q_g!{I~ MAHARASHTRAzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
~
< tf&lRfr.~cJfzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAC lzU i
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Form 26
(See rule 4 A)
AFFIDAVITAffidavit to be filed by the candidate alongwith nomination paper the returning Officer
For election to the COUNCIL OF STATESfrom the elected members of MaharashtralegislativeAssemblyconstituency.
PART-A
I, RAMDAS ATHAWALE son ofBANDU ATHAWALE aged 54 Years, resident of
"37 Savindhan Bunglow", Near Gurunanak Hospltal.. 647 Gandhi Nagar, Bandra
(East), Pin Code 400051., a candidate at the above Election, do hereby solemnly affirm
and state on oathe as'under:-
(1) I am a candidate set up by REPUBLICAN PARTY OF INDIA (A).I
(2) My name is enrolled in 176 Bandra (E) Assembly, Mumbai, Maharashtra State, at.~ serial No. 642 in Part No 221
I •m ~3)My Contact telephone Number IS 9004809627 and my E-mail Id IS
,
(4) Details of Permanent and Account Number (PAN)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& Status of filling of Income tax Return
Sr. No Names Permanent The Financial Total Income
Account for which the Shown in
Number last Income Income Tax
Tax Return has Return
been filed (in Rupes
1 Ramdas Athawale AEAPA6269D 2012-13zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA6,33,0001-
2 Mrs Seema Athwale AHZPA3382P 2012-13 3,09,0001-
3 Smt Housabai Athawale NUl APLICABLE NO'! APL :AH ,F. NOTAP ,K ,1-'.
4 Master Jeet Athawale NOT APTICABLE NOTAP :AR .F NOT APLlCAHLE
-
(5) I am not accused of any offence (s) punishable with imprisonment for Two years or more in a
pending cases (s) in which a charge (s) have been framed by the courts (s) competent jurisdication.
If the deponent is accused of any such offience (s) he shall furnish the following information:-
i) The Following case are pending against me in which cognizance has been taken by the court:-
No
(a) NOT APLICABLECase !First information Report No./Nos.
together with complete details of concerned
- ~"-.. StationlDistrictistate -zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA~ r-~~~~~~~~~~--------------------~--------------~-----------------
~,~~ (b) ',' Section (S) of the Concerned Acts(s) and... . "':":."
~"\~«,, .Short description of the offence (s) f~r ""'. . :': NOTAPLICABLE
:~.:;:.
.....~_. 1\' . which charged " '~. ) -Name of the Court, Case No. and Date
;{~ . of order taking cognizance
'>-i -I J :t.J Court (s) which framed the chargee s)
-<:.. /t:t(e) , Date (s) on which the charged (s) was
'i'i~-~- Iwere framed
~;::..::..':(£1~ Whether all or any of the proceeding (s)
have been stayed by any Court( s) of
competent Jurisdiction
NOT APLICABLE
NOT APLICABLE
NOT APLICABLE
ii) The Following case (s) is lare pending against me in which cognizance has been taken by the court
(other than the cases mentioned in items (i) to above)
(a) Name of the Court, Case No. and date of i) Ahmednagar Case No. 864/97
Order taking cognizance : ii) Aurangabad Case No. 9551/2007
(b) The details of cases where the court has i) I PC 143Ahmednagar 864/97
taken cognizance, Section(s) of the Act (s) Rasta Roko Andolan for Marathwada
and descriprion of the offence (s) for University & Govt. disided to withdrawl the
which cognizance taken Political Cases
ii) I PC 500 Aurangabad sect No 9551/2007
Judgment Passed Ex.133/B Dt.20.12.2012
Favour to Deponent
(c) Details of Appeal(s)/Application(s) for i) Case is be Pending no Cognizance
Revision (if any) filed against the above ii) Case judgment complete
Order (s)
(6) I have not been convicted of an offence (s) [other than any offences (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 People
Act, 1951 (43 of 1951) and sentenced to imprisonment for one year or more.
If the depodent is convicted and Punished as aforesaid, shall furnish the following information:
,\
------------ ----------------~.-~-----------
InzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAthe following cases, I have been and sentenced to imprisonment by a court of law:
(a)
Whether any appeal was /has been filed
against the conviction order. If so, details
and the present status of the appeal.
