District : South 24 Parganas

In the Court of the Learned Additional Chief Judicial Magistrate, Baruipur,

South 24 Parganas

Misc. Case no. of 2024

In the matter of :

Smt. Putul Mondal, Wife of Sri Kartik Mondal, aged about 50 years, residing at Premises being no. C/42, Jamuna Nagar, Post Office – Mukundapur, Police Station – Purba Jadavpur, Kolkata – 700099, District – South 24 Parganas.

_______Aggrieved Person

- Versus –

P.S. : Purba Jadavpur

Kartik Mondal, Son of Late ShreekantoMondal, aged about 61 years, residing at Premises being no. C/42, Jamuna Nagar, Post Office – Mukundapur, Police Station – Purba Jadavpur, Kolkata – 700099, District – South 24 Parganas, and also at Premises being no. H/20, Baghajatin, Police Station – Netaji Nagar, Kolkata – 700093, District South 24 Parganas.

__________Respondent

AFFIDAVIT

I, Smt. Putul Mondal, Wife of Sri Kartik Mondal, aged about 51 years, by faith Hindu, by Occupation House Wife, residing at Premises being no. C/42, Jamuna Nagar, Post Office – Mukundapur, Police Station – Purba Jadavpur, Kolkata – 700099, District – South 24 Parganas, do hereby solemnly declare and affirm as under:

PART - I

PERSONAL INFORMATION RELATING TO THE DEPONENT

S.No.	Description	Particulars
1.	Name	PUTUL MONDAL
2.	Age	51 Years
3.	Residential Address	Premises being no. C/42, Jamuna Nagar, Post Office – Mukundapur, Police Station – Purba Jadavpur, Kolkata – 700099, District – South 24 Parganas.
4.	E-mail Address	NIL
5.	Date of marriage	1989
6.	Date of separation	3^rd September’ 2021
7.	Educational qualifications	NIL
8.	Professional qualifications	NIL
9.	Occupation	House Wife
10.	Monthly income (as mentioned at serial no.45)	NIL
11.	Monthly expenditure (as mentioned at serial no.60)	Rs. 15,000/- (Rupees Fifteen Thousands) only
12.	Whether you are assessed to Income Tax?	NO
13.	Whether you have sufficient income to support yourself?	NO
14.	If not, whether you have claimed maintenance from your spouse? If so, how much?	Yes, Rs. 15,000/- (Rupees Fifteen Thousand) only
15.	Whether you are staying at matrimonial home?	YES
16.	If not staying at matrimonial home, relationship and income of the person with whom you are staying.	NIL
17.	Members of the family: (a) Dependent	NIL

	(b) Non-dependent	NIL
18.	Whether your spouse has claimed maintenance from you? If so, how much?	NOT APPLICABLE
19.	Whether you have voluntarily paid or willing to pay maintenance to your spouse? If so, how much?	NOT APPLICABLE
20.	Whether you are willing to pay litigation expenses to your spouse? If so, how much?	NOT APPLICABLE
21.	Particulars of pending litigation between the parties	THIS PRESENT APPLICATION
22.	Whether any maintenance order has been passed by any Court? If so, give particulars and attach copy of the order?	NOT APPLICABLE
23.	Whether the maintenance is being paid in terms of the aforesaid order? If so, file the statement of maintenance paid up to date	NOT APPLICABLE
24.	Expenses incurred on this litigation	NOT YET ASSESSED
25.	Particulars of the bank account with name and address of the bank for the purpose of payment from or receipt of maintenance, as the case maybe	Saving Bank Account Number : 34066199948 State Bank of India Branch : Madurdaha Code : 16639 IFSC : SBIN0016639 MICR : 700002472
26.	Name of your counsel and his/her mobile number and e-mail address	Sri Ashok Kumar Singh, Advocate. High Court Bar Association Room No. 15, High Court at Calcutta, Mobile Number : 9883070666 / 9836829666, E-mail : aksinghadvocate@rediffmail.com

