K_Ir • CO-AZ. ieD [Mit pt-- - 101 al, TrOe - 4 20 FORM VI See rule 22 Nomination Paper Election for the Cantonment Board, KIRKEE to be held on 211 ii44' 11)1.1 2015 (To be filled by the Proposer) I hereby nominate be EPAk IcAsviMmt LPIL AGiRRoAL as a candidate for election from Ward No 3- at the election referred to above. Full name of proposer Electoral roll rape oRno S IbA'/ I51-li,JAR. 53 42_ Number of proposer Ward No. 3. Roll No. 534-2."- Name of candidate's Eather / husiand_kfaSliti Full postal address of candidate Part No. AGIF) el- .1.1$5- Dth OalzA2, kARKEE PODOP1 — 5. Electoral roll No. of candidate. Ward No. 3 3250 Roll No. 3250 Date Signature of Proposer (To be filled by the Candidate) I, the above mentioned candidate, hereby declare that to the best of my knowledge and belief I am eligible for election as a member of the Cantonment Board and assent to this nomination. The symbols I have chosen are in order of preference. i) ii) Cs-k S0.uCtY C e)C- c9 .i)-7r1.S.S•ANce_ Cooe-r- Date : ° 11212-011 Signature of Candidate 16112ive 002 211 Further declaration to be made by a Scheduled or a Scheduled Tribe candidate.. I hereby declare that am? I \ miber of the Scheduled Caste / 1 e of the State of *caste/trihe which is a in relation to (area) in at State. Dated : t 0 1 121 — Signature of Candidate ••• •• • • •• • • ' • •• •• • . . . •• . . To be filled by the Returning Officer Serial No. of nomination Paper Date 10112A 1 1 •• • •- ...... • . • • • • • • 211 6 This nomination was delivered to me at my office at un • it *20 rm. (hour) (date) by the *cl<ate/ prop/ er / election agent 10112_110 1I (11=r.X0 1 cl Returning OtRcer Kirkee Contament Board *Strike off one of the alternatives as necessary 003 ••: Rs. 100 5. ONE HUNDRED RUPEES 100 - .,- 0100 - ' p,10010 CI it, . i ., P*1 ( :::, C) 1 C . C20 1 0(-31 . A10 .ii 001 00 -, r — 11 c.31--) 4110” INDIA --- „c--„,_..). _ INDIA NON JUDICIAL ,. ..„..„,,,_,_„„ :. „ ,,_,, ,.„._, MAHARASHTRA iiti •• •i 2014 C 1Lr , • . I' . L W 552608 GF•iltit Trxr?/ Witri? drd 4).rVfl e.:AnTs” ::rez ? ri ?1 qta:J.47 '4".".1-1"-Zrrt q1-2; 4 r1v7D,Ri•:.: 7177 trni :- f*trT. •Ttl:)) rM .3,Y:7-4.441 171 4 IIMT -4 %m; al ••77--; fz:: • tritikT/1 DEC 71114 • :._ 4,44104 to wetia-ffij 41.,,v,1 117Mg4,17:NTA r tifi ? ■39100 0, 71-40. • • WIAlt5,2:01 ,Ilisi."-41-1 f 1-r . r3T 444441 I( 1 • POWER OF ATTORNEY (A letter of Power of Attorney for Appointment of Election Agent for election of Kirkee Cantonment Board, Ward No 7 to be submitted to the Returning Officer.) 015 Agarwal, son of Kashmirilal Agarwal, Age : 48 siness, R/a- 485, Old Bazar, Kirkee, Pune : reby appoint Mr. Niket Yadav son of Ishwar ge about 30 years, R/a - 19, Darga Vasahat, Kirkee Pune - 411 003 as my Election Agent for the ensuring general Election of Kirkee Cantonment Board, of Ward No 7 My aforesaid Election Agent will represent me in the Cantonment Board Election 2008 and I hereby auth iktePIW him to appoint polling agent, to apply for permission "Y %WO hold meeting for the said election, to make application'for the same, to make applications for the said election to the concerned authority as and when necessary, to remain present in the election office, to receive necessary application on my behalf, to collect letters; orders from the Returning Officer appointed for said purpose by the Kirkee 2 004 ...... •I ttitioto. db ...9.0 Mr didi •Ter...re (V. 7:10) '84.oI 1, 0:dk'f Oh, W e Rs. 100 ONE HUNDRED RUPEES 100 Trgr4a x4-4 1 JO p!!11 001 001 C.,. rui 001 001 ( .41T1 INDIA )( ()01 ) r)() "`i1 c)( 1 (_34,-_4, I (..)." (C . r)( ) ( ) 1 1 (..)41) c..)( ) c) (-3. . 