(4) Details of Permanent Account Number (PAN)* and status of filing of Income Tax " return: ‘Sk_| Name PAN The financial year] Total income shown Z No. for which the last | in Income-Tax return Income tax return | (in Rupees) for the has been filed last five Financial Years completed (as on 31st March) 1. | Self QUNPS46506 | WIL iL AMRITPAL SINGH 2 | Spouse ‘No PAN NIL NIL KIRANDIP KAUR | Allotted HUF (if candidate | NIL Wit NIL is Karta/coparcener) 4. | Dependent-1 NIL it. ‘NIL S| Dependent -2 NIL ‘NIL NL & | Dependent -3 NIL ‘NOL NIL Note: It is mandatory for PAN holder to mention PAN and in case of no PAN it should be clearly stated “No PAN allotted” (5) Pending criminal cases oO a) declare that there is no pending eriminal ease-against me, (Tick this alternative if there is no criminal case pending against the Candidate and write NOT APPLICABLE against alternative (ii) below) OR ‘The following criminal cases are pending against me (if there are pending criminal cases against the candidate, the tick this alternative and score offalternative (i) above, and give details of all pending cases in the Table Below) whe Meraz Akfitar | NOTARY DIBRUGARH Regd. No. DBR - t4 [CANDIDATE IS IN PREVENTIVE DETENTION AT CENTRAL JAIL, DIBRUGARH, ASSAM UNDER NATIONAL SECURITY ACT SINCE 23.04.2023] you Oq-0S-2224 fe Signature Ajtested vn eee balls contrat 0B Asstt, Jailor Central Jail, Dibrugarh courteTable 1 proceedings (Mention YES or NO) Regd. No. 3 | eh Meraz Akfitar| NOTARY DIBRUGARH (@ |FIRNo.withnameand address of __|FIRNO 0064 DATED 20.02.2024. police Station concerned ‘DIBRUGARH DISTRICT DIBRUGARH, ASSAM (b) [Case No, with Name ofthe Court __|INVESTIGATION IS PENDING (©) |Section(s) of concerned Acts/Codes 353, 143 IPC linvolved (give no. of the Section, e.g. Section win Of IPC, eC.) [@ [Brief description of offence ‘ALLEGATIONS OF RECOVERY OF UNAUTHORISED ELECTRONIC GADGETS FROM JAIL. (©) |Whether charges have been framed No (mention YES or NO) (0 _| Ifanswer against € above is YES, then|NA | igive the date on which charges were framed (@ _|Whether any Appeal / Application for [NA lrevision has been filed against the lproceedings (Mention YES or NO) Zs (@) [FIRNo. withnameand address of —_ |FIRNO. 19 DATED 30.03.2023 PS, [police Station concerned MEHTIANA DISTRICT HOSHIARPUR, PUNIAB (b)_[CaseNo. with Name ofthe Court [INVESTIGATION IS PENDING I(@)_|Section(s) of concerned Acts/Codes |279, 212, 120-B, 201 IPC linvolved (give no. of the Section, e.g. [Section wn Of IPC, €t0.) |(@)_ [Brief description of offence ‘ALLEGATIONS OF RASH DRIVING ((@) [Whether charges have been framed [No (mention YES or NO) (| tanswer against (e)aboveis YES, [NA Ithen give the date on which charges lwere framed. [(@) |Whether any Appeal / Application for [NA revision has been filed against the Asstt. Jailor Central Jail, Dibrugarh DBR - 143. [(@) [FIRNo. with name and address of _ |FIRNO.37 DATED 23.03.2023 PS. BILGA [police Station concerned DISTRICT JALLANDHAR-R, PUNJAB. [(6) |CaseNo. with Name ofthe Cout —_ [INVESTIGATION IS PENDING ( SSection(s) of concerned Acts/Codes involved (give no. of the Section, e.g. \Section .... of IPC, etc.) '386,342,506,34 IPC 25,27 ARMS ACT (@) [Brief description of offence ALLEGATIONS OF ENTERING IN HOUSE OF COMPLAINANT AND SNATCHING OF MOTORCYCLE, SHAWL, SPECS, SHORT [TURBAN AND FORCE HER SON TO ASSIST [THEM TO CROSS SATLE] RIVER. \(@) Whether charges have been framed [No |(mention YES or NO) (| ifanswer against (e) aboveis YES. [NA Ithen give the date on which charges Iwere framed |(@) |Whether any Appeal / Application for [NA revision has been filed against the [proceedings (Mention YES or NO) 4, [(@) JFIRNo. withname and address of __ |FIRNO.48 DATED 21.03.2023 PS. [police Station concerned \SHAHKOT DISTRICT JALLANDHAR-RURAL, PUNJAB. [(0) [Case No. with Name ofthe Court _ INVESTIGATION IS PENDING (© [Section(s) of concerned Acts/Codes [212,216 1PC 25,27 ARMS ACT linvolved (give no. of the Section, eg. (Section sw. of IPC, etc.) ((@) [Brief description of offence ALLEGATIONS OF REGOVERY OF CAR ALLEGEDLY USED BY CANDIDATE TO FLED AWAY ON 18.03.2023. ((@) [Whether charges have been framed [No |(mention YES or NO) (@ | Ianswer against (¢) aboveis YES, [NA ithen give the date on which charges ere framed |(@ |Whether any Appeal / Application for [NA Irevision has been filed against the raceedings (Mention YES or NO) sled Meraz Akfitar NOTARY DIBRUGARH Regd. No. DBR - 14 «bl Courter OG OSH ARMY ft Signature Attestod “ays Jailor Jail, Dibrugarh Superev central ts Centr asa fragt5, Regs. No. DER - 14 (a) |FIR No, with name and address of FIR NO. 47 DATED 21.03.2023 P.S. SHAHKOT ‘police Station concerned DISTRICT JALLANDHAR RURAL, PUNJAB (b) Case No. with Name of the Court INVESTIGATION IS PENDING I(c) |Section(s) of concemed Acts/Codes |386,506,148,149 IPC 25, 27 ARMS ACT involved (give no. of the Section, e.g. Section of IPC, etc.) |ALLEGATIONS OF ENTERING IN THE (4) Brief description of offence |HOUSE OF COMPLAINANT AND TAKING \CLOTHS UNDER THREAT BY SHOWING | pIsTOL. [(e) [Whether charges have been framed [No \(mention YES or NO) (| Wanswer against € above is VES, then|NA lgive the date on which charges were liramed (g)_ |Whether any Appeal / Application for [NA Irevision has been filed against the lproceedings (Mention YES or NO) (a) |FIR No. with name and address of | FIR NO, 28 DATED 20.03.2023 P.s. |police Station concerned MEHATPUR DISTRICT JALLANDHAR RURAL, PUNJAB \(b) Case No. with Name of the Court |INVESTIGATION IS PENDING | (c) |Section(s) of concerned Acts/Codes '449-342-506-34 IPC 25, 27 ARMS ACT linvolved (give no. of the Section, e.g. |__|Section ... of PC etc.) |ALLEGATIONS OF ENTERING IN HOUSE (d) [Brief description of offence |AND TAKING MEAL BY THREATING BY ASSOCIATES OF CANDIDATE. (©) [Whether charges have been framed No |(mention YES or NO) (| IFanswer against (e) above is YES, [NA then give the date on which charges ‘were framed (@) |Whether any Appeal / Application for [NA ‘revision has been filed against the \proceedings (Mention YES or NO) suns Bs 5 WR eed 2 ead ost / lv fe Signatu ested Meraz Akfter “ae” 1H NOTARY DIBRUGARH rallor Central Jail, Diorugarh Courtarsigned Sigs)yae (a) |FIR No. with name and address of FIR NO. 27 DATED 19.03.2023 P.s. ‘police Station concerned |MEHATPUR DISTRICT JALLANDHAR RURAL, PUNJAB. ((b) [Case No. with Name of the Court