Schedule-18(Relating to Rule 118)
Statement of Property Form
Employee’s name and code number361:
Name: Office where to statement is submitted:
Class and post :
Office: Name:
Address:
(a) Immovable property (house, land)
| SN | Brief details of house, land and other immovable properties | Measure ment and other details | Address where the house and land are located (Village, Municipality, District) | Name of owner under whose ownership it is, and in case of others, state relationship with him or her | How property was obtaine d | Remarks (in the case of house, storey is also to be mentioned) (in the case of land, area or measurement (Ropani or other) is to be mentioned) |
(b) Cash, jewels, gold, silver etc.
| SN | Brief details of the properties | Measurement, weight and quantity | How the property was obtained | Remarks |
(c) Statement of Shares and the Bank Balance
| SN | Brief details of proper ties | Name and address of the company or bank | Total value | Name of owner under whose ownership the property is, and in case of others, state relationship with him or her | How the property was obtained | Remarks |
(d) Details of loan / mortgage borrowed and given
| SN | Details of loan / mortgage | Name and address of lender /borrower | Reasons | Total value | Term for repayment | Remarks |
(e) Details of loan or mortgage, if any lent or undertaken:
| SN | Details of loan/ mortgage | Name and address of borrower or mortgagee | Reasons | Total value | Term for repayment | Remarks |
I hereby sign covenanting that the above-mentioned details are true and correct
to the best of my knowledge and information.
Name and post:
Date:
Note :
1. In cases where the property is increased or decreased after submission of
this statement, such details have to be submitted in a sealed envelope to
the concerned body.
2. This statement shall not be used for other purposes except for legal
proceedings to be undertaken as per law against the government
employee. No person other than the concerned official shall be allowed
to see this Statement. This Statement shall be maintained as confidential
without publication.