NOT APPLICABLEThe details of cases, sections (s) of the
Concerned Act, and description of the
Offence(s) for which convictedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
(b) Name of the Court, Case No. and
Date (s) of order (s)
NOT APPLICABLE
(C) Punishment imposed NOT APPLICABLE
(7) That I give herei:~beIOWthe det " s of the assets ( movable and immovable ect of myself my spouse
and all dependents; • '
_./
(A) Details ofm val ,..ssetsr-
(d)
NozyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
42,345/-
S.Alc no.2016 New S.Alc no.7193
45,006/- NOT
APPLICABLE
(iv) Details of
NOT
APPLICABLE
NOT APPLICABLE
Dependent -2
Name Mast.
Jeet.
R.Athawale
Sr. Description Self
NOT
APPLICABLE
Detalis of Deposit
(ii) in Banks account'':;::-. -. (FDR, Term
l: ~~; . Deposits and all
'" k~~'.'. other types ofzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAt \ ~. ' .., deposites saving,
_,:..' ~ccount) Deposits: with Financial
1-; . Instituions and
.t Non-Banking
.~.~ Finacial Companies
_/ - and Co-op
Societies and the
amount in each
such deposit
investment in NSS
Postal Saving,
Insurance policies
and investment in
any Financial
instruments in post
office or insurance
Company and the
amountzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA~--~==~=---------~-------------+--------------~----------~----------~(v) Personal Loans I
advansed given to
any person or entity
including firm,
company, trust ect.
& other receivables
from debtors and
the amount
P.P.F. P.P.F.
Rs.2,62,997/- Rs.2,62,997/-
Fixed Deposit Alc Max New York
with State Bank of Life Insurance
India, Delhi - Rs.7,24,3701-
Rs.I0,00,0001-
(i) Cash in hand
Dependent -1
Name: Smt.Spouse Name:
Mrs. Seema R.
Athawale Hausabai B.
AthawaleNOT
APPLICABLE
Saraswat
Bank.Bandra
(E) Br SIB Alc
02021510003
11465.
Rs.l,20,833/-
NOT
APPLICABLE
Max New
York Life
Insurance -
Rs.9,34,232/-
NOT
APPLICABLE
NOT NOT
APPLICABLE APPLICABLE
~'-------___:"'-- --------
New India
co-op Bank
Charkop,
Kandivali (W)
Rs.42,539.55
Saraswat
Bank.Bandra (E)
Br SIB Alc
020203110000002
83.
Rs.l ,07,461Jl:::..
NOT
APPLICABLE
India Bank
Charkop,
Kandivali.(w).
Rs.43,279.21
SBI- Delhi Alc
No.15775
Rs.83,304.68
SBI- Alc
No.l0768207191
RsJ006.85, ,
SBI-Alc
No.10768210535
Rs.7,78,171.65
Bank of
Maharashtra -Ale
No.20045721828
RsJ3,986.00
(iii) Details of
investment in
Bonds, Debentures
I shares and units in
in Companiesl
mutual funds and
other and the
amount
NOT
APPLICABLE
NOT
APPLICABLENOT
APPLICABLE
\
(vi) Motor Vehiclesl
AircraftIY achts.shi .zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANOT NOT NOT NOT
P (details of make, APPLICABLE APPLICABLE APPLICABLE APPLICABLE
registration number
etc.) year of
purchase and amt
(vii) Jewellery, bullion Ornaments Gold Ornaments Gold Ornaments Ornaments
and valuable things 72 grams 225 Grams Gold Gold
(s) (give details ofzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBARs.2,10,0001- Rs.6,57,0001- 40 grams- 100 grams-
weight & value) Rs.l,16,8001- Rs.2,92,0001-
viii) Any other assets NOT NOT NOT NOT
such as value of APPLICABLE APPLICABLE APPLICABLE APPLICABLE
claims! interests
(ix) Gross Total ValuezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBARs.24,57,091/- Rs.18,39,374/- Rs.l,16,800/- Rs.13,47,065/-
B. Details of Immovable assets
Sr. Description Self Spouse(s) Dependent-l Dependent- 2
No Mrs. Seema Smt Housabai Master
B. Athawale Jeet
(i) Agricultural Land 1) At.Dhalewadi
- Location(s) Tal.Kavate NOT NOT NOT
- Survey number(s) manhkal APPLICABLE APPLICABLE APPLICABLEzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
~
Dist.Sangli
~.'.
