31,
.--
No.
Ucta.'.
ASSAM
"'|als\
FORM 26 (See nne,LA)
537
g
f
cA
I
' lffidsvta b b.lfl.d by ah. dilte
Olficcr for Elcli.ttr b
!9 No. Kokr8jhrl W.!
Rctufliry j
ahc Houdc) ftiom ?
(Nr.d. of ahe Cooldtrcncy).
7
b.foF tbc
PARr-A
!.
a
E
I SMT ABIINA BRAEMA, Wife ofsri Thabetr&E Brahm4 aged aboul- 41 years,
a residert of Village- Cloro Binyakhda, P.O.- Bhyakhd4 P.S.- co
aon, DidFohajhar, B.T.A.D., AssdD. a csndidrte at the above election, do hereby sol€dr y
effirf, ard $ate on oelh [s utrder!
tr (D t u- a cotrtesting as an ildep€ddenr c0ndidate.
F
(2) My nene is €Drolled
h
No. 29 Kolaajh6r, Wsst (ST) LAC of Assam (Nane of the
constituency @d the Stare), et Serial No. 687, in Pofi No. 65.
Arhrrtul Alon
A(Socrt., GolsrigroL
I
x
Page
I of 1l
Di.jt- KoIraihar
Reld No.z
a
t'
(1,
(3) My contlct
telefrhooo numb€r
is atrdhy +mail id (if
any) is.
(4) Details of P€nDdrdt Aocout Numb€r (pAl0 and srahs of filing of Iorlme To(
rgtuml
sl.
N
N&tre
PAN
The fJrecid
T6l
ye€r
income
for which
dre
L Self- (SMT ARUNA BRAEMA)
2.
4.
5.
l.it
shown
IncoDe-tax
returtr
AI'EPB8OI7G
Nit
NiI
Spouse Sri Thab€odra Brabsa
Nil
Dep€ndent-l Mss Monalika Brabma
Nil
Nil
Nil
Nil
Nil
Nil
Nit
Nil
Nil
Nil
Nit
Dep€[d€|lt-2 Sri Kunal Brahma
Dep€ddet-3
Alh|zfrI
AJom
Govt. of .A.ssa.n
in
hcome. tax
Page 2
of
11
(3)
Dt.accused
) m whlch a
offenc€(sl punlshabte with
impnsonment
in
(s) hasi/have been framed by the court{s) o
is acc sed of ery such offerrce(s) he shall fi-rmsh the following
C
of
(a)
Nos
First IDfomation Repod No /
together wtth complete dehrls
conc€med
(i)
a
The
NIL
Police
I
Station/District/State
o)
Section(s) of th€ concemed Act(s)
afld short descnption
the
off€nce(s) for whicb cha!'
NIL
Name of th€ CoEt, Case No ard
dals of order taking cogniz€dce:
NIL
of
(c.l
Cour{s) which franed
(d)
the
Dat{s) on which the charg{s)
Whether
all or my of
the
proceedings(s) have been stayed by
any Court(s) of competent jwisdrction
(ii) the
g
NIL
was/were ftam€d
(0
{
NIL
(s,
(e)
II
NIL
follo
I cas€(s) is/are peoding against me m 'rhich cogrizanca has been taken by me corm
[other than the cases m€ntioned in item (i) abor/elt
(a)
Nane of the CouI!
(b)
Th€ details
Case No. a,td
date of order taldng cognizafte:
of
of tlrc Ac(s)
r here
the
arld doscription
of
cases
offence(s) for which
(c,
Details
co
NIL
NIL
the
e taken
of
Appeal(s/ Application(s) for rev$ion
(f any) filed against rhe above
ord€(s)
NTL
(6) I have bear,&ave not been convict€4 of sn offeno{s)
[other tlal any ofrenc€ (s) refer€d to ill subseclion (1) or sub-section (2), or coverEd in sub-sectron (3), of s€ctior 8 of the ReFesentation
of the
P-eople Act 1951 (43 of 1951) and s€ntenc€d to jmprisonmed for one year or more.
f_the
deponent
is
convicted
ard
prmished
|nIormallon
as
aforesard
h; sha
flnnish the fou
.\!
Advocstrq Gossaigsotr.
Lalil
--il
€rvt- of /cassarn
Regd. Nc. !.]c.rrn.- ?
Go=s!i:!f cn. i.-Dkrajt tot
page 3
of I I
(4)
I0 the folowiag casg I have been convicted alld
sertenced to imprison nent by a court
Details of cases, section(sf
of
coDc€med Acf(s) alrd descriDtion
s) for
of tie Cour!
whict c.nvicted
Case No. and
oforder(s):
any appeal was,/has b€eo
filed against the conviction order.
