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ANNEXURE – I
Statement of Immovable Property possessed, acquired and disposed of by Sri / Smt. / Kum.
__________________________________________________________________________________________________________________________
or any other Person on his / her behalf or any member of his / her Family during the Year ending 31.12. .
[Sub Rule (7) of Rule 9 of APCS (Conduct) Rules’ 1964]
Whether
Situation of Date and
information given Annual
Nature of Property (Survey mode of Price paid / Source of
S. No. Held in whose Name or sanction Income from
Property Muncipal No. acquisition / obtained Payment
obtained (with Ref. Property
with extent) disposal
No. & Date)
01. 02. 03. 04. 05. 06. 07. 08. 9
01. House
02. Flat
03. Shop
04. House Plot
Agrl. Land
05.
(Dry or Wet)
Any other
06. Immovable
Property
NOTE: Details of acquisition of Properties standing in the Name of Hindu undivided family or partnership in which the Officer holds a
Claim or share should be separately shown in the Statement.
Signature of the Government Servant with Date
/media/D DRIVE/UDAY/FORMS/PROPERTY STATEMENT.doc
ANNEXURE – II
Statement of Movable Property possessed, acquired and disposed of by Sri / Smt. / Kum.
__________________________________________________________________________________________________________________________
or any other Person on his / her behalf or any member of his / her Family during the Year ending 31.12. .
[Sub Rule (7) of Rule 9 of APCS (Conduct) Rules’ 1964]
Date and Name and Address of Whether
S. mode of Person from whom transaction done Price paid /
Nature of Property Held in whose Name Source of Payment
No. acquisition / acquired / to whom within the limits obtained
disposal disposed of of Jurisdiction
01. 02. 03. 04. 05. 06. 07. 08.
Movables (Whose Value exceeds Rs. 1,00,000/)
Vehicles
Motor Car
01.
Motor Cycle / Scooter
or any other Vehicle
Electrical Goods
Air Conditioner
02. V.C.R. / Television
Refrigerator
Any other Goods
Jewellery
03.
Ornaments Vessels etc.
Investment & Cash
Bank Deposits /
04.
Debentures / Shares
Bank Balances etc.
Furniture
05. Live Stock any other
goods
NOTE: Details of acquisition of Properties standing in the Name of Hindu undivided family or partnership in which the Officer holds a
Claim or share should be separately shown in the Statement.
Signature of the Government Servant with Date