No.407/12/2014-AVD-IV-B Government of India Ministry of Personnel, Public Grievances & Pensions Department of Personnel and Training North Block, New Delhi-110001. Dated the 18.03.2015. Office Memorandum Subject : Declaration of Assets and Liabilities by public servants under section 44 of the Lokpal and Lokayuktas Act, 2013 — Clarification regarding formats to be used for filing returns under the Act. The undersigned is directed to refer to this Department's DO letter of even No. dated 29 th December, 2014 and the O.M. of even No. dated it January, 2015 regarding furnishing of information relating to assets and liabilities by public servants under section 44 of the Lokpal and Lokayuktas Act, 2013, forwarding therewith copies of the Central Government's notifications dated 26th December, 2014 containing — (a) Amendment to the Lokpal & Lokayuktas (Removal of Difficulties) Order, 2014, for the purpose of extending the time limit for carrying out necessary changes in the relevant rules relating to different services from "three hundred and sixty days" to "eighteen months" , from the date on which the Act came into force, i.e., 16 th January, 2014; and (b) The Public Servants (Furnishing of Information and Annual Return of Assets and Liabilities and the Limits for Exemption of Assets in Filing Returns) Amendment Rules, 2014, extending the time limit for filing of revised returns ( pl see proviso under sub- rule 2 of rule 3 of the principal rules) by all public servants from 31 6' December 2014 to 30 th April, 2015. 2. In this regard, it is clarified that :(i) The first return (as on l at August, 2014) under the Lokpal Act should be filed on or before the 30 th April, 2015; (ii) The next annual return under the the Lokpal and Lokayuktas Act, 2013 for the year ending 3l 81 March, 2015 should be filed on or before 31 st July, 2015; and (iii) The annual return for subsequent years as on 31' March every year should be filed on or before 31 6t July of that year. The following Assets & Liabilities Return forms (both in English and Hindi) are 3. enclosed herewith as indicated below :A. Declaration to be filed with Return of Assets and Liabilities on First Appointment (Under Sec 44 of the Lokpal and Lokayuktas Act, or as on the 31' March, 20 2013.) [Appendix-I of the notification dated 14.07.2014]. B. (a) FORM No. I - Details of Public Servant, his/ her spouse and dependent children[Appendix-II of the notification dated 14.07.2014]. (b) Modified FORM No. II - Statement of movable property on first appointment or as on the 31st March, 20...[Appendix-II of the notification dated 14.07.2014 as modified vide notification dated 26.12.2014]. (c) FORM NO. Ill - Statement of immovable property on first appointment or as on the 31st March, 20.... (e.g. Lands, House, Shops, Other Buildings, etc.) [Held by Public Servant, his/her spouse and dependent children] [Appendix-II of the notification dated 14.07.2014]. (d) Modified FORM No. IV - Statement of Debts and Other Liabilities on first [Appendix-II of the notification appointment or as on 31st March, 20 dated 14.07.2014 as modified vide notification dated 26.12.2014]. that all officers and staff in your ensure It is requested to 4. Ministry/Department/organizations file the said declarations/returns within the prescribed time-limits, in the afore-mentioned forms. 111319e1S Enc:- As above. (JnuBar) Joint S etary(V-2) 1. Secretary All Ministries/Departments of the Government of India (as per standard mailing list) 2. The Chief Secretary All State Governments/Administrators, UTs (as per standard mailing list) Copy , with a request for similar action, forwarded to : (i) Secretary General, Lok Sabha (ii) Secretary General, Rajya Sabha (iii) Comptroller and Auditor General of India (iv) Secretary, Election Commission of India APPENDIX-I I Rule 3(1)1 Return of Assets and Liabilities on First Appointment or as on the 31 gMarch, 20......* (Under Sec 44 of the Lokpal and Lokayuktas Act, 2013.) • 1. Name of the Public servant in full (in block letters) 2.(a) Present public position held (Designation, name and address of organisation) (b) Service to which belongs ( if applicable) Declaration: I hereby declare that the return enclosed namely, Forms Ito IV are complete, true and correct to the best of my knowledge and belief, in respect of information due to be furnished by me under the provisions of section 44 of the Lokpal and Lokayuktas Act, 2013. Date Signature * In case of first appointment please indicate date of appointment. Note 1. This return shall contain particulars of all assets and liabilities of the public servant either in his/her own name or in the name of any other person. The return should include details in respect of assets/ liabilities of spouse and dependent children as provided in Section 44 (2) of the Lokpal and Lokayuktas Act, 2013. (Section 