lbqltu 101(swytu rlgb-5)
yr"rlgble fjb 21 ylu 22 nuX¤ hrsMxu[Nl v{btKvºt btxule yhS
(swytu dwsht; bqÕg JrDo; Juht yr"rlgb 2003 le fjb 21 ylu 22)
v{r;©e,mntgf JtrKßgf Juht frbNlh©e,"xf ( ), htsftux.
1. su "k"t btxu yhS fhe ntug ;u "k"tlwk ltb &......................................................
2. (f) su "k"tltk hrsMxu[Nl btxu yhS fhe ntug ;ult ytJf Juhtltu ftgbe Ft;t lkch (PAN)...................................
(F) ytgt; rlftm ftuz lkch..........................................................
(d) furL÷g ytcfthe sft; hrsMxu[Nl lkch............................................
(D) rJ¼w; Nr¾; vwhJXt muJt lkch....................................................
(a) dwsht; ÔgJmtg Juht yr"rlgb nuX¤ ltU"Ke v{btKvºt lkch......................................................
(A) dwsht; ÔgJmtg Juht yr"rlgb nuX¤ hrsMxu[Nl v{btKvºt
lkch...................................................
(s) furL÷g JuatKJuht yr"rlgb,1956
yne vtmvtuxomtRÍltu Vtuxtu
atuxtzJtu
nuX¤ hrsMxu[Nl lkch, stu ftuR ntug ;tu.............................................
3. "k"tlt btrjflwk ltb &
©e/©eb;e/fwbthe&....................................................................
sLb ;theF&.............................. M:¤&.....................................
rv;t/vr;lwk ltb&.....................................................................
"k"tlt btrjfltu ’hsstu&..............................................................
"k"t btxu sJtc’th Ôgr¾;lt
4. "k"tlt bwÏg M:¤lwk mhltbwk & hnuXtKlwk mhltbwk &
Yb/çjtuf/Vjux
lkch
Yb/çjtuf/Vjux
lkch
Bgw. lkch ylu
bftllwk ltb
Bgw. lkch ylu
bftllwk ltb
hM;tu/Nuhe/
sbel
hM;tu/Nuhe/
sbel
rJM;th/j;tu/
Jtuzo
rJM;th/j;tu/
Jtuzo
vtuMx
ytuVem
vtuMx
ytuVem
;tjwftu/vuxt
rJCtd
;tjwftu/vuxt
rJCtd
dtb/ldh/Nnuh dtb/ldh/Nnuh
SÕjtu SÕjtu
vel ftuz lkch vel ftuz lkch
xujeVtul lkch xujeVtul lkch
Vufm lkch Vufm lkch
R-buRj ytRze
lkch
R-buRj ytRze
lkch
Juc-mtRx Juc-mtRx
5. "k"tltu ’hsstu & (jtdw vz;t Ftltbtk ‘‘ ¥¥ lwk rlNtl fhJwk.)
yuf btºt btrjfe Ctde’the Ftlde rj. fwtk vrçjf rj. ftwk.
yua.gw.yuV M:trlf m;tbkz¤ ftuvtuohuNlmnfthe bkz¤e(rnL’w yrJC¾; fwxwkc )
yumtumeyuNl yLg
6. "k"tle v{J]r;ytult v{fth & (jtdw vz;t Ftltbtk y:Jt Ftltytubtk ‘‘ ¥¥ lwk rlNtl fhtu)
Wðvt’f Vhe Jualth (rhmujh) ytgt;fth rlftmfth
sÚ:tck" Jualth Awxf Jualth frbNl yusLxme.yuLz yuV yusLx
(ntuj mujh) (rhxujh)MxturfMx rzMx[eçgwxh
(rJ;hf)
Jfom ftuLx[tfxh ntgh vhauÍh jeÍ´d ntuxurjyh
7. "k"tlu jd;e ............................. ................................aes JM;wytult ltb & .............................................................
............................. ................................
............................. ................................
8. "k"tle rbÕf;le rJd;tu &...................................................................