PART - II

RELEVANT INFORMATION RELATING TO THE SPOUSE

27.	Educational and professional qualifications of your spouse	Plumber
28.	Whether your spouse was/is earning? If so, give particulars of the occupation and income of your spouse.	The Respondent Kartik Mondal, earning about Rs. 30,000/- (Rupees Thirty Thousand) only, from his occupation.
29.	Whether your spouse is staying at matrimonial home. If not, whether he/she is staying at his/her own accommodation or at a rented accommodation? If staying at a rented accommodation, what is the rent being paid by him/her?	Yes, the Respondent Kartik Mondal, is residing at the matrimonial house of the aggrieved person,
30.	Particulars of the assets and liabilities of your spouse	Land with Pucca Structure thereon at Premises being no. C/42, Jamuna Nagar, Post Office – Mukundapur, Police Station – Purba Jadavpur, Kolkata – 700099, District – South 24 Parganas;
`
31.	Do you have any documents relating to the income, assets and expenditure of your spouse? If so, give the particulars and attach copies thereof?	NO;

PART - III

32.	Children from the marriage with their name and age	(1) Tumpa Mondal – Daughter – Married; (2) Subrata Mondal – Son – Married;
33.	Who has the custody of the minor children	NOT APPLICABLE
34.	Name and address of school(s) where the children are studying	NOT APPLICABLE
35.	education	NOT APPLICABLE
36.	How much expenditure has been incurred on the from the date of separation till now?	NOT APPLICABLE
37.	If the children are in custody of your spouse, whether you have voluntarily paid or willing to pay the expenses for the children maintenance and education? If so, how much?	NOT APPLICABLE
38.	Details of expenditure on children	NOT APPLICABLE
	(i)School/College fees	NOT APPLICABLE
	(ii) Crech/Day Care/After school care	NOT APPLICABLE
	(iii) Books/Stationery	NOT APPLICABLE
	(iv) Private Tuitions	NOT APPLICABLE
	(v) Pocket Money/Allowances	NOT APPLICABLE
	(vi) Sports	NOT APPLICABLE
	(vii)Outings/summer camps/vacations	NOT APPLICABLE
	(viii) Entertainment	NOT APPLICABLE
	(ix) Others	NOT APPLICABLE
39.	TOTALEXPENDITURE (Give monthly expenditure)	NOT APPLICABLE

RELEVANT INFORMATION RELATING TO THE CHILDREN

PART-IV

STATEMENT OF INCOME

S.No

Description

Particulars

40.

In case of salaried persons:

(i) Designation

(ii) Name and address of the employer

(iii) Date of employment

(iv) Gross Income including the salary, D.A., commissions/incentives, bonus, perks etc.

(v) Perquisites and other benefits provided by the employer including accommodation, cars/other automotive, sweeper, gardener, watchman or personal attendant, gas, electricity, water, interest free or concessional loans, holiday expenses, free or concessional travel, free meals, free education, gifts, vouchers, etc. credit card expenses, club expenses, use of movable assets by employees, transfer of assets to employees, value of any other benefit/amenity/service/ privilege and the value of such perquisites and benefits

(vi) Deductions from the gross income

(vii) Income Tax paid

(viii) Net income

(ix) Value of stock option benefits if provided by the employer

(x) Pension and retirement benefits payable at the time of retirement

NOT APPLICABLE

41.

In case of self-employed persons:

(i) Nature of business/profession

(ii) Whether the business/profession is carried on as an individual, sole proprietorship concern, partnership concern, company or association of persons, HUF, joint family business or in any other form. Give particulars of your share in the business/ profession. In case of partnership, specify the share in the profit/losses of the partnership

(iii) Number of employees

NOT APPLICABLE

(iv) Annual turnover/gross receipts

(v) Gross Profit

(vi) Net Income

(vii) Income Tax

(viii) Details and value of benefits in kind, perks or other remuneration e.g. provision of car, payment of accommodation etc

(ix) Amount of regular monthly withdrawal or drawings

42.

In case the business/ profession is carried on as a

Partnership Firm/Company:

(i) Registered/Corporate Office of the firm/company

(ii) Information and particulars with regard to your shareholding, involvement in the affairs and management of the firm/company

(iii) -

(a) Salary

(b) Interest

(d) Commission

(e) Others

(iv) List of all the bank accounts of the firm/company

(v) Location of the statutory records and books of account of the firm/company

(vi) List of immovable assets, land and building etc. of the firm/company.

(vii) Number of workmen/employees

(viii) Current value of your business interest(s)

(ix) Current value of your business assets

(x) List of directorships held, sitting fees, commission or any other remuneration

(xi) Net worth of the company in which you are Director along with the number of shares held in the Company

NOT APPLICABLE

43.

Income from Other Sources:

(i) Agricultural Income

NOT APPLICABLE

(ii) Rent

(iii) Interest on bank deposits and FDRs

(iv) Interest on investments including deposits, NSC, IVP, KVP, Post Office schemes, PPF, loans etc.