S.no.7130
2)At Kalamdevi
'\. Tal- Dahanu,-
l' ' . .'. -,;#
- '1f;" -,- Dist Thane
I"l·'_'~'_i - •
J
, ~
S.No 73/7...1 ·Area (Total 1) 0 Hector 10
/measurement inacres) Guntha NOT NOT NOT
2) 12 A~resAPPLICABLE APPLICABLE APPLICABLE
Whether inherited 1) Yes .NOT NOT NOT
property (yeslNo) 2) No APPLICABLE APPLICABLE APPLICABLE
Date of Purchase in 1)NOT APPLICABLE
case of self acquired NOT NOT NOT
property 2)20105/2010 APPLICABLE APPLICABLE APPLICABLE
Cost of land (in case 1) NOT APPLICABLE NOT NOT NOT
of purchase( at the APPLICABLE APPLICABLE APPLICABLE
time of purchase) 2) 6,00,0001-
Any Investment on
the land by way of NOT NOT NOT NOT
development, APPLICABLE APPLICABLE APPLICABLE APPLICABLE
construction ect
Approximate Current 1)RsJO,OOOI- NOT NOT NOT
Market Value ~)Rs.l 0,00,0001- APPLICABLE APPLICABLE APPLICABLE
(ii) Non Agricultural NOT NOT NOT NOT
Land- Location(s) APPLICABLE APPLICABLE APPLICABLE APPLICABLE
- Survey number(s)
Area (Total NOT NOT NOT NOT
measurement inacres) APPLICABLE APPLICABLE APPLICABLE APPLICABLE
Whether inherited NOT NOT NOT NOT
property (yeslNo) APPLICABLE APPLICABLE APPLICABLE APPLICABLE
Date of Purchase in NOT NOT NOT NOT
case of self acquired APPLICABLE APPLICABLE APPLICABLE APPLICABLE
property
Cost of land (in case NOT NOT NOT NOT
of purchase( at the APPLICABLE APPLICABLE APPLICABLE APPLICABLE
time of purchase)
Any Investment on NOT NOT NOT NOT
the land by way of APPLICABLE APPLICABLE APPLICABLE APPLICABLE
development,
construction ect
Approximate Current NOT NOT NOT NOT
Market Value APPLICABLE \ A !-PPye-ABLE APPLICABLE APPLICABLE
CX'~ ~_-
(iii)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBACommercial A Shop No.14 House, S.No
BuildingzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANOT Booked, at Sai 4(2) Savlaj NOT
(including APPLICABLE Krupa Mall,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA36/35 APPLICABLE
apartment Dahisar Thane Tal- Tasgaon,
(location (s)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA(in under Dist Sangli,
Survey number (s construction)
Area (Total NOT 166.73 Sq ft o Acre NOT
measurement in acres) APPLICABLE 1Guntha APPLICABLE
Whether inherited NOT No Yes NOT
pr~Q_erty(yes/No) APPLICABLE APPLICABLE
Date of Purchase in NOT 16/05/2010 NOT NOT
case of self acquired APPLICABLE APPLICABLE APPLICABLE
property
Cost of Property (in NOT Rs.l3,61,890/- NOT NOT
case of purchase( at APPLICABLE APPLICABLE APPLICABLE
the time of purchase)
Any Investment on NOT NOT NOT NOT
the land by way of APPLICABLE APPLICABLE APPLICABLE APPLICABLE
development,
construction ect
Approximate Current NOT Rs 25,00,0001- Rs.2,00,000/- NOT
Market Value APPLICABLE APPLICABLE
(iv) Residential A Flat Booked,at i) S.no.149, 91 CTS no.90-93
Building Adarsh Vihar, plot, sec7 46-C-3Marve
(including Gurgoan, state Charkop, M.Co.Soc.
apartment Hariyana.( in Kandivali Malad(W)
-~ (location (s) under (W)Mumbai Mumbai
". .Survey number (s construction)
..~-, ii) Bunglow at NOT
'l,',
Bandra -r- CTS APPLICABLE
~
., ..,,' . No No.647,
S.No.341,
" ; Mumbai
. ~ iii)_Flat at New
./' '. , . Delhi-RZ-F. .