1I iN011N,p1A NON JUDJCI .• 0 2014 0 ATI MAHARASHTRA LW 552580 ANR/31-itt-7, (7t1 914.LY1 ibmri arrO 4i1 ? t7Tift tjn7 ar.C.:z.Tffl 774 tkEi4ib er■14rc-I4T4 VaiZfidiii T4-7 •••, :"" 77f474 f447d .ecli=art 704 4 MiT - 4 DEC 2M4 T741.7.501 rAlrti ;{14 4 TM 77tf 74--4311 fit) Ti3 qet 31-1.WritT R •m(i 64) %},c4atitret/trd - i/ iPTal ',11 .777 3i171714Ta cr-41;urr 3. ?Joigoo WM- 0, 3 Y Its , u-41, 30-7e. Cantonment Board and to make applic present for the meeting organized by the Retur cer and do all acts and things on my behalf as my election agent of Ward No 7 for the Cantonment Board Election 2015 3 016 binding on me as if it would have been done by me as if personally present. SIGNED AT KIRKEE, PUNE - 3 ON THIS P_ DAY DECEMBER OF 2014 Place : Kirkee Date : 411), 101 8 RE ME SUNIL GARWAL NOTARY U N OF INDIA KNADKP uNE al 9 DEC 2014 .1) Deepak Agarwal EXECUTANT (‘‘c2. *( (01 al' 141. 04.TA NG*;e. ,1:11 eet o. 6 K Niket Yadav I ACCEPT THE POWER OF ATTO NOTED AND REGISTERED AT SERIAL NUMBER 3 r) 1(4 3 r- it/ 4 005 .N1-Trwr INCOME TAX DEPARTMENT GOVT. OF INDIA DEEPAK KASHMIRILAL AGARWAL KASHMIRILAL AGARWAL 20/07/1965 Permanent Account Number AAPPA5862K Signature 0 1. * SUNIL N. \ * AGARWA1_ 1 PUNE ( 6) 0 4 4to REGD. No. 6233 la 4Ss\ NI ‘ 006 - C A 0 O ■ SUN"- t4A AGAR E N PU REGD. O. 623 . 2313 / • ZU6 I U0 • and Non-Governmentservices in future. (D CD CD C 5' N. 5 (0 0 (D 3 3 co 113 03 . 3 • • 11.0 authenticateonline. Toestablish identity, • > > CL 0- C` 7" A, 11.) • 4 o o. 0 0 co O O C-) CND u) -90 NOLLVINIJOA NI C a 1799C9909 6170/ —t 17S9£ S909 6POL 2 1 1 007 I • •••••7:4-. owN1.•••• HUNDREDIRREES MAHARASHTRA C 2014 C L V 876683 •••••■■•••■•1111■1110111 a • OM-4T Sr4S1R/3T-ft144 ?PIM tWr 91;713FT c4'4,iviPf 311t1 Gt ? I tql7 31376'/IM I lerWrVIT te, f? 4+r tourkitnt t-4 4r&.. ••• • ow 2 DEC I • ,ck7rr-.87 • I :- ..123P° 92/ c • 4R41,11, .c-741iTe/tra-1/ RPTErili ttram 4 ;09900 -10. crfa-s, N113 t E, ilo AFFIDAVIT Affidavit to be furnished by the candidate bef for election as Ward Member to Ward No. 7 in Kirkee I, Deepak Agarwal son of Kashmirilal Agarwal, Age : usiness, R/a— 485, Old Bazar, Kirkee, Pune : - 411 003, have applied for nomination as Candidate in the above election, do hereby solemnly affirm / state on oath as under:- 7014 017 1. I have NOT been accused of any offence(s) punishable with imprisonment for more than two years or for any offence under Chapter IX-A of the Indian Penal Code (45 of 1860) in pending case(s) in which charge(s) has / have been framed by the Court(s) of competent jurisdiction. onent is not accused of any such offence(s), he/she shall furnish information. :0 st information report No./Nos. Not Applicable /441' ation(s) Not Applicable District(s) Not Applicable GP(Nr. S , \0g4•/? s) of the concerned Act(s) and short description of the e(s) for which the candidate has been charged Not Applicable urt(s) which framed the charge(s) Not Applicable. (v) Date(s) on which the charge(s) have been framed Not Applicable (vi) Whether all or any of the proceeding(s) have been stayed by a court(s) of competent jurisdiction & if so details thereof NO SUNI AGAR PU: %.