1. |
Name of the Government servant. |
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2. |
Scale of Pay and present pay. |
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3. |
Purpose of application-sanction for transaction/prior intimation of transaction. |
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4. |
Whether property is being acquired or disposed of. |
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5.(a) |
Probable date of acquisition/disposal of property. |
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6. |
Mode of acquisition/disposal. |
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7.(a) |
Full details about location, viz. Municipal No., Street/Village, Taluk, District and State in which situated. |
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(b) |
Description of the property, in the case of cultivable land, dry or irrigated land. |
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(c) |
Whether freehold or leasehold. |
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(d) |
Whether the applicant’s interest in the property is in full or part. (in case of partial interest, the extent of such interest must be indicated). |
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(e) |
In case the transaction is not exclusively in the name of the Government servant. Particulars of ownership and share of each member. |
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8. |
Sale/purchase price of the property.(Market value in the case of gifts) |
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9. |
In cases of acquisition, source or sources from which financed/proposed to be financed:-
(a) Personal savings
(b) Other sources giving details. |
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10. |
In the case of disposal of property, was requisite sanction/intimation obtained/given for its acquisition (A copy of the sanction/acknowledgement should be attached). |
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11.(a) |
Name and address of the party with whom transaction is proposed to be made. |
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(b) |
Is the party related to the applicant?
If so, state the relationship. |
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(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? |
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(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). |
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12. |
In case of acquisition by gift, whether sanction is also required under Rule 13 of the CCS (Conduct) Rules, 1964. |
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13. |
Any other relevant fact which the applicant may like to mention. |
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