If
sq details and the present status ofthe
(4
That I give hereh b€low the daails ofthe assets (movable
strd immovable etc.) ofmyself,
Ey spouse a.nd all dependents:
Note: 1. Assets io joint narae ildicating the
8M[
er.te ofjoint
ownership
will
also have
detail
dd
tei 2. Io, case of deposit/investrDen! the
deposil $e scherne. Name of the B
Note:
s per
..
3_
Notei
4
Note: 5.
to
t
b€
oun! date of
;;;
(
current market \,,s.lue in Stock exchdrce
as per books in case of non-tisted compani-es
Depetrdent here hos the same meanrng as asstgned
in Explanation (v) und€r
'
section 75A of the RErresentation ofthe people-Acr_
| 95 |
Details including anrouat is to be
elven sep;a;din .op.o of
investment.
*"t
Details
deposit
Bank
(FD
of
iD
Bank of
Idia,
accolmts
Rs, TerEr
Deposits
ad
all
other tt?es of
deposits
ircluditg
Rs. 10,206/- only.
saving acaounts),
Deposits
sdrh
Finsncial
Institutiotrs, NonBmking
Finadcial
Compani€s
and
Coop€rative
societies and the
amoud
in
each
suoh deposit
Page4ofll
Advocetq Gorsaigson
t
{
(5)
86.
N
tgr
('v)
N
Nrl
Ntl
Nil
Nil
NN
Nil
NrI
Nrl
Nil
Nil
N
N'l
N11
N
qs erd the
Details of mvestrnent in
NSS, Postal Saving
lnsurance policies and
investnent in any Financial
insbuments in Post offic€ or
Iosurance Company and the
amount
(")
Person4l loaqJadvance
glveh to any person or enflty
mcluding firm, compaty,
Trust etc, snd other
recelvables from d€h'tors
atrd the amoult
("i)
{
Motor Vehioles/
Aircrafts^f achts/Ships(Deh i
ls
N
NiI
Value- Rs 54,000/or y,
Nil
Nil
Nit
Ni1
N
Nil
N
Nit
N
Nil
Nrt
Nil
N
Jewellery, bullion and
valuable thinB(s) (grve
detads of weigbt and
valu€)
(viiD Any other assets $rch as
value of clalms/int€rest
(i-{) Gross Total Valua
(
Ntl
ofMake,
ation
Drdber etc year of pwchae
&rd amount)
(vn)
{
,
5
t
Gold- 2 Tol4
R$
1
,4J06l- obly
B. Dgrils.ogEDqvrblc.Alssgi
Note: 1. Properties in Joint ownership indicating the extent ofjoint oRnership will
also have to
be mdicated
Note: 2. Each land or building or apartnent should be mentioned seprrately in tlus forma
Dep€nd€nt-l D€pendent-2 Dependent-3
Spouse
Self
Sl No
Descnption
t
&riecltu-r4-!c!rl
I-ocation(s)
Suryey
mrmber(s)
Area (iotal
messulemont
in
Whethor inherited
propdty (Yes or N o
Ash;rful Alom
Nil
Nrl
Nil
Not Applicable
Nil
Not
Lcable
Nil
Nil
Nrl
Not
Not
Applicable
Applicable
Not
Not
Not
Applicabl€
Applicable
Applicable
Not
Appli
rt
Page 5
of 1l
le
I4
ti
,*
o
Not Applicable Not Applicable
f,
0,\"tu ':tiil
,and (in case of
) at the time of
d?\
Not Applicable Not Applicable
Not
Not
Not
Applicable
Applicable
Applicable
Not
Not
Not
Applicabte
Applicable
Applicable
rnveshent on the
of
land by way
Not Applicable Not Applicable
developmen!
construction etc
App
rmate current
Not Applicable Nol Applicable
msrket value
(r,
on-Adicul iural Ltrd:
Incatlon(s) Swvey
Not
Not
Not
Applicable
Applicable
Applicable
Not
Not
Not
Applrcable
Applicable
Applicable
N
NiI
Nil
NiI
N
Nil
numb€r{s)
Area (total
N
measlrcm€nt in sq ft )
Not Applicabl€
Bu tup
m
Area (Total
lllem€It in sq. fit.)
Not Applicable Not Applicable
Whedrcr inherited
property (Yes or No)
Date ofpuchase
c€s€
Nil
in
.