."362A,Mahavir
Enclave
~
Area (TotalzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAs. rf, 1000 5,. H. "~ '''3'_zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAsC J. ~4. S~O .s.".I~. NOT
measurement in ~)" - ~:~?\~{2: ,t: APPLICABLE CBuilt up area (Total 1000 Sq.ft i) 1031 sq.ft 550sq.ftt NOT "
measurement inSq.ft) ii) 2496 sq. ft. APPLICABLE
iii) 1000 sq.ft
Whether inherited No i) No No NOT
property (yes/No) ii)Gift (Mhada APPLICABLE
Plot) From
Shila Wadekar
iii)No
Date of Purchase in i) 09/10/1997 24/08/1995 NOT
case of self acquired 20/08/2008 ii)16/0 112006 APPLICABLE
property ii)09/0 112012
Cost of Property (in .) Rs.I0,25,000/- NOT
case of purchase( at Rs.15,53,000/- ii)Gift Rs.l,79,0161- APPLICABLE
the time of purchase) i'i)Rs.11,02,400/-
Any Investment on
the land by way of NOT NOT NOT NOT
development, APPLICABLE APPLICABLE APPLICABLE APPLICABLE
construction ect
Approximate Current ")Rs.63,20,520/- Rs.15,00,000/- NOT
Market Value ~.40,00,000/-APPLICABLE
·i)Rs.l,35,48,750/-
iii)Rs.18,OO,OOOI-
(v) Othes (Such as NOT NOT NOT NOT
Interest in Property) APPLICABLE APPLICABLE APPLICABLE APPLICABLE
(vi) Total of currentNOT
market value of (i) to Rs. 50,30,000/- ~s.2,41,69,270/- Rs.17,00,000/- APPLICABLE
(v) above ./
~
.~
(8) I given herein below the details of liabilitieszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA1 dues to public fmancial institution and Government:
Sr. Description Self Spouse Dependent -1 Dependent -2+
No (Mrs Smt Hausabai Master Jeet
Seema) B. Athawle
(i) Loan Or dues to Bank!
Financial institution(s) name NOT NOT NOT NOT
Of the Bank or fmancial APPLICABLE APPLICABLE APPLICABLE APPLICABLE
Institution, Amount
Ouststanding, nature of
Loan
Loan or dues to any other
Individuals/entity other NOT Personal Loan NOT NOT
than mentioned above APPLICABLEzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBARs.21,40,500/- APPLICABLE APPLICABLE
Name (s)Amount outstanding
nature of loan
Any other liablity NOT NOT NOT NOT
APPLICABLE APPLICABLE APPLICABLE APPLICABLE
Grand total of liablities NOT Rs.21,40,500/- NOT NOT
APPLICABLE APPLICABLE APPLICABLE
(ii) Government Dues
Dues to department NIL NILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANIL NIL
dealing with Government
accommodation
:..~~~ ~Dues to department~- ' ~ea~g with supply of NIL NIL Nil., NIL'"
_"., -. -" Watet.