…….............................................................9. cUf Ft;tle rJd;tu &y.lk.
cukflwk ltb NtFtlwk mhltbwk ylu ;ultu
ftuz
Ft;t lkch Ft;tltu v{fth
cUfhlwk mej ylu mne
10. "k"tlt J"thtltk M:¤tult mhltbt. (dwsht; cnthlt ntug ;u mrn;ltk M:¤)
(rJd;tu ytvJt lbqlt 101 f ylu 101 F ltu Wvgtud fhJtu)11. fjb 66f nuX¤ yr"f]; Ôgrf;ytule rJd;tu &
(rJd;tu ytvJt lbqlt 101 d ltu Wvgtud fhJtu)12. Ctde’thtu/zehufxhtu/sJtc’th Ôgr¾;ytuyu fhJtltu yufhth &
(rJd;tu ytvJt lbqlt 101 D ltu Wvgtud fhJtu)
13. (f) ;t.............. lt htus yhs’thltk "k"tlwk fwj xlo ytuJh Yt.5,00,000 fh;tk v{:b Jægwk Au.(F) ;t............ ltk htus yhs’thltk "k"tlwk Juhtvtºt xlo ytuJh Yt.10,000 fh;t v{:b Jægwk Au.(yr"rlgble fjb 22 nuX¤ yhS fh;t Juvthelu jtdw vz;wk l:e)
14. nwk...........................................................................................(1) ©e.................................................................... lt b]ðgwltk
vrhKtbu(2) ................................................ rnL’w yrJC¾; fwxwkclt
Ctdjtltk vrhKtbu(3) ................................................................ vuZeltk rJmsollt
vrhKtbu(4) vqhtu y:Jt ykN;& "k"tu ;c’ej fhe ytvJtltk vrhKtbu(5) btrjfebtk VuhVth :Jtlt vrhKtbu
©e/bummo........................................... ltk "k"tbtk……..............(;theFu)ylwdtbe :gtu Awk ylu ;u:e Juhtu ChJtlu sJtc’th :gtu Awk ylu hrsMxu[Nl btxu yhS fÁk Awk. m’hnwk ©e/bummo................................................ yr"rlgb nuX¤ ;theF...................lt hSMxu[Nl lkch..................................... :e hSMxh :gt n;t.
15. nwk yt mt:u, rlgb 59 bwscltk jeMxbtk sulwk ltb ’tFj fhJtbtk ytJuj ntug ;uJt JuatKJuht ÔgJmtge îtht gtuøg he;u v{btrK; fhujt leault ’M;tJustu stuzwk Awk &-
(1) "k"tlt M:¤le mtrc;elu jd;tu ’M;tJus <(2) yr"Jtmltu vwhtJtu <(3) yhs’thltu vtmvtuxo mtRÍltu Vtuxtu <(4) fuNbubtu, Juht Chr;gwk, Aqxf Chr;gwk, rzjeJhe ajl, sbt/W"th raXXe y:Jt XhtJujt ftuR lbqlt y:Jt ftuR stnuhltbtlu stuzujt lbqltbtk mne fhJt btxu yr"f]; ntug ;uJe Ôgr¾;/Ôgr¾;ytult ltb, ntu’tu ylu lbqltle mne.
16. v{:b J»to btxu yhSle ;theF:e NY :;e bw’; ’hrBgtl yk’tS;
xloytuJh...............................................................................
yufhthWvgwof; yuLxhv{tRÍ (mtnm) ltu
nwk ..................................................yt:e stnuh fYk Awk fu, Wvh ytvJtbtk ytJuje rJd;tu mtae ylu mkvqKo Au. nwk yt:e, dwsht; bqÕg Jr"o; Juht yr"rlgb, 2003 le fjb 21 ylu 22 nuX¤ hrsMxu[Nl v{btKvºt ftZe ytvJt btxule yhSltu lbqltu mt’h fY Awk.
M:¤ &…………... mne &……………………………….;theF &………… yhs’thlwk ltb &……………………..
’hsstu &…………………………….
vntUa
©e/©eb;e/fwbthe.................................................................. ;hV:e dwsht; bqÕg Jr"o; Juht yr"rlgb, 2003 le fjb 21 ylu 22 nuX¤ hrsMxu[Nl btxu yhS b¤uj Au.
ytJf (RlJzo) hme’ lkch &..............................ytJf (RlJzo)/hme’ bégtle ;theF &..............................MJefthlth fauhe &..............................MJefthlth fboathele mne &..............................