Not Applicable
Not Applicable Not Applicable
of self-acquired
Cost of Iand (in case of
puchas€) ar the trme of
Not Applrcable
Not applicable
Not
Not
Not
AtrT,licable
Applicable
Applicable
Not
Applicible
Not
Not
Applicable
Applicable
Not
Not
Applicable
Applicable
F
t
Not
Not
Not
Applicable
Apphcable
Not
Not
Applicable
Apphcable
Not
Any mvestment on the
land by way
of
Not Applicable Not Applicable
development
Not
Not
Nol
Applicable
Applicable
Applicable
constuction etc
ApproxrtrEte qment
mdket value
(n1)
Commercial Build
(irclud
apartnents>
tncations(s)-Suvey
numbe(s)
Area (total
measuremert in Sq. ft.)
Built-up Area (total
Eeasurement in Sq ft)
Whether inherited
property (Yes or No)
Date ofpwohase
AdYotrte, Gossaigaon.
Not
Not
Applicable
Applicable
Not
Applicable
Nrl
N
Nit
Nil
Nil
Not Applicable Not Applicsble
Not Applicable Not Applicable
Not Applicable Not Applicable
in
of self-acquired
property
case
Not Appl rcable Not AppIcable
Not Applicable Not Applicable
-?
Not
Applicable
Applicable
Applicable
I
Not
Not
Not
Applicable
ADplicable
Applicable
Not
Not
Not
Applicable
Applicable
Applicable
Not
Not
Not
Applicable
AoDlicable
Applicable
Not
Not
Not
Applicabl€
Applicable
Applicable
z
=<
rl
(7)
tt K,
Not Applicable
Not Applicsble
Not Applicable
Not Applicable
construction etc
Aptroxrlnate current
msrket value
Not Applicable
Not
Applicable
Not
Applcable
Not
Applicable
Appiicable
Not
Nof
Not
Applicable
Applic€ble
Nil
Nd
Nil
Nit
Not
Not Applrcable
('v)
Nrl
Area (total
reasurement in sq. ft.)
Built-up Area (total
fteaswement in sq ft
Whether inherih_d
Foperty (Yes o. No)
Date ofpurchase
Nil
NO
Not Applicable
acqurcd property
Cost ofproperty (in
of purchase) at
the hm€ ofpwchase
cas€
Any inocsttne.rt
Nil
Nil
Not
Applicable
NotApplicabie
NO
in
c€se of self-
f
\ot
Applicable
Not
Applicable
N
Not Applicable
Not
Apphcable
t
Applicable
AppljcabJe
Not
Not
Not
Applicable
Applicable
t
Applicable
Applicable
Not
Not
Nil
Not Applicable
Not
Not
Not
Applrcable Applicable Applicable
)orlstructiotr etc.
Approximato current
meket value
Others (such
Not
Applicable
Applrcable I ADDIcable
I
Not Applic€ble
Nil
Not
Not
IAppticable
Not Applicable
Not
as
mrcrest
m prope.ty)
Nil
Nil
Nil
Not Applicable
Not
Not
Applicable
Not
Appllcable
Applicable
Nil
Nrl
Nil
Not
Not
Applicible
Applicable
Tot4l ofcurrentm
value of (i) to (v)
mment-
deails of liabilities/dues to
s:ffi?'J."1xtrfft
publi"Gi[i"t
Applicable
t
Not
,ti*. _d
detaiJs of name of banlq inst'|Miorr
emitv or indivrdurl and
PageTofll
Advo.ate, Gor6aigron.
J
,f
(
ona"
)rop6ty by way
developnen!
(vt
Not
Applicable
orr the
"'Ft
(v,
Not
Applicable
\
(8)
6l No
nv :\
tcrpuon
\{
Spodse
Dependenr-1
Dependort-2
Dependent-
N
N
N'l
Nil
Ni1
Nrl
N
N
Nrl
Ni1
Any other liability
N
N
Nll
Nd
Nrl
Grand total of liabilities
Nil
N
Nil
Nil
N
N
N
Nil
Nil
Nil
wlth supply of water
Nil
Nit
N
Nil
N
Dues to departrnent d
widl supply of elecEicity
Nll
Nrl
N
Nil
Nil
Dues to departrnent deal
wth supply of
Ni1
Nrl
N
Nil
Nil
Nrl
Nil
Nit
Nil
N
Nil
Nit
Nil
Nil
N
Wealth tax dues
N'l
Service tax dues
Nrl
Nrl
N
N
Nrl
Nrl
N!l
Nil
Nil
dues
Nrl
N
Nil
N
Nrl
Sales tax dues
Nrl
NiI
Nil
Nil
Nrl
Nil
N'l
Nrl
AIIy other dues
Nrl
Nrl
Grand total of all
Government dues
Nrl
Nrl
NJ
Nil
Nil
Loan or dues to ary other
mdividualvenbty oth€. thar
rh€ntioned abov€ Name(s),
Ahount
of loar
(rD
Seif
outst€rd
natrre
Covemnent dues:
Dues to deparherts
dealing with Govemrnent
accormnodation
Dues to deparhent dealing
tel€phondmobil€s
Du€s to
wift
=.l
dE)
ent dealing
emment transport
(includ aircrafu and
MmicipaYProperty Tsx
0n)
P 8ofl1
Advocsta, Gossaigron.
