âForm â IV (see rule 7) Statement of Assets and ... - Lokayukta

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Particulars to befurnishedPublicServantSpouseDependentFatherDependentMotherDependentChildren1 st 2 nd 3 rd(a) Cash(1) (2) (3) (4) (5) (6)i) Cash on handii) Cash kept in locker(give details)iii) Whether it ispersonal savingsiv) If not, mention thesource of acquisition(b) Bank depositsi) Account / CertificateNo. nature of deposit,amount and name &branch of bankii) Whether it ispersonal savingsiii) If not, mention thesource of acquisitioniv) Date of deposit(c) Bank Accountsi) Account No. &nature of A/C amountand name & branch ofbankii) Whether it ispersonal savingsiii) If not, mention thesource of acquisition(d) Post OfficeAccounts
i) Account /CertificateNos nature of deposit,amount and name &place of Post Officeii) Whether it ispersonal savingsiii) If not, mention thesource of acquisition(e) National SavingsCertificates and otherCertificatesobtainedthrough the PostOffice,i) No, of the NSCs andothercertificates,amount, name & placeof post officeii) Whether it ispersonal savingsiii) If not, mention thesource of acquisition(f) Units of UnitTrust of Indiai) particulars of units,name of the branchand amount.ii) Whether it ispersonal savingsiii) If not, mention thesource of acquisition(g) Government andother Securitiesi) Particulars ofsecurities, name &place of office of
Page 1: “Form - IV(see rule 7)Statement o
Page 5 and 6: and Provident Fundsi) Particulars o
Page 7 and 8: d) Silverwarei) Particularsii) Cost
Page 9 and 10: c) Buildings(including flats)i) Com

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âForm â IV (see rule 7) Statement of Assets and ... - Lokayukta