Vf; fauheltk Wvgtud btxu &
ytJf/hme’ lkch &..............................ytJf (RlJzo)/hme’ &..............................bégtle ;theF &..............................MJefthuje yhS/lfthuje yhS &..............................mwltJKele ;theF &..............................mwltJKelwk M:¤ &..............................M:¤le bwjtft;le ;theF &..............................su yr"ftheyu M:¤le bwjtft; je"entug ;u yr"fthelwk ltb ylu ntu’tu &..............................Vt¤Jujtu hSMxu[Nl lkch &..............................
hSMxh fhlth m;tr"ftheltu ftuz lkch
ftgoJtne fhlth m;tr"fthe hSMxh fhlth m;tr"fthelemne &................... mne &....................ltb & ltb &ntu’tu & ntu’tu &;theF & ;theF &
vntUa
©e/©eb;e/fwbthe................................................................. ;hV:e dwsht; bqÕg Jr"o; Juht yr"rlgb, 2003 le fjb 21 ylu 22 nuX¤ hrsMxu[Nl btxu yhS b¤uj Au.
ytJf (RlJzo) hme’ lkch &..............................ytJf (RlJzo)/hme’ bégtle ;theF &..............................MJefthlth fauhe &..............................MJefthlth fboathele mne &..............................
mtbuj &1. lbwltu-1012. Jfejt;ltbwk3. ctnU"hevºt4. lbwltu-101(f)5. lbwltu-101(F)6. lbwltu-101(d) lkd.............7. lbwltu-101(D) lkd.............8. lbwltu-101(a)9. lbwltu-10610. lbwltu-10711. btjef / Ctde’thtu / ztghufxhtultk Vtuxt (v{btKe;)
12. ytR.xe.vtlo ftzo / lbwltu-49(f) le Íuhtuût lkd.............. (Ôgr¾;)13. ytR.xe.vtlo ftzo / lbwltu-49(f) le Íuhtuût (vuZe / fkvle)14. ztubemtRjltk vwhtJtle Íuhtuût15. cuLf auf cwf fJh vuRs Íuhtuût16. hnuKtkflt vwhtJtle Íuhtuût
17. "k"tltk M:¤ltu vwhtJtu
18. J"thtlt "k"tltk M:¤ltu vwhtJtu
19. dtuztWlltk M:¤ltu vwhtJtu..........................................
20. Ctde’the ’M;tJusle lfj / bubtuhuLzb ;:t ytxeofÕm ytuV yumtumeyuNlle lfj
21. yLg....................................
lbqltu 101 f(lbqlt 101 mt:u stuzuj)
dwsht; htßgbtk "k"t / NtFt / dtu’tbltk J"thtlt M:¤tule btrn;e
"k"tlwk ltb &........................................................................................
01 & mhltbwk....................................................................................
.................................................................................... ....................................................................................
....................................................................................
vel ftuz xujeVtul &
mne & ………………………. ;theF &
02 & mhltbwk....................................................................................
.................................................................................... ....................................................................................
....................................................................................
vel ftuz xujeVtul &
mne & ………………………. ;theF &
03 & mhltbwk....................................................................................
.................................................................................... ....................................................................................
....................................................................................
vel ftuz xujeVtul &
mne & ………………………. ;theF &
ltU" & dwsht; htßgle cnthlt M:¤u ytJuje NtFt/dtu’tblt mhltbt btxule btrn;e ChJt btxu nJulwk vtlwk swytu.
lbqltu 101 F(lbqlt 101 mt:u stuzuj)
dwsht; htßg cnthle c{tLa / dtuztWl ltk mhltbt
01. htßg……………………. mhltbwk &.....................................................................................
..................................................................................... ……….............................................................................
vel ftuz xujeVtul &
htßgltk ftg’t nuX¤ltu ltU"Ke lkch…………………………….htßgltk ftg’t nuX¤ltu furL÷g ltU"Ke lkch……………………….
mne & ………………………. ;theF &
02. htßg……………………. mhltbwk &.....................................................................................
..................................................................................... ......................................................................................
vel ftuz xujeVtul &
htßgltk ftg’t nuX¤ltu ltU"Ke lkch…………………………….htßgltk ftg’t nuX¤ltu furL÷g ltU"Ke lkch……………………….
mne & ………………………. ;theF &
03. htßg……………………. mhltbwk &.....................................................................................
..................................................................................... .....................................................................................
vel ftuz xujeVtul &
htßgltk ftg’t nuX¤ltu ltU"Ke lkch…………………………….htßgltk ftg’t nuX¤ltu furL÷g ltU"Ke lkch……………………….
mne & ………………………. ;theF &
lbqltu 101 d(lbqltu 101 mt:u stuzuj)
(swytu rlgb 14 ltu vuxt rlgb (1))fjb 66 f v{btKu yr"f]; Ôgr¾;ltu mneltu lbqltu
(1) nwk, ©e/©eb;e/fwbthe...............................................bummo..................... ......................................... lt btrjf.............................xel "htJlth
(2) nwk/ybu, ©e/©eb;e/fwbthe...........................................bummo.....................