INVESTIGATION 1S PENDING (© SSection(s) of concerned Acts/Codes [279-188 IPC 25 ARMS ACT involved (give no. of the Section, e.g. | |Section....... of IPG ete,) |ALLEGATIONS OF RASH DRIVING AND ((d) [Brief description of offence |SHOWING OF WEAPON, (e) [Whether charges have been framed [No (mention YES or NO} (9 | Ifanswer against (c) above is YES, [NA then give the date on which charges ‘were framed (@ |Whether any Appeal / Application for [NA ‘revision has been filed against the iproceedings (Mention YES or NO) 8. (@ |FIRNo.withnameandaddress of |FIRNO, 26 DATED 18.03.2023 P.s. |police Station concerned KHALCHIAN DISTRICT AMRITSAR RURAL, PUNJAB \(b) |Case No. with Name of the Court INVESTIGATION IS PENDING (©) [Section(s) ofconcerned Acts/Codes |279-186-506-336-427 IPC 25 ARMS ACT involved (give no. of the Section, eg. (Section ..... of IPC, etc.) (@) [Brief description of offence "ALLEGATIONS OF BREAKING POLICE [BARRICADING AND THREATEN POLICE OFFICIALS BY SHOWING WEAPONS. (e) |Whether charges have been framed No (mention YES or NO) (O | Ifanswer against (e) above is YES, |NA then give the date on which charges |were framed (=) |Whether any Appeal / Application for [NA sion has been filed against the gedings (Mention YES or NO) Isp Meraz Akfitar’ NOTARY DiBRUGARH Regd, No, OBR « 14 A-08- 2°84 Signature Attested i agin Bee Sie als?" Ganral Jes dine sane Jailer Dibrugarh Central Jai Countarsaned N9. [(@ [FIRNo. with name and address of __ [FIR NO. 39 DATED 24.02.2023 PS. AINALA, Ipolice Station concerned DISTRICT AMRITSAR RURAL, PUNJAB (b) [Case No. with Name of the Court —_|INVESTIGATION IS PENDING (©) [Section(s) of concerned Acts/Codes /386,506,148,14307-353-186-332-333-506- linvolved (give no. of the Section, eg. |120-B-427-148-1499 IPC \Seetion .... of IPC etc.) ‘ALLEGATIONS OF CONSTITUTE, ((d)_ [Brief description of offence UNLAWFULL ASSEMBLY AND CAUSE DAMAGE TO PROPERTY AT PS. AJNALA ‘AND ATTACK ON POLICE OFFICIALS AND (CAUSE INJURIES UPON THEM. (©) [Whether charges have been framed No (mention YES or NO) (| IFanswer against (e)above is YES, NA Ithen give the date on which charges |were framed [(@) | Whether any Appeal / Application for [NA lrevision has been filed against the wroceedings (Mention YES or NO) 10. FIR No. with nameand address of |FIRNO. 34 DATED 22.02.2023 Ps. BAGHA |police Station concerned PURANA DISTRICT MOGA, PUNJAB | [(B) [Case No. with Name ofthe Court __|INVESTIGATION IS PENDING I(e)_ |Section(s) of concerned Acts/Codes [121-A, 143-153-A, 153-B, 505(2),188 IPC involved (give no. of the Section, eg. [Section ..... of IPC, etc.) ALLEGATIONS OF PROVOCATIVE SPEECH. |(@) [Brief description of offence [(©) [Whether chargeshave been framed [No |(mention YES or NO) (| lfanswer against (e) above is YES, [NA Ithen give the date on which charges lwere framed ((@ [Whether any Appeal / Application for [NA lrevision has been filed against the ARY IN proceedings (Mention YES or NO) Regd. No. DBR - 14 { au Rey - BERY ‘ 04-05 ae ash Cantons ested Qian piu EE NOTARY DIBRUGARH Asstt Jeilor , Dibrugarha (@) [FIRNo. withnameand address of __ |FIRNO. 