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Vide: Rule 62 of the State Bank of Hyderabad Officers' Service Rules 1979

FORM NO. I STATEMENT OF IMMOVABLE PROPERTY AS ON 31.03.2013


(e.g. Lands, House, Shops, Other Building etc.)

NAME DESIGNATION DATE OF JOINING BASIC SALARY Rs. PF INDEX NO. POSTING.

: Srinivas B : Probationary Officer : 02.07.2012 : 14,500.00 : 403566 : KESAMUDRAM,Kesamudram Remarks

Serial No. 1

Details/Description of Property & its Location If not in own name, state in whose name held & How & when acquired Values of the property (See notes 1&5 below) his/her relationship, if any to the employee (See notes 2 & 6 (See Note 3 below) House/Building/Land No. below) 2 3 4 5

Total Annual Income from the property 6

Note : 1) 2)

3)

4) 5) 6)

If the property is not wholly owned the extent of share may also be indicated. For the purpose of column 4 the term "lease" would mean a lease of immovable property from year to year for any term exceeding one year of reserving a yearly rent. Where, however, the lease of immovable property is obtained from a person having official dealings with the employee, such a lease should be shown in this column irrespective of the term of the lease whether it is a short term or long term, and the periodicity of the payment of rent. In column 5 must be shown (a) Where the property has been acquired by purchase, mortgage or lease, the price of premium paid for such acquisition. (b) Where it has been acquired by lease the total annual rent thereof also and (c) Where the acquisition is by inheritance, gift or exchange the approximate value of the property so acquired. The annual return is respect of immovable property may also be submitted in this form as on 31st March. Name of District, Division, Taluka & Village in which the property is situated & also its distinctive number etc. will be given in column 2. Whether by purchase, mortgage, lease, inheritance gift or otherwise & name with details of person/persons from whom acquired (Address and connections of the employed, if any with person/persons concerned here also to given in column 4).

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Vide: Rule 62 of the State Bank of Hyderabad Officers' Service Rules 1979

FORM NO. II Statement of Assets (Other than Immovable Property) & Liabilities
on First Appointment / as on 31st March 2013

NAME DESIGNATION DATE OF JOINING BASIC SALARY Rs. PF INDEX NO. POSTING.

: Srinivas B : Probationary Officer : 02.07.2012 : 14,500.00 : 403566 : KESAMUDRAM,Kesamudram

ASSETS A. Liquid Assets & Investments (including deposits & LIC Policies)
Sr No. Description 1 Amount/Original Price 2 Held in the name of & relationship 3 How acquired 4 Annual Income Delivered 5

B. Movable Properties
1 TWO WHEELER 60,000.00 , FATHER 60,000.00

LIABILITIES I. Liabilities to the Bank/Financial Institutions


Sr No. 1 Type of Loan FESTIVAL ADVANCE Principal Amount 28,000.00 Present Outstanding 19,600.00

II. Liabilities to friends and relatives


Sr No. Type of Loan Principal Amount Present Outstanding

III. Other Liabilities (if any)


Sr No. Type of Loan Principal Amount Present Outstanding

N.B. : Additional sheets may be attached where necessary. Note : 1) In case of shares, securities, debentures etc. face value and approximate market value as on the date of statement may be mentioned. Note : 2) In case of Life Insurance Policies date of maturity may also be stated. Note : 3) Under B information may be given regarding items like [a] Gold/gold ornaments : Approximate weight only be stated. [b] Silver including ornaments, vessels etc. (approximate weight) [c] Other precious metals, items of jewellery, precious stones forming part of jewellery etc. Approximate value to be stated. [d] [i] Motor Car [ii] Scooters/Motor cycles [iii] Refrigerator/Air-conditioners [iv] Radios/ Radiogram/Television sets and other articles the value of which individually exceeds Rs. 2.500/- [e] value of items of movable property individual worth less than Rs. 2,500/- other than articles of daily use such as clothes, utensils, books, crockery etc. added together as lump sum. Note : 4) In column 4, may be indicated whether the property was acquired by purchase gift or otherwise. Note : 5) Under Liabilities brief details should be given.

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Vide: Rule 62 of the State Bank of Hyderabad Officers' Service Rules 1979

FORM NO. III Detailed Statement in respect of Shares/Debentures purchased under Promoters'/Employees' Quota as on 31st March 2013 in Officers' own name and also held in the name of Spouse and dependent children

NAME DESIGNATION DATE OF JOINING BASIC SALARY Rs. PF INDEX NO. POSTING.

: Srinivas B : Probationary Officer : 02.07.2012 : 14,500.00 : 403566 : KESAMUDRAM,Kesamudram

A. SELF
Sr No. Name of the Company No. of Shares 3 900 Face Value Cost of acquisition 5 11.11 18,000.00 Whether promoter /employee quota 6 Employee How acquired Position held at the time of acquisition and if the company had any borrowing or other facilities at that time 8

1 1

7 SALARY

B. SPOUSE AND DEPENDENT CHILDREN


(Please give name and relationship) Sr No. Name of Spouse/Dependent Name of the Company No. of Shares Face Value Cost of acquisition Whether promoter /employee quota How acquired Position held at the time of acquisition and if the company had any borrowing or other facilities at that time

(2) Any additions/deletions to this statement during the year ended the 31st March 2013 and the profit/loss incurred by me is given below.

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Form IV
To be submitted along with Assets & Liabilities Statement as at the end of March every year

Form for giving intimation where total transactions in Securites, Debentures & Investment in Mutual Fund schemes etc. exceeds Rs. 25,000/- during the year ended the 31st March, 2013
1. Name and Designation PF Index Scale of pay & present pay Details of each transaction made in shares, securities, debentures, Mutual funds schemes etc. during the financial year Particulars of the party/firm with whom transaction is made (a) Is party related to you ? (b) Did you have any dealings with the party in your official capacity at any time or is the applicant likely to have any dealing with you in the near future ? Source or sources from which financed (a) Personal savings (b) Other sources, give details Any other relevant fact which you may like to mention : Srinivas B,Probationary Officer : 403566 : 14,500.00 :
NO

2. 3.

4.

: :

NO

5.

: : :

NO

6.

NO

The data has been saved. For submitting it finally, please click on 'Final Submission' on main page, take print out, sign on each sheet and submit to the BM/HOD.