.................................... lt Ctde’th............................... xel "htJlth
(3) nwk/ybu, ©e/©eb;e/fwbthe...........................................bumm..................... ........................... lt zehufxh/buluSkd zehufxh.......................... xel "htJlth
(1) :e (3) btk su jtdw vz;wk l ntug ;u Aufe ltkFJwk. yt:e ybthe vuZebtk Ctde’th/buluSkd zehufxh/zehufxh/bulush y:Jt............................................... ;hefu Vhs cstJ;tk ©e/©eb;e/fwbthe....................................... lu, fjb 66 f nuX¤ yr"f]; fY Awk/fheyu Aeyu.
fjb 66 f nuX¤ yuJe he;u yr"f]; fhuje Ôgr¾;le rJd;tu
1 vwY ltb
2 rv;t / vr;lwk ltb
3 sLb ;theF
4 "k"tbtk rn; mkck"lwk v{btK (Ctde’the vuZe)/ ftg’umhltu ’hßstu ylu ntjle nurmg;:e stuztgtle ;theF (jebexuz fkvlebtk rzhufxhtultk rfMmtbtk)/ "k"tbtk ftbfts btxu sJtc’th (yr"f];) Ôgrf;ltu ’hsstu ylu ftbdehe
5 ntjlwk hnuXtKlwk mhltbwk
xujeVtul lkch
R-buRj
6 ftgbe mhltbwk
xujeVtul lkch
ytJe he;u yr"f]; fhuje/Ôgrf;ytult mneltu lbqltu / mnelt lbqlt leau v{btKu Au &
yr"f]; Ôgr¾;lwk ltb ’hßstu mneltu lbqltu
nwk ybu, yt:e sKtJwk Awk / sKtJeyu Aeyu fu Wvh bwsclt ltble Ôgr¾;yu ybthe ntshebtk mne fhe yu ylu nwk / ybu, yt:e, dwsht; bqÕgJr"o; Juht yr"rlgb, 2003 ylu bqÕg Jr"o; Juht rlgbtu, 2006 ltk nu;w btxu mnelu mtae ylu btLg ;hefu v{btrK; fYk Awk / fheyu Aeyu.
;theF &
mne ylu ’hßstu
ltU" & (’huf Ôgr¾; btxu yjd lbqlltbtk ChJw.)
lbqltu 101 D (swytu rlgb 5)
(lbqltu 101 mt:u stuzuj)Ctde’thtu/zehufxhtu/sJtc’th Ôgr¾;ytule rJd;tu
1 vwY ltb
2 rv;t / vr;lwk ltb
3 sLb ;theF4 "k"tbtk rn; mkck"lwk v{btK
(Ctde’the vuZe)/ ftg’umhltu ’hßstu ylu ntjle nurmg;:e stuztgtle ;theF (jebexuz fkvlebtk rzhufxhtultk rfMmtbtk)/ "k"tbtk ftbfts btxu sJtc’th yr"f];) Ôgrf;ltu ’hsstu ylu ftbdehe
5 htßgbtklt yLg "k"tbtk rn; mkck" &
(rlr’o»X fhJwk)
6 htßgle cnthltk yLg "k"tbtk
rn; mkck" &
(rlr’o»X fhJwk)
7 ntjlwk hnuXtKlwk mhltbwk
xujeVtul lkch
R-buRj
8 ftgbe mhltbwk
xujeVtul lkch
9 ytJf Juhtltu ftgbe Ft;t lkch
(PAN)
;theF &
mne ylu ’hßstu
lbqltu 101 a (swytu rlgb 14)
(lbqltu 101 mt:u stuzuj)
"k"tle J"thtle btrn;e &
hrsMxu[Nl lkch &................................
Juvthelwk ltb &......................................................................................
Juvthelwk mhltbwk &..................................................................................
..................................................................................