44(2):A public servant shall, within a period of thirty days from the date on which he makes and subscribes an oath or affirmation to enter upon his office, furnish to the competent authority the information relating to— (a) the assets of which he, his spouse and his dependent children are, jointly or severally, owners or beneficiaries; (b) his liabilities and that of his spouse and his dependent children.) Note 2. If a public servant is a member of Hindu Undivided Family with Co-parcenary rights in the properties of the family either as a `Karta' or as a member, he should indicate in the return in Form No. III the value of his share in such property and where it is not possible to indicate the exact value of such share, its approximate value. Suitable explanatory notes may be added wherever necessary. Note 3:— "dependent children" means sons and daughters who have no separate means of earning and are wholly dependent on the public servant for their livelihood (Explanation below Section 44(3) of Lokpal and Lokayuktas Act, 2013) APPENDIX-II JRule 3(111 FORM No. I Details of Public Servant, his/ her spouse and dependent children Name SL No. Public Position held, if any Whether return being filed by him/her, separately Self 2 Spouse 3 Dependent-1 4 Dependent-2 5.* Dependent-3 * Add more rows, if necessary. Date Signature "FORM No. II Statement of movable property on first appointment or as on the 31s t March. 20... (Use separate sheets for self, spouse and each dependent child.) A of public servant/spouse/dependent child: i (iii) (iv) (v) (vi) Remarks, if any Description o * i)** Cash and bank balance: Insurance (premia paid) : Fixed /Recurring Deposit(s) : Shares/Bonds : Mutual Fund(s) Pension Scheme/Provident Fund Other investments, if any : Personal loans/advance given to any person or entity including firm, company, trust, etc. and other receivables from debtors and the amount (exceeding two months basic pay or Rupees one latch, as the case may be): Motor Vehicles (Details of Make, registration number, year of purchase and amount paid): Jewellery [Give details of approximate weight (plus or minus 10 gms in respect of gold and precious stones; plus or minus 100 gins in respect of silver).] Gold: Silver: Precious metals and precious stones: Composite items: (indicate approximate value)*** Any other assets [Give details of movable assets not covered in (i) to (v) above] (a) (b) (c) (d) (e) (f) Furniture Fixtures Antiques Paintings Electronic equipments Others [Indicate the details of an asset, only if the total current value of any particular asset in any particular category (e.g. furniture, fixtures, electronic equipments, etc.) exceeds two months' basic pay or Rs. 1.00 latch, as the case may be.] Date Signature * Details of deposits in the foreign Bank(s) to be given separately. •• Investments above Rs. 2 lakhs to be reported individually. Investments below Rs2 lakhs may be reported together. • *• Value indicated in the first return need not be revised in subsequent returns as long as no new composite item had been acquired or no existing items had been disposed of, during the relevant year."; FORMNO. III C) .5 s0 E. 0 0 irs To ° t. cat o E c °goo ° F-' es 6 = — ; C 0. >4 at> te b a'v a o . '0u 11 — "° aa).5 5-8-o 0.40 1 >-. ° t -6 a a so a E _ 45 t o-, a> d' )4 6 0 P., eu j 0 0 , = ,.. TO le 4" 0. > o. tc > t 01 0 a .. ,.0 ,.CP g -5 -cyla. - E„5. ,0 0.0.6.0 E a - -= 30-g o 0 ,, cl i., 0 .0 •-•- 0 s.... a .... o 5 G '5 a cr. 0g 0 4..^ 0 C ° a ..0 a 5 a a oa E am 1- Is- 5 ea0 c a 0 " C E %0 E = P. g 1.- o _ -.E. c sfi 0 0 C ... _ Cn 0 b 0 .... .... ,--, 0 ci) • ... ...0 .0 4 0 CI. 4,4.,borD•=007 ti 12' CC ..--a be .4a3 4+ 0 wn. 0 0 5 7 ›, 0 .= a 0. a ..0 g < 40.. a z0 — , . -o Pei g° a u t Es 0g c -....._ ... a re, .0 -sa E. ,.., 2 a: i o -6 .1-1 0 .= o a s.. lc E 0 t 0 3 00 — b , 17). o E = 0- — 0 iel ' 0. 40 .4 : 0 g 0 "" cr E E an o -o 0 > - c * 2 8 b.c-otosb5o 4_, aim :I: a 0 ea to. a Z cs — E cg r_ en . SI nn CID a 8 ' 7 to d . - .. c a d t-5 t t .ca -- 5 1,:,i-0.2 a -- a .0 E a d 4.. •E a — 13 0 -> a5 5 S ...., Ts = ..c 2 - a 5 p E-• > 3 5. -sZ To -a a ,e a 0-1 . -: .C., , 0 CI g p a t o -* --- ..a g a g ) = ma . ft) o...... P-4 X C 1 I 4 Vs ° • a ET,' z A • • ca t a' 8 yy >t 2 0 L .c 3 E • g U 0 5 2 , E 8 » af, O c • =E • (7a3 cc 5 = 0 e5 og sa E L' O e 2 t E 5 O 5 0 e 2 s5 g a *5 3o 8 3I g 2 e 8 '6 -o >g 5a I II 6' 1 1- z. z 171 "FORM No. IV Statement of Debts and Other Liabilities on first appointment or as on 31 5t March, 20..... S I. No. Debtor (Self/ Spouse or dependent children) 2 Date Name and address of Creditor Nature of debt/ liability and amount 3 4 Remarks 5 Signature Note 1: Individual items of loans not exceeding two months basic pay (where applicable) and Rs. 1.00 lakh in other cases need not be included. Note 2. 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