(v) Dividends

(vi) Mutual Funds

(vii) Annuities

(viii) Lease of machinery, plant or furniture

(ix) Sale of movable/ immovable assets

(x) Gifts

44.

Any other income not covered above

NOT APPLICABLE

45.

TOTAL INCOME

(Give monthly income)

NIL

PART V

STATEMENT OF EXPENDITURE

S. No.	Description			Amount (in Rs.)
46.	Housing	(i)	Monthly rent	-
		(ii)	Mortgage payment(s)	-
		(iii)	Repairs & Maintenance	Rs. 1,000/-
		(iv)	Property tax	-
47.	Household expenditure	(i)	Groceries/Food items/ Personal care/clothing	Rs. 10,000/-
		(ii)	Water	-
		(iii)	Electricity	Rs. 1,170/-
		(iv)	Gas	Rs. 830/-
		(v)	Telephone/Mobile	-
		(vi)	TV Cable/Set-top Box charges & Internet services	-
		(vii)	Maintenance, replacement and repair of household items, appliances and kitchenware.	-

		viii) Telephone	-
		(ix) Domestic full time/part time helper(s)	NIL
		(x) Others(specify)	-
48.	Maintenance of Dependents	(i) Parents	NIL
		(ii) Children (as mentioned at serial no.39)	NIL
		(iii) Others	NIL
49.	Transport	(i) Private Transport	-
		(a) Driver(s)	-
		(b) Fuel	-
		(c) Repair/Maintenance	-
		(d) Insurance	-
		(e) Loan repayment	NIL
		(ii) Public Transport	-
		(a) Bus	NIL
		(b) Taxi	-
		(c) Metro	-
		(d) Auto	-
50.	Medical expenditure	(i) Doctor	Rs. 500/-
		(ii) Medication	Rs. 1,500/-
		(iii) Hospital	NIL
		(iv) Other medical expenditure	NIL
		(v) Others(specify)	NIL
51.	Insurance	(i) Life	-
		(ii) Annuity	-
		(iii) Householders	-
		(iv) Medi-Claim	-
52.	Entertainment	(i) Club	NIL

	and recreation	(ii) Health Club	NIL
	and recreation	(iii) Gym	NIL
53.	Holiday and vacations		NIL
54.	Gifts		NIL
55.	Legal/litigation expenses		Not yet assessed
56.	Discharge of Liabilities	(i) Credit card(s)payment	NIL
		(ii) Hire purchase/lease	NIL
		(iii) Repayment of Loans	NIL
		(a) House loan	NIL
		(b) Car loan	NIL
		(c) Personal loan	NIL
		(d) Business loan	NIL
		(e) Any other loan	NIL
		(iv) Name of the lenders	NIL
		(v) Mode of repayment	NIL
		(vi) Installment amount	NIL
		(vii)Other personal liabilities	NIL
57.	Miscellaneous	(i) Newspapers, magazines, books	NIL
		(ii) Religious contributions/ Charities	NIL
		(iii) Others(specify)	NIL
58.	Pocket Money/Allowance		NIL
59.	Other expenditure (Not specified above)		NIL
60.	TOTALEXPENDITURE (Give monthly expenditure)		Rs. 15,000/- (Rupees Fifteen Thousand) only;

PART - VI

STATEMENT OF ASSETS

S. No.

Assets

List of Assets

At the time of marriage

At the time of Separation

Present

Present Estimated

Market Value

61.

Real Estate Including

(i) Land

(ii) Built up properties

(iii) Lease hold properties

(iv) Agricultural land

(v) Investment in real estate such as booking of plots, flats and other immovable properties in your name or in joint names.

(vi) Other properties Note 1. : - List your interest in properties, including lease hold

interest and mortgages, whether or not you are registered as owner.

Note 2. : - Provide legal descriptions and indicate estimated market value of your interest without deducting encumbrances or costs of disposition. (Record encumbrances under

debts.)