ûtb;t ylu Wðvt’l &
(f) ûtb;t yufb (bu.xl)
sÚ:tu bqÕg (Yt.)
jtgmLg:e ytvuje ûtb;t &M:trv; ûtb;t &(F) Wðvt’l &aesJM;w yua.yum.y
ul.ftuzbux[ef
xlbwÕg ÃjtLx ylu gkºt
mtbd{elwkfwj bqÕg&
FhuFh Wðvt’l &ftbu htFuje Ôgr¾;ytule mkÏgt &Jes d{tnf lkch &JvhtN (Jtr»tof) &Jes¤e &fuÃxeJ vtJh ÃjtLxbtxulwk $"K &
yufb hfb
;theF &
mne ylu ’hßstu
lbqltu 106(swytu rlgb 13)
"k"tlt bulush ykdultu yufhth / mw"thujtu yufhth
ltU"Ke f{btkf...................................
ltU"tgujt Juvthelwk ltb............................................................................
............................................................................
nwk fjb 65 nuX¤ yt mt:ultu yufhth / * ydtWlt yufhthlu h’ fhelu mw"thujtu yufhth hsw fY Awk.
©e................................................................................................. fu suytu……............................... (yn´ ntu’tu y:Jt ’hsstlwk ltb sKtJtu) m’hnwk yr"rlgb ylu ;u nuX¤ fhuj rlgbtule studJtRytulwk ;btb mbgu vtjl fhNu.
M:¤ ;theF mne ’hßstu
ltb rlgw¾; fhuj Ôgr¾;le mtbe mne........................................
ltb rlgw¾; fhuje Ôgr¾;ltu ’hßstu..........................................
ltU"tguj Juvthele mne.....................................................
;theF....................
* su sYhe l ntug ;u Aufe ltkFtu.
lbqltu 107(swytu rlgb 14 ltu vuxt rlgb - (2) ylu (3))
cUflt Ft;t ykdultu mw"thujtu yufhth.(dwsht; bqÕgJr"o; Juht yr"rlgb, 2003 le fjb-66 nuX¤)
ltU"Ke f{btkf...................................
ltU"tgujt Juvthelwk ltb ........................................................................................................................................
Wvh sKtJujt Juvtheltk cUf Ft;tytule btrn;e ykdult ydtWltk yufhthlu h’ fhelu nwk leau v{btKu cUf Ft;tltu mw"thujtu yufhth fY Awk. &-
f{btkf
cUflwk ltb NtFtlwk mhltbwkylu ;ultu
ftuz
cUf Ft;tlkch
Ft;tltuv{fth
cUfhlwk mej
ylu mne
1
2
3
4
nwk................................................. (ltU"tgujt Juvthe J;e yufhth vh mne fhlth yr"f]; Ôgr¾;lwk ltb) yt:e stnuh fY Awk fu Wvh sKtJuj rJd;tu mtae ylu mkvqKo Au.
;theF &......................
.................................
yr"f]; Ôgr¾;le mne
su. ce. NuX yuLz ftwk.402, ftuMbtu
ftuBvjuût,bnejt ftuujus atuf
vtmu, htsftux.;theF & / /
200ltU"Ke lkch btxu
fjb &- 21 & VhSgt; / 22 & MJiråAf / & x[tLmVhe ;hefu.
vuZelwk vwÁ ltb &
vwY mhltbwk &
Vtul lkch & ytu. hume.
ck"thK &"k"tu NY fgtole ;theF &
cuLf Ft;tle rJd; & cuLflwk ltb & Ft;t lkch && c{tka &
rnmtce J»to &"k"tlwk M:¤ & Ctzu:e / vuZele ykd; btjefelwk / Ctde’th fu btjeflt ltbu Auc{tka & J"thtle "k"tle søgt & Au / l:e. JFth & Au / l:e.ntug ;tu mhltbwk & ntug ;tu mhltbwk &
v{:b Fhe’e Yt. & ;theF & cej lkch &v{:b JuatK Yt. & ;theF & cej lkch &
bwÏgðJu fR aestultu Juvth &muLx[j muÕm xu¾m lk. juJtltu Au& nt / ltytgt; vtºt aestult ltb &stbeldehe ykdu &
btjefe vuZe ntug ;tu &btjeflwk ltb &Dhlwk mhltbwk &ôbh &M:tJh rbÕf; & bwze htuftK &ydtWle v{J]r; & rJbtu &btjef/bwÏg Vtubobtk mne fhlth Ctde’thle sLb ;t................. sLb M:¤...........
mne &..................................
Ctde’thtu / ztghufxhtule rJd;
ltb ôbh
Dhlt mhltbt
rnMmtu(%)
bq¤J;l bwze htuft
K
rJbtu M:tJh rbÕf;
ydtWle v{J]r;
