2023-2349640-65905490876582275
2023-2349640-65905490876582275
2023-2349640-65905490876582275
SL Name of Name & Details Cost of Present value* If not in own name, state How acquired whether Annual income from Remarks
NO. Khasra No., of Property construction/Acq in whose name held and by purchase, lease**, property
Village/City, (Description) uirement his/ her relationship to mortgage inheritance,
Taluk, Sub- (and year when the Govt. Servant gift or otherwise with
Division, purchased) date of
District including of acquisition and name
in which land in case of with details of
property is house person(s) from whom
situated (full acquired.
location &
postal address)
1 2 3 4 5 6 7 8 9
1 NIL, NIL, NIL, NIL, NIL NIL NIL NIL, NIL, NIL, NIL NIL, NIL - NIL NIL NIL
NIL
1230583
PB-BHUBANESWAR DDK - DD
NOTES:
1) * In case where it is not possible to assess the value accurately, the approximate value in relation to present conditions may be indicated.
3) The declaration form is required to be filled in and submitted by every member of Class I and Class II services under relevant provisions of Conduct Rules and the first appointment to the Service and
thereafter, at the interval of every twelve months, giving particulars of all immovable property owned, acquired or inherited by him or held by him on lease or mortgage, either in
his own name or in the name of any member of his family or in the name of any other person dependent on Government Servant.
Signature Not
4) The wording Verified
‘No Change or No Addition or As in previous year’ may be avoided and all details filled up.