NIL

62.	Joint Properties (i) Properties presented at or about the time of marriage, which belong jointly to both the husband and wife. Give the status of their possession. (ii) Other joint properties of the parties. Give the status of their possession. (iii) Whether any litigation pending with respect to the joint property? If so, give particulars.	NIL			NIL		NIL		NIL
63.	*Liquid Assets*: (i) Details of all bank accounts including Current, Savings and Demat Accounts in your name, or joint name and balance in the said account	Account Number				Name of Bank			Current Balance
		01	Saving Bank Account Number : 34066199948			State Bank of India Branch : Madurdaha Code : 16639 IFSC : SBIN0016639 MICR : 700002472			8,000.00



	(ii) Cash in Hand
64.	*Investments* (i) Details of all investments you hold or, in which you have interest and their current value: a) FDRs, NSC, IVP, KVP, Post Office schemes, PPF etc. b) Deposits with Government and Non-Government entities			Particulars				Current Value
				NIL				NIL

	c) Stocks, shares, debentures, bonds, units and mutual funds, etc. d) Life and endowment policies and surrender value e) Loan given to friends, relatives and others f) Other investments not covered by above items
65.	*Pensions and Retirement Savings* *Plan*	Particulars	Maturity amount
		NIL	NIL
	Indicate name of institution where accounts are held, name and address of pension plan and pension details.
66.	*Corporate/Business Interests*	Particulars	Current value
	List any interest you hold, directly or indirectly, in any corporation, unincorporated business, partnership, trust, joint venture and Association of Persons, Society etc.
		NIL	NIL
67.	*Movable Assets*	Particulars	Current value
	(i) Motor Vehicles (List cars, motorcycles, scooters etc. along with their brand and registration number) (ii) Livestock (iii) Mobile phone(s) (iv) Computer/Laptop (v) Other electronic gadgets including I-pad etc. (vi) TV, Fridge, Air Conditioner, Microwave, Washing machine, etc. (vii) Other household and kitchen appliances (viii) Quantity of gold, silver and diamond jewellery (ix) Quantity of Silver Utensils
		NIL	NIL

68.	*Intangible properties* Including patents, trademark, copyright design and goodwill and their value	NIL	NIL
69.	*About disposal of properties* Particulars of properties (movable	Particulars	Present Estimated market value
69.		NIL	NIL
	as well as immovable) sold/agreed
	to be sold between the date of
	marriage till the date of filing of
	this affidavit and the sale
	consideration received from the
	purchaser
70.	*Others* List anything else of value that	Particulars	Estimated current value
70.	*Others* List anything else of value that	NIL	NIL
	you own, including precious
	metals, collections, works of art,
	jewellery or household items of
	high value. Include location of
	safety deposit lockers.

PART - VII

STATEMENT OF LIABILITIES

S. No.	Description	Particulars of Debts	Current Value
71.	*Secured debt(s)* List all mortgages, loans, and any other debts secured against an asset	NIL	NIL
72.	*Unsecured Debt(s)* List all bank loans, personal loans, credits, overdrafts, credit cards and any other debts	NIL	NIL
73.	*Other* List any other debts, including obligations that are relevant to a claim	NIL	NIL

PART - VIII

GGENERAL INFORMATION RELATING TO THE STATUS,

STANDARD OF LIVING AND LIFESTYLE

S. No.	Description	Particulars
74.	Particulars of residential accommodation where your are presently staying (in sq. feet)	Pucca Structure
75.	Who is the owner of the residential Accommodation? In case of rented accommodation, specify the monthly rent	Respondent
76.	Number of part-time/full time domestic helpers and their wages	NIL
77.	Average monthly withdrawal from bank(s)	NIL
78.	Mode of travel in city/outside city	NIL
79.	Membership of clubs/health clubs/gyms, Societies and other associations. Specify the membership fee and subscription	NIL
80.	Particulars of credit/debit card(s), its limit and usage	NIL
81.	Particulars of frequent flier cards	NIL
82.	Frequency of foreign travel, business as well as personal	Not Applicable
83.	Category of hotels ordinarily used for stay, official as well as personal	Not Applicable
84.	Category of hospitals opted for medical treatment including type of rooms	Government Hospital
85.	Brand of vehicle, mobile and wrist watch, pen, sunglasses, wallet/bags.	No Brand
86.	Expenditure ordinarily incurred on family functions including birthday of the children	NIL

87.

Expenditure ordinarily incurred on festivals

NIL

88.

Expenditure incurred on marriage of family members

NIL

89.

