IPR Proforma Bilingual
IPR Proforma Bilingual
IPR Proforma Bilingual
FORM
HR :
Name of the officer: Present Pay
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Present Post held:
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3mfefeR, 3QFR 3TW fefe 3W fer T) eft Tlf I fefe ffefe 31ftiTO if fe 3TRT Annual
f^iclF, aa fehdrf, dlcdd) fefe, 3ildl’$k 3lk 3W M<
am 3TT ottfaa ar aw fefer Income from
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Present the property.
Name and details of 'IRd)l{l d>4dl<f 44 fen arnfe ? I
Name of District, Sub Value
Division, Taluk and property, Housing If not in own name, state in whose How acquired ? Whether by purchase, lease, mortgage,
Village in which the lands & other, name held & his/her relationship to inheritance, gift or otherwise with date of acquisition and name with
property is situated. buildings Govt. Servant. details of persons from whom acquired.
1. 2. 3. 4. 5. 6. 7.
fefeft : few rar TOT am^f ^ferkfecTfeiT (3iraw) ferofei964 &fera 18(1) & 3ifer fen # umr fejffe nr fefi-l w fefe ll {fefe fe fe fefe safe aro arar jr^a ITOT 3TTWW # 31k ^fe Wim fe fefe fe & 3feW <R W 3TIU fefe 3fe> HW <R 3TW
3fe> few & fefe WI & WT tR 3TW 3W fefe otjfef $5 HPT *R 3lffe, T^RlffeR # PW, rfew fe T^feswfeirafe^ 3ranfefenn few fen mife 1
In case where It Is not possible to assess the value accurately the approximately value in relation to present conditions may be indicated. ** Note : The declaration form is required to be filled and submitted by
3tc4cbidl<h iff Includes shortterm lease also. every member of Class-1 and class-ll service under Rule 18(1) of
the Central Civil Services (Conduct) Rules 1964 on the first
appointment to the service and thereafter at the interval of every year giving particulars of all immovable property owned, acquired or inherited by him or held by him on lease or mortgage either in his own name or in the
name of any members of his family or in the name of any other person.
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Name of the officer:
ftilRd, 3ildl^a did ftMfcd & HIM < PR led ^>ft 3ifofd $1 pf ? 3PT eft 3$?**, 'duiicd ft dlffttb 3P^fa-d^l
lofcTT, W Q_ <4? 3tfc 3RI ^TcFTt Remarks
H$ £ eft W f3> fdpft) HPT ft t W w, 3aKiRtd>i< WR 3TW fft)ftt 3RT RJPT ft eft nf I “dlft'ia foKimi 3TRT
diecjcp 3TR 71T3 3>f
3ife 33 HPT 33lft <i<d)lft cbftdlft 4)1 wnwt ? 3Tf^H>r< ft eft 7^ w 3RT onfftd 3)i HPT foi'tift eftnf i Annual Income
HPT <iHpd t Present
Name and details of If not in own name, state in whose How acquired ? Whether by purchase, lease, mortgage, Inheritance, from the
Name of District, Sub Value
property, Housing name held & his/her relationship gift or otherwise with date of acquisition and name with details of property.
Division, Taluk and
lands & other, to Govt. Servant. persons from whom acquired.
Village in which the
property is situated. buildings
1. 2. 3. 4. 5. 6. 7.
?^W</Sig nature
fcHicr>/Date