proprietary business]

(iv)Property Tax 35/- NIL

 C. Personal Details :-

GPF/CPF/PRAN NO. :-

3 2 4 3 1 7 2 7 8 0 2

Gender :- ( M/F)

Date of Birth :- (DD/MM/YYYY)

1 0 0 1 1 9 6 4

Class/Group :- (A/B/C)

Cadre :- (Full name e.g. B.A.S-Bihar Administrative Service)

B E S

Home District :-

BHAGALPUR

I hereby declare that the above details are true to the best of my knowledge and belief.

Signature .................................................

Name of the Employee:-DEO KUMARI

Place: BHAGALPUR Designation:-ASSISTANT TEACHER

Date: 24.01.2017 Department:-EDUCATION

Note:- Please sign each page of the declaration. Asset declaration must be in A4 size white paper
with computer typed (Single Side) in prescribed format.