Status of the deponent and his/her family:

- High

- Upper Middle

- Middle

- Lower Middle

- Low

- Below poverty line

Low Class

PART - IX

DOCUMENTS RELATING TO ASSETS, INCOME AND EXPENDITURE

PART A DOCUMENTS RELATING TO PERSONAL INFORMATION
S. No.	Description
1.	Ration Card	Not Applicable
2.	Voter ID Card	Not Applicable
3.	Aadhar Card	625662229941
4.	Driving Licence	Not Applicable
5.	PAN Card	CEBPM5931B
6.	Passport	Not Applicable

PART B DOCUMENTS RELATING TO INCOME, ASSETS AND LIABILITIES
S. No.	Description	Please Tick
		Attached	Not Applicable	To follow
7.	Statement of Account of all bank accounts including current, savings and Demat accounts for last 3 years

Income Tax Return(s) along with Statement of Income and Annexures for last 3 years

I n case of Salaried Persons

(i) Appointment letter along with salary structure at time of appointment.

(ii) Last Salary Slip

(iii) Forms 16, 16A, 12BA &26AS

(iv) Cost to Company Certificate and CIBIL Certificate, where verapplicable

(v) Copies of TDS certificates

NIL

10.

I n case of self-employed persons

(i) Balance Sheet and Profit & Loss Account

(ii) Balance Sheet and Profit & Loss Account of the proprietorship firm, if the business is carried on in the name of a sole proprietorship concern

(iii) Balance Sheet and Profit & Loss Account of the partnership firm, if the deponent is a partner in a firm along with the Schedule showing the distribution of

share of profits/losses of the partnership firm and the copy of the partnership deed

(iv) Balance Sheet and Profit & Loss Account of the Company in which the deponent is a

NIL

	Director (v) Balance Sheet and Profit & Loss Account of the Association of Persons, HUF, Joint Family business or trust in which the deponent has share (vi) Copy of account of the deponent in the books of the business (vii) Copies of TDS certificates
11.	I n case of Income from others sources: (i) Lease Deed(s)/Rent Agreement(s) /Licence Agreement(s) in respect of the rentalincome (ii) Interest Certificate in respect of the interest income on deposits and investments (iii) Dividend Certificates in respect of dividend income (iv) Demat holding Statement (v) Sale Deed(s)/transfer documents in respect of the profit on sale of property/properties	NIL	NIL	NIL
12.	Other relevant documents relating to Income/Assets
13.	Other relevant documents relating to liabilities
PART C DOCUMENTS RELATING TO EXPENDITURE
14.	(i) Documents relating to the expenditure on education of children including tuition fees (ii) Rent and maintenance receipts (iii) Electricity, water, security and

gas bills

(iv) Documents relating to the salary paid to the employees including domestic helper(s)

(v) Documents relating to expenditure on conveyance

(vi) Debit and Credit Card statements of all cards

(vii)

statements

(viii) Mobile and landline phone bills

(ix) Internet and TV cable/ Set-

Top Box bills

(x) Documents relating to the re- payment of the loans

(xi) PPF, EPF and other superannuation fund receipts

(xii) Receipts of premium of insurance policies

(xiii) Receipts of payments in respect of mutual funds

(xiv) Documents relating to payment of interest on bank and other loans

(xv) Documents relating to the payment of taxes, including Income Tax and Property Tax

(xvi) Other relevant documents relating to Expenditure

Declaration:

1. I solemnly declare and affirm that I have made full and accurate voluntary disclosure of my income, expenditure, assets and liabilities from all sources. I further declare and affirm that I have no assets, income, expenditure and liabilities other than set out in this affidavit.

2. I undertake to inform this Court immediately upon any material change in my employment, assets, income, expenditure or any other information included in this affidavit.

3. I understand that any false statement made in this affidavit may constitute an offence under Section 199 read with Sections 191 and 193 of the Indian Penal Code punishable with imprisonment up to seven years and fine, and Section 209 of Indian Penal Code punishable with imprisonment up to two years and fine. I have read and understood Sections 191, 193 199 and 209 of the Indian Penal Code.

DEPONENT

Verification:

Verified at on this day of September’ 2024,

that the contents of the above affidavit relating to my assets, income and expenditure are true to my knowledge, no part of it is false and nothing material has been concealed there from, whereas the contents of the above affidavit relating to the assets, income and expenditure of my spouse are based on information believed to be true. I further verify that the copies of the documents filed along with the affidavit are true copies of the originals.

DEPONENT

Identified by me,

Advocate

Prepared in my Chamber;

Advocate

Date : _____September’ 2024,

Place :Alipore Criminal Court, N O T A R Y

ASHOK KUMAR SINGH

Friday, October 11, 2024

Affidavit of Assets and Liabilities in PWDV Act 2002 by the Aggrieved Person

PART - I

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