Professional Documents
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Form for giving prior intimation or seeking previous sanction under Rule 18 (2) of the
CCS (Conduct) Rules, 1964 for transaction in respect of immovable property.
Rajesh Kumawat
1. Name and Designation.
Disposed off
4. Whether property is being acquired or disposed of.
15.11.2017
5. Probable date of acquisition/disposal of property.
Sale
6. Mode of acquisition/disposal
Residential House
(b) Description of the property, in the case of cultivable
land, dry or irrigated land.
Leasehold
(c) Whether freehold or leasehold.
Full
(d) Whether the applicants interest in the property is in
full or part. (in case of partial interest, the extent of
such interest must be indicated).
Not applicable
(e) In case the transaction is not exclusively in the name
of the Government servant. Particulars of ownership
and share of each member.
Enclosed
10. In the case of disposal of property, was requisite PMG Indore, Memo No.
sanction/intimation obtained/given for its acquisition Staff 7/ PF/ RKK/ 78
(A copy of the sanction/acknowledgement should be dated 10-12-10
attached).
No
(c) Did the applicant have any dealings with the party in
his official capacity at any time, or is the applicant
likely to have any dealings with him in the near
future?
Direct
(d) How was the transaction arranged? (Whether
through any statutory body or a private agency
through advertisement or through friends and
relatives. Full particulars to be given).
Not applicable
12. In case of acquisition by gift, whether sanction is
also required under Rule 13 of the CCS (Conduct)
Rules, 1964.
Nil
13. Any other relevant fact which the applicant may like
to mention.
DECLARATION
I, Rajesh Kumawat, hereby declare that the particulars given above are true. I request that I
may be given permission to acquire/dispose of property as described above from/to the
party whose name is mentioned in item 11 above.
OR
I, .. hereby intimate the proposed acquisition/disposal of
property by me as detailed above. I declare that the particulars given above are true.
Station : Indore
Signature : (Rajesh Kumawat)
Date : 05.10.2017 Designation : Asstt Supdt. (vig)
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Note :1. In the above form, different portions may be used according to requirement.
2. Where previous sanction is asked for, the application should be submitted at least
30 days before the proposed date of the transaction.
FORM-II
(c) Did the applicant have any dealings with the party in his
official capacity at any time, or is the applicant likely to have
any dealings with him in the near future?
DECLARATION
OR
Station :
Signature :
Date : Designation :
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Note :1. In the above form, different portions may be used according to requirement.
2. Where previous sanction is asked for, the application should be submitted at least
30 days before the proposed date of the transaction.
..
5. Total annual income from all sources during the Calendar year immediately
proceeding the 1st day of January 19.
6. Declaration
I hereby declare that the return enclosed namely, Forms I to V are complete, true and
correct as on.to the best of my knowledge and belief, in respect of information
due to be furnished by me under the provisions of sub-rule (1) of rule 18 of the Central
Services (Conduct) Rules, 1964.
Date. Signature
Note 1. This return shall contain particulars of all assets and liabilities of the Government
servant either in his own name or in the name of any other person.
1 2 3 4 5 6 7
8 9 10 11 12 13
Date.. Signature.,.
Note (1) For purpose of Column 9, the term "lease" would mean a lease of immovable
property from year to year or for any term exceeding one year or reserving a yearly rent.
Where, however, the lease of immovable property is obtained from a person having official
dealings with the Government servant, such a lease should be shown in this Column
irrespective of the term of the lease, whether it is short term or long term, and the
periodicity of the payment of rent.
(a) where the property has been acquired by purchase, mortgage or lease, the price
or 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.
FORM NO. II
(2) Deposits, loans, advances and investments (such as shares, securities, debentures,
etc.
1 2 3 4 5 6 7
Date..
Signature..
Note 2. The term "emoluments" means the pay and allowances received by the
Government servant.
FORM NO. III
1 2 3 4 5 6
Date Signature.
