1

ANNEXURE A1

(FORMAT OF AFFIDAVIT OF ASSETS, INCOME AND EXPENDITURE TO BE

FILED BY THE BOTH PARTIES)

AFFIDAVIT

I, Tarun Kumar son of / wife of Babu Lal , aged about 40 years, resident of 853, Ground
Floor, H.No. 523, Village- MahipalPur Near Holi Chauk , New Delhi 110037 do hereby
solemnly declare and affirm as under:
PART - I
PERSONAL INFORMATION RELATING TO THE DEPONENT
S.No. Description Particulars
1. Name Tarun Kumar
2. Age 40
3. Residential Address 853, Ground Floor, H.No. 523, Village-
MahipalPur Near Holi Chauk , New Delhi
110037
4. E-mail Address N/A
5. Date of marriage 18.11.2010
6. Date of separation 01.04.2021
7. Educational qualifications B.TEC/MBA
8. Professional qualifications N/A
9. Occupation Home Tuition
10. Monthly income (as mentioned at serial no.45) 50,000
11. Monthly expenditure (as mentioned at serial no.60) 40,000
12. Whether you are assessed to Income Tax? N/A
13. Whether you have sufficient income to support N/A
yourself?
14. If not, whether you have claimed maintenance from Self Depend
your spouse? If so, how much?
15. Whether you are staying at matrimonial home? Yes, I have staying at my Home
16. If not staying at matrimonial home, relationship and N/A
income of the person with whom you are staying.
17. Members of the family: Mother
(a) Dependent
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(b) Non-dependent N/A

18. Whether your spouse has claimed maintenance The Spouse has not claimed any
from you? If so, how much? maintenancCe from the Deponent yet.

19. Whether you have voluntarily paid or willing to pay 16,000

maintenance to your spouse? If so, how much?

20. Whether you are willing to pay litigation expenses

to your spouse? If so, how much?

21. Particulars of pending litigation between the parties Complaint case no. is Pending in
the Hon’ble court of
The Domestic Violence case is
pending before the Hon’ble Court
The maintenance Case is Going on
Before The Hon’ble court In
The Divoce Case is Pending in the
Hon’ble court of
22. Whether any maintenance order has been passed by Yes Maintenance has been passed on
any Court? If so, give particulars and attach copy dated 1.12.2021
of the order? 16,000/ Per monthly

23. Whether the maintenance is being paid in terms of 1.12.2021

the aforesaid order? If so, file the statement of
maintenance paid upto date

24. Expenses incurred on this litigation 1,50,000/-

25. Particulars of the bank account with name and SBI Account
address of the bank for the purpose of payment
from or receipt of maintenance, as the case may be

26. Name of your counsel and his/her mobile number Psrikshit Sharma
and e-mail address Mob. No. 8410746826
E-Mail-
[email protected]
PART - II
RELEVANT INFORMATION RELATING TO THE SPOUSE
27. Educational and professional qualifications of your Dubble M.A , B.ed Currently working
spouse as private Teacher
28. Whether your spouse was/is earning? If so, give 10th Class 60,000/- Approx
particulars of the occupation and income of your Tutions Amount. 50,000/- Approx
spouse.
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29. Whether your spouse is staying at matrimonial Parental Home

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?
30. Particulars of the assets and liabilities of your N/A
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spouse
31. Do you have any documents relating to the income, N/A
assets and expenditure of your spouse? If so, give
the particulars and attach copies thereof?

PART - III
RELEVANT INFORMATION RELATING TO THE CHILDREN
32. Children from the marriage with their name and age Sara – 12
Natik - 6

33. Who has the custody of the minor children Mother

34. Name and address of school(s) where the children Happy Public School
are studying
35. Yes bearing the expenditure of Children’s
education Eight Thousand per month both
education children’s
36. How much expenditure has been incurred on the Yes Eight Thousand per month both
children’s
from the date of separation till now?
37. If the children are in custody of your spouse,
whether you have voluntarily paid or willing to pay
the expenses for the ch maintenance and
education? If so, how much?
38. Details of expenditure on children Amount (in Rs.)
(i) School/College fees N/A
(ii) Crech/Day Care/After school care N/A
(iii) Books/Stationery N/A
(iv) Private Tuitions N/A
(v) Pocket Money/Allowances N/A
(vi) Sports N/A
(vii)Outings/summer camps/vacations N/A
(viii) Entertainment N/A
(ix) Others N/A
39. TOTAL EXPENDITURE N/A
(Give monthly expenditure)
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PART-IV
STATEMENT OF INCOME
S.No Description Particulars
40. In case of salaried persons:
(i) Designation N/A