‘REGD. N 2. If the Deponent is convicted and punished by a Criminal Court for a term * 7441'• exceeding two years for an offence which declared by the Central Government to be such as to unfiVim/her to become an elector or has been sentenced by a Criminal Court for any offence under Chapter IX-A of the Indian Penal Code (45 of 1860), he/she shall furnish the following information :(i) .Qase/First information report No./Nos - Not Applicable (ii) 'Court(s) which ordered the sentence (iii) Police Station(s) - - Not Applicable Not Applicable District(s) State(s) - Not Applicable (iv) Section(s) of the concerned Act(s) and short description of the offence(s) for which the candidate has been sentenced - Not Applicable (v) Date(s) on which the sentence(s) has been pronounced Applicable - Not 008 (vi) Whether the sentence(s) has/have been stayed by any court(s) of competent jurisdiction & if so details thereof - Not Applicable 3. That I state on oath that I comply with all the qualifications mentioned in Section 28,29 & 30 of the Cantonments Act 2006 and Rule 38 of Cantonment Electoral Rules, 2007. 4. My Educational Qualifications are as under :(Name of School/College from where passed out & Certificate thereof) Name Sr No. 1. of School . Degree/Certificate College Alegaonkar High School Maharashtra Kirkee, Pune L N. WA' WE O. 6233 / Board/University Alegaonkar Passed SSC Board. Junior Maharshtra College Kirkee, Pune Passed HSC Board VERIFICATION I, the above named deponent, do hereby verify and declare that the contents of this Affidavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed therein. Verified at Kirkee Pune — 3 on this 09th day of December 2014. su Signature of the D \«‘ 13 RE ME NOTED AND REGISTERED AT SERIAL NUMBER GARWAL SUNIL NOTARY UN N OF INDIA KHADKI, PUNE ) (( .19 DEC 2014 NS 009 No.7/1/Property/POffice of the Cantonment Board Pune 411003 Kirkee 2014 Date: December Tel No. 25817510 el To, Shri. Deepak Kashmirilal Agarwal 485, Old Bazaar Kirkee Pune - 411003. ( Oso 41_7,.., zp SUB: CERTIFICATE Ref: Your application Dt. 08/12/2014. ► tall ls z ,,,,, NGN„ot.:9 in\ ,, 1:0° , ‘...z...„.. .....___No k The requisite Certificate required by you is appended below. Thel)letke --. —_.-against the Cantonment Board for an Court matter. TRU COPY SUNIL GARWAL NOTARY, UNION 01- INDIA d EF EXECUTIVE OFFICER KIRKEE CANTONMENT BOARD CHIEF EXECUTIVE OFFICER CANTONMENT BOARD KIRIM KHAoKs, PUNE. 1 0 DEC RAF/GATE To whomsoever it may concern This is to certify that after verification of the Property Tax Register maintained by Cantonment Board, Kirkee, There is no due against the name of Shri. Deepak Kashmirilal Agarwal , R/a. 485, Old Bazaar, Kirkee Pune - 411003. This Certificate is issued to the applicant at his bonafied request. CI-(IEF EXECUTIVE OFFICER KIRKFLFAVM yillitRiTeNgthp CANTONMENT BOAROKIROF 010 • gft.r 016 alTatTf arta-CM ELECTION COMMISSION OF INDIA IDENTITY CARD WZS5916697 rrffcriT4 Rter : Electors Name TTM : Deepak Kashmirilal Aagarawal 9T4 Father's Name Cilrf aTITRB : alT17-1R9' : Kashmirilal Aagarawal 11-Fnf / MALE PT / Sex XX/XX/1966 9 4-:1'RRITAIDate of Birth TRU OPY _ G A RY sow- 14 - SUNIL N. A ARWAL AGAR■im Pk‘" .7) NOTARY, UNION OF INDIA KHADKI. PUNE. pu E REG0 ".6"3 1 0 DEC 2014 WZS6916A - 4 11r14 ITRWTT a1w,1 fl* V41-W.,( .462*4644 sift 11cliS•t Tr; vr-64ffrq--*-r. RTST ; Argue:if? Address: 484 4, Juna Chowk,Alafistan Line Ar Pune City TEHSIL. Pune DISTT. Pune Date 500 i1/ 19/2001 209-1q HC151( Gopi l ,Gfar, No. , 42t4A116.1v* A r. .e., 1003 /7: ^,." 7,74rew. *PR aftiwtr • Facsi 1a a Electoral R ,istration Officer for 209-Shivajinagar Constituency 'MT azv1RZATIWR-Ti .3T1q14 91ql,iit;17.74:11 i?{;1417.5 T*0. 3Trig sir rittrIW sac Wit 113 411,fi/ ,T.TrfrIT 3TIT,Tqi fOr7-1f. in case of change in address, mention this Card No, in ,'the relevant Form for incluciing your name in the roil at the changed addrriis and to obtain the card wit;i :;31716 ,number 209/7,17ni93 011 mar RT1--Kmrr 4T7TRIrt-6' 914**7ff:Kr tumrr 3r kKTRT atrrazwv ib-ry mum zItg. "Trzrmi-4t qv:13? 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