54 DATED 22.02.2023 PS. DIVISION- [police Station concerned '8 POLICE COMMISSIONERATE, AMRITSAR, PUNJAB ((B) [Case No. with Name ofthe Court —_|INVESTIGATION IS PENDING (©) _|Section(s) of concerned Acts/Codes _|153-A, 506 [PC linvolved (give no. of the Section, eg. \Section ..... of IPC, etc.) (a) [Brief description of offence ‘ALLEGATIONS OF PROVOCATIVE SPEECH [(@ Whether chargeshave been framed No |(mention YES or NO) [() | ifanswer against (e)aboveis YES, [NA |then give the date on which charges | lwere framed | (g)_|Whether any Appeal / Application for [NA lrevision has been filed against the lproceedings (Mention YES or NO) 12. (@) |FIRNo. with nameand address of __ |FIRNO. 29 DATED 16.02.2023 P.S. AINALA Ipolice Station concerned [DISTRICT AMRITSAR RURAL, PUNJAB (b}_|Case No, with Name ofthe Court __ [INVESTIGATION IS PENDING ((_|Section(s) of concerned Acts/Codes [365-323-506-379-B 140-149 IPC linvolved (give no. of the Section, e.g. \Section ..... of 1PC, etc.) [(@)_|Brie? description of offence [ALLEGATIONS OF KIDNAPING OF COMPLAINANT AND AFTER BEATING HIM AND SNATGHING OF TWO MOBILE IPHONES AND RS. 2000/-, RELEASE HIM. \() Whether charges have been framed [No (mention YES or NO) @ | Wanswer against (e) aboveis YES, [NA ithen give the date on which charges ‘were Framed \(g) (Whether any Appeal / Application for [NA revision has been filed against the iy 4 Heraz Akfitar NOTARY DIBRUGARH Rega. No. OBR = 14 Signature At} per cages tani host, Jal Central(6) Cases of conviction v (Tick this alternative, if the candidate has not been convicted and write NOT () [declare that | have not been convicted for any criminal offence APPLICABLE against alternative (if) below) oR (ii) Thave been convicted for the offences mentioned below: NOT APPLICABLE (if the candidate has been convicted, then tick this alternative and score off alternative (1) above, and give details in the Table below) Table (@_[CaseNo. INA [NA_ [NA [NA [NA ((b) _ [Name of the Court INA__NA_|NA_|NA__[NA |(@) Sections) of Acts/Codes involved (giveINA_ [NA [NA [NA |NA no. of the Section, eg. Section «... of IPC, etc:) (@) [Brief description of offence for whichINA [NA [NA [NA [NA convicted (e) [Dates of orders of conviction INA |NA_|NA__|NA__|NA ( __ [Punishment imposed INA [NA [NA |NA_ |NA (g) Whether any Appeal has been filedNA [NA |NA [NA [NA lagainst conviction order |(Mention YES or NO) (Qs) _[lfanswer to (g) above is YES, INA [NA [NA [NA |NA lgive details and present status of appeal | (6A) [have given full and up-do-date information to my political party aboutall pending criminal cases against me and about all cases of conviction as given in paragraphs (5) and (6). AM CONTESTING AS AN INDIPENDATE CANDIDATE. [candidates to whom this Item is not applicable should clearly write NOTAPPLICATION IN VIEW OF ENTRIES IN 5(1) and 6 (0, above] Note: 1. __ Details should be entered clearly and legibly in BOLD letters. 2 Details to be given separately for each case under different columns against each tem, 3 Details should be given in reverse chronological order, i.e, the latest case to be mentioned first and backwards in the order of dates for the other cases. dditional sheet may be added ifrequired. countyragred j 4 kA supeMnery Meraz Akhtar NOTARY DIBRUGARH Regd. No, DBR = 14