(ii) Name and address of the employer N/A

(iii) Date of employment N/A
(iv) Gross Income including the salary, D.A.,
N/A
commissions/incentives, bonus, perks etc.
(v) Perquisites and other benefits provided by the
employer including accommodation, N/A
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 N/A
(vii) Income Tax paid
N/A
(viii) Net income N/A
(ix) Value of stock option benefits if provided by
the employer N/A
(x) Pension and retirement benefits payable at the
N/A
time of retirement
41. In case of self-employed persons: Tarun Tutions Classes
(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 N/A
in the business/ profession. In case of
partnership, specify the share in the
profit/losses of the partnership
(iii) Number of employees N/A
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(iv) Annual turnover/gross receipts N/A

(v) Gross Profit
N/A
(vi) Net Income N/A
(vii) Income Tax
N/A
(viii)Details and value of benefits in kind, perks or
other remuneration e.g. provision of car, N/A
payment of accommodation etc
(ix) Amount of regular monthly withdrawal or
N/A
drawings
42. In case the business/ profession is carried on as a
Partnership Firm/Company:
(i) Registered/Corporate Office of the N/A
firm/company
(ii) Information and particulars with regard to
your shareholding, involvement in the affairs N/A
and management of the firm/company
(iii) -
(a) Salary N/A
N/A
(b) Interest
(c) Rent N/A
(d) Commission
N/A
(e) Others N/A
(iv) List of all the bank accounts of the
N/A
firm/company
(v) Location of the statutory records and books of N/A
account of the firm/company
(vi) List of immovable assets, land and building
N/A
etc. of the firm/company.
(vii) Number of workmen/employees N/A
(viii) Current value of your business interest(s) N/A

(ix) Current value of your business assets N/A

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

(xi) Net worth of the company in which you are

Director along with the number of shares held N/A
in the Company
43. Income from Other Sources: 10,000/- Per Annum
(i) Agricultural Income
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(ii) Rent 20,000/- P/M

N/A
(iii) Interest on bank deposits and FDRs
(iv) Interest on investments including deposits,
NSC, IVP, KVP, Post Office schemes, PPF, N/A
loans etc.
N/A
(v) Dividends
(vi) Mutual Funds N/A
N/A
(vii) Annuities
(viii) Lease of machinery, plant or furniture N/A
(ix) Sale of movable/ immovable assets
N/A
(x) Gifts N/A
44. Any other income not covered above N/A
TOTAL INCOME 30,000/-
45. (Give monthly income)

PART V
STATEMENT OF EXPENDITURE
S. No. Description Amount
(in Rs.)
46. Housing (i) Monthly rent 20,000/-

(ii) Mortgage payment(s) N/A

(iii) Repairs & 2,000 Per Month
Maintenance
(iv) Property tax N/A

47. Household (i) Groceries/Food items/ 10,000/-P/M

expenditure Personal care/clothing
(ii) Water 1000/-P/M
(iii) Electricity 5000/-P/M
(iv) Gas 1000/-P/M
(v) Telephone/Mobile 900/-P/M
(vi) TV Cable/Set- 500/-P/M
top Box charges &
Internet services
(vii) Maintenance, 4000/-P/M
replacement and
repair of household
items, appliances and
kitchenware.
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viii) Telephone N/A

(ix) Domestic full N/A
time/part time
helper(s)
(x) Others (specify) 2000/-P/M

48. Maintenance of (i) Parents Mother

Dependents
(ii) Children (as mentioned N/A
at serial no.39)
(iii) Others N/A

49. Transport (i) Private Transport Bike Hunk

(a) Driver(s) N/A
(b) Fuel 500/-
(c) Repair/Maintenance 1000/-
(d) Insurance 700/-
(e) Loan repayment N/A
(ii) Public Transport 500/-

(a) Bus 500/-

(b) Taxi 500/-

(c) Metro 500/-

(d) Auto 500/-

50. Medical expenditure (i) Doctor 500/-

(ii) Medication 4000/-

(iii) Hospital 1000/-

(iv) Other medical 1000/-

expenditure
(v) Others (specify) 1000/-

51. Insurance (i) Life N/A

(ii) Annuity N/A

(iii) Householders N/A

(iv) Medi-Claim N/A

52. Entertainment (i) Club 1000/-

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and recreation (ii) Health Club N/A