F
d
t
{
helicopteN)
Income tax dues
?
Wle|th€f an)r other
liobiliti€s ae in dispute,
if
,:rZt,
e!
so, meation thc
mount
hvotved and the
authodfy before u/hich it
2
Details of prof€ssion or occupatioD:
(a)
Self-
Social worker
O) Spouse- C\rltildd
(
10)
My educational qualific€tion is
Exarnination Passed
High School l-eaving
Cenificate (H.S.L.C.)
Hisher Secondarv (H.S.)
es
lmde{i
In which institutioa/ Bodd
RamfrIbil H.S. School./SEBA
Year ofPassinc
Jdata College/AHSEC
1992
1990
(Give d€tailr ofhighest Schoouuniversity educatioa nientioniq the firll form ofrh€
certificate/diploma/degree course, name of the Schooycollogerunivemity and the year
itr which the course was completed.)
PABId
(I
I)
ABSTRACT OF THE DETAILS GIVEN IN
t. Nade oflhe
(I) TO (IO)
Catrdidste
Full postal address
3.
Numb€r and ndme
corstituenoy ed Stote
g
OF PART-A:
cC
SMT ARUNA BRAHMA
Vilage- Choto BinFlftor4 P.O.- Binyakhat4
P.S.. Cossaigaoq Dist- Kokajhar. B.T.A.D.
Assah.
2.
pf
the
No. 28 Gorgignon LAC ofAsssn.
Name oflhe political party \ 41ich set
4
up the cEdidate-
(otherwis€ u/rito
'Independenf )
(i) Total number of psnding
5.
Itrdcpendena
cases
where charges have been ftarned by dre Court
for offences putrishable wirh impdsotrmom
for two yegrB or more
(ii) Total number of perding cases
whete the cour(s) have taken cognizalce
lother thatr the cases m€ntio{ed h item (i)
Nil
Nit
abovel
Page 9
Ashr{frrl Abm
t
of l1
t
I
F
Y
(r0)
and s€Dt€nc€d to impdsonment for one
[exc@t for offeoces reffired to in
1),(2)
or (3) of
of th€ People Ac!
s€ction
8
oI
19511.
Year for which last
income tax retum
DetsilsofAs ed
Purchas€ price
Liabilities in
of
self-acquired
immovable
J
Devolopment /
cotrs&uction cost
of
ftrnrovable property
aft€r purchase
(if
@plicable)
(a) selfacquned
dssets (Toral
value)
O) inheritcd assots
(Toftt value)
Id€nqlied by :
Ashratul Alom
Page
lodll
s
from Bar*,
Highest educa
(Give details
.#iG^-6l
I
':-r^--'
:ertilcaY
$elotEa/ degree coursg raE€ of the SchooVColtege/
year
in which the course was completd.)
Univers
tho
VERF'ICATION
alEdavi
Dolhiq
(a)
the coDtents of this
Pdt ofit is false and
There is. no clT ofconviction or pending
cuse against mo other thatr those montroned
m
items 5 atrd 6 partA atrd B above
O) L.l.*:*.,or Ey depend€ors d: n9r.have aqy asset or liability, ofter than
those
oetrtiooed ir itd 7 aad t ofparr A and ireos g
8. *a fo of i* 6'ii".*--.
V€rifid
ar Cossaigaon
q|ftis
rhe 226 Day of
Mdch/20l6.
A".n*. |'-&"""DEX)NENT
Not€! l. Affidavir sbould be fiIed
Nomiiations.
laresfi
by 3.00 pM on &o last dry of filiag
Commissioner or MagisFate of the First
be left blank. If there is no infonualion
Iicable,', as the case may be, should be
Notei 4. The Affidavit should
Advocrig Golsrigoon
be either
t}?ed or nritter legibly and neatly. ,