Note 1. In this Form information may be given regarding items like (a) jewellery owned by
him (total value); (b) silver and other precious metals and precious stones owned by him
not forming part of jewellery (total value), (c) (i) Motor Cars (ii) Scooters/Motor Cycles;
(iii) refrigerators/air-conditioners, (iv) radios/radiograms/television sets and any other
articles, the value of which individually exceeds Rs. 1,000 (d) value of items of movable
property individually worth less than Rs. 1,000 other than articles of daily use such as
cloths, utensils, books, crockery, etc., added together as lumpsum.
Note 2 : In column 5, may be indicated whether the property was acquired by purchase,
inheritance, gift or otherwise.
1 2 3 4 5 6 7 8 9 10
Date. Signature
FORM NO. V
Remarks
Sl. Amount Name and Date of Details of
No. address of incurring Transaction
Creditor Liability
1 2 3 4 5 6
Date .. Signature.
Note 1. Individual items of loans not exceeding three months emoluments or Rs. 1,000
whichever is less, need not be included.
Note 3. The term "emoluments" means pay and allowances received by the Government
servant.
Note 4. The statement should also include various loans and advances available to
Government servants like advance for purchase of conveyance, house building advance,
etc. (other than advances of pay and travelling allowance), advance from the GP Fund and
loans on Life Insurance Policies and fixed deposits.
[Cab. Sectt. DP&AR O.M. No. 25/7/65-Ests. (A) dated 6th January, 1973]
FORM I
Sir,
This is to report to you that I propose to build a house/to make an addition to my house.
This is to request that permission may be granted to me for the building of a house/the
addition to the house.
The estimated cost of the land and material for the construction/extension are given
below:-
Land
(2) Area
(3) Cost
I have/had official dealings with the contractor and the nature of my dealings with him
is/was as under :
Amount
Full details
Yours faithfully,
FORM II
Sir,
for the building of a house. The house has since been completed and I enclose a Valuation
Report, duly certified to by (A firm of Civil Engineers or a Civil engineer of repute)
2. The cost of construction indicated in the enclosed valuation report was financed as
under :-
Amount
Yours faithfully,
(Signature)
Date :
(Note :- Variations, if any, between the figures given above and the figures given in Form I
may be explained suitably)
VALUATION REPORT
I/We hereby certify that I/We have valued House(Here enter details of the house)
...constructed by Shri/
Shrimatiand I/We give below the value at which
we estimate the cost of the house under the following heading :-
Headings Cost
Rs. Ps.
(1) Bricks
(2) Cement
(4) Timber
..
Form for giving prior intimation or seeking previous sanction under Rule 18 (2) of the
CCS (Conduct) Rules, 1964 for transaction in respect of immovable property.
6. Mode of acquisition/disposal
(c) Did the applicant have any dealings with the party in
his official capacity at any time, or is the applicant
likely to have any dealings with him in the near
future?
13. Any other relevant fact which the applicant may like
to mention.
DECLARATION
OR
I, .. hereby intimate the proposed acquisition/disposal of
property by me as detailed above. I declare that the particulars given above are true.
Station :
Signature :
Date : Designation :
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Note :1. In the above form, different portions may be used according to requirement.
2. Where previous sanction is asked for, the application should be submitted at least
30 days before the proposed date of the transaction.
..
FORM-II
(c) Did the applicant have any dealings with the party in his
official capacity at any time, or is the applicant likely to have
any dealings with him in the near future?
13. Any other relevant fact which the applicant may like to
mention.
DECLARATION
OR
Station :
Signature :
Date : Designation :
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Note :1. In the above form, different portions may be used according to requirement.
2. Where previous sanction is asked for, the application should be submitted at least
30 days before the proposed date of the transaction.
..
(b) Did the applicant have any dealings with the party in his official capacity at any
time or is the applicant likely to have any dealings with him in the near future.
Declaration :-
Signature:
Station :
Designation:
Date :