, '~ Diles to department
dealing with supply of NIL ,:NIL·: .., NIL NIL
-1. electricity
....\,,~
- ",Dues to department'-"1
,',
.,
_/.,.dealing with supply of NIL NIL NIL NIL
, . telephone 1 mobiles
-_._-_ ."_ ., Dues of Department
Dealing with Government NIL ' ' NIL NIL NIL
Transport (including
Aircrafts and helicopters)
Income Tax dues NIL NIL NIL NIL
Wealth Tax dues NIL NIL NIL NIL
Service Tax dues NIL NIL NIL NIL
MuniciapllProperty Tax dues NIL NIL NIL NIL
Sales Tax dues NIL NIL NIL NIL
Any Tax dues NIL NIL NIL NIL
(iii) Grand Total of all
Government dues NIL NIL NIL NIL
(iv) Whether any other liabilities
Are in dispute, if so, NIL NIL NIL NIL
Mention the mount involved
and the authority before
which -it is pending
(9) Details of profession or accupation :-
(a) Self:- Social Worker
(b) Spouse: - House Wife
(10) My educational qualification is as under: -
Siddharth College of Arts and Science, fort Mumbai -1, 1972-73 Inter Arts,
PARTB
(11) abstract of the details given (1) to (10) of PART A
1 Name of the Candidate Ramdas Athawale
2 Full postal address "37 Savindhan Bunglow" Near
Gurunanak Hospital, 647 Gandhi Nagar,
Bandra (East), Pin Code 400051
3 Number and name of the constituency Bandra (E) 176
And state Maharashtra State
4 Name of the Political Party which set Republican Party of India (A)
up the candidate (otherwise write Reg. Un Recognized
Independent
5 (i) Total Number of pending cases
~;~zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
VWhere charges have been framed by thezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANOT
Courtfor offences punishable withAPPLICABLE
imprisonment for two years or more
(ii) Total Number of pending cases wherezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA~~the court (s) have taken cognizance (other c ,~~T T ,T">T
ru. ~.~~ I'
than the cases mentioned in item(i) above
6 Total Number of cases in which convicted NOT
and sentenced to imprisonment for one APPLICABL~
- .....'; '-, year or more (expect for offence referred.. ,.._t; 1 -... to in sub-section (1). (2) of section 8 of
"-..-...--. -
",-
..Representation of the people Act;'1951).I
'\ -7\, .- PAN of : Year for which Total Income Shown_
..'~)- :- - lastlncome Tax
.- , Return filed
Ii"a) Candidate: AEAPA6269D 2012-13 Rs.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA6,33,0001-
;;; ...: . .' .
,,_
... .. . Vb) Spouse : AHZPA3382P 2012-13 Rs. 3,09,0001--.-- - _ ..- .
c) Dependent .NOT NOT
APPLICABLE APPLICABLE
-
8) Details of Assests and Laiblities in Rupees
Sr. Description Self Spouse Dependent -1 Dependent -2
No (Mrs Smt Hausabai Master Jeet
Seema) B. Athawle
(A) Movable Asset: Rs.24,57,0911- Rs. 18,39,374/- Rs.l,16,8001- Rs.13,47,065/-
Total Value
B Immovable Asset Rs. 50,30,0001- Rs.2,41,69,2701- Rs.17,00,0001- NOT
APLICABLE
(i) Purchase Price andNOT
Self acquired Immovable Rs.21,53,0001- RsJ4,89,2901- Rs.1,79,016/- APLICABLE
Property
(ii) Development 1
Construction cost of NOT NOT NOT NOT
Immovable propertyAPPLICABLE APPLICABLE APPLICABLE APPLICABLE
after purchase
(if applicable)
(iii) Approximate CurrentNOT
Market Price of Assets Rs.50,30,0001- Rs.2,41,69,2701- Rs.17,00,0001- APPLICABLE
(Total Value)
(a) Self -acquired ~)Rs.50,00,0001- a)Rs.1,06,20,5201- a)Rs.15,00,0001- NOT
asset (Total Value)APPLICABLE
(b) Inherited assests b)RsJO,OOOI- b)Rs.l,35,48,7501- b)Rs.2,00,0001-
(Total Value)
9 Liabilities:
(i) Government Dues (Total) NIL NIL NIL NIL
(ii) Loans from Bank,
Financial Institution NIL
/NIL NIL
And others (Total
. - W'
10zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBALiablities that are under Dispute
(i) GovemementdueszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANIL NIL NIL NIL
Total
(iii) Loansfrombank,Financial institutionand NIL NILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBANIL NIL
Others(Total)
11 Highest Educational Qualification :-
Siddharth Colleage of Arts and Science, fort Mumbai -1, 1972-73 Inter Arts,
VERIFICATION
I , the deponent above named, do hereby verify and declare that the content of this affidavit are
true and correct to the best of my knowledge and belief , no part of it is false and nothing
material has been concealted there from I further declare that :
(a) there is no case of conviction or pending case against me other those mentioned in items 5
and 6 of Part A and B above:
(b) I.My spouse or my dependent s do not have any assest or liability, er than those
mentioned in ite~7)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAM Id 8,9 and 10 of part of B above
, ~7 f!lhrJ 10' J ~"" s --"Verifiedat 'L:'\~ Vvt. this the 2 ;d!lJOv»ayzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
i)I
1zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAI
"
"''''''''''~'L'1IcS ATHAWALEDEPONENT
BEFOREMB
otar;~~gi. No,
'"'r, No. _=z_~~ Ot. 'l:.7) 1 1 'j