(iii) Gym 1000/-

53. Holiday and vacations 5000/- Per Annum
54. Gifts 15000/- Per Annum
55. Legal/litigation expenses 5,00,000/-
56. Discharge of (i) Credit card(s) payment N/A
Liabilities
(ii) Hire purchase/lease N/A
(iii) Repayment of Loans N/A
(a) House loan N/A
(b) Car loan N/A
(c) Personal loan N/A
(d) Business loan N/A
(e) Any other loan Two I Phone /A/C
(iv) Name of the lenders N/A
(v) Mode of repayment N/A
(vi) Installment amount
(vii)Other personal N/A
liabilities
57. Miscellaneous (i) Newspapers, 500/- P/M
magazines, books
(ii) Religious Tarun Foundation
contributions/
Charities
(iii) Others (specify)
58. Pocket Money/Allowance N/A
59. Other expenditure N/A
(Not specified above)
60. TOTAL EXPENDITURE N/A
(Give monthly expenditure)
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PART - VI
STATEMENT OF ASSETS
S. No. Assets List of Assets
At the time of At the time of Present Present
marriage Separation Estimated
Market Value
61. Real Estate Including
(i) Land YES
(ii) Built up
N/A
properties
(iii) Lease hold
properties
(iv) Agricultural land YES
(v) Investment in
real estate such
as booking of
plots, flats and N/A
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, N/A
whether or not you are
registered as owner.
Note 2. : - Provide
legal descriptions and
indicate estimated
market value of your
interest without N/A
deducting
encumbrances or costs
of disposition. (Record
encumbrances under
debts.)
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62. Joint Properties

(i) Properties presented
at or about the time
of marriage, which N/A
belong jointly to
both the husband
and wife. Give the
status of their
possession.
(ii) Other joint
properties of the
parties. Give the N/A
status of their
possession.
(iii) Whether any
litigation pending
with respect to the N/A
joint property? If
so, give particulars.
63. Liquid Assets: Account Number Name of Bank Current
Balance
(i) Details of all bank (i) 65033684400 SBI Bank 80,000/-
accounts including
Current, Savings (ii) PNB N/A
and Demat
Accounts in your (iii)
name, or joint
name and balance (iv)
in the said account
(ii) Cash in Hand
64. Investments Particulars Current Value
(i) Details of all investments you N/A
hold or, in which you have
interest and their current value:
a) FDRs, NSC, IVP, KVP, Post
N/A
Office schemes, PPF etc.
b) Deposits with Government
and Non-Government N/A
entities
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c) Stocks, shares, debentures, N/A

bonds, units and mutual
funds, etc.
d) Life and endowment policies N/A
and surrender value
e) Loan given to friends,
N/A
relatives and others
f) Other investments not
covered by above items N/A
65. Pensions and Retirement Savings Particulars Maturity amount
Plan
N/A
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 N/A
or indirectly, in any corporation,
unincorporated business,
partnership, trust, joint venture
and Association of Persons,
Society etc.
67. Movable Assets Particulars Current value
(i) Motor Vehicles (List cars, Bike Hunk Brand Hero
motorcycles, scooters etc.
along with their brand and
registration number)
(ii) Livestock N/A
(iii) Mobile phone(s) I Phone 14 80,000/-
(iv) Computer/Laptop
N/A
(v) Other electronic gadgets
N/A
including I-pad etc.
(vi) TV, Fridge, Air Conditioner, TV, Fridge, Air Conditioner 20,000/-
Microwave, Washing
machine, etc.
(vii) Other household and kitchen N/A
appliances
(viii)Quantity of gold, silver and
diamond jewellery N/A
(ix) Quantity of Silver Utensils N/A
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68. Intangible properties

Including patents, trademark, N/A
copyright design and goodwill and
their value
69. About disposal of properties Particulars Present Estimated
market value
Particulars of properties (movable
as well as immovable) sold/agreed
to be sold between the date of YES 20 Lack
marriage till the date of filing of
this affidavit and the sale
consideration received from the
purchaser
70. Others Particulars Estimated current
value
List anything else of value that
you own, including precious
metals, collections, works of art, N/A N/A
jewellery or household items of
high value. Include location of
safety deposit lockers.

PART - VII
STATEMENT OF LIABILITIES
S. No. Description Particulars of Current Value
Debts
71. Secured debt(s)
List all mortgages, loans, and any other
debts secured against an asset
72. Unsecured Debt(s)
List all bank loans, personal loans,
credits, overdrafts, credit cards and any N/A