q_g!{I~ MAHARASHTRAzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

~

< tf&lRfr.~cJfzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAC lzU i

••

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

I ramdasathawale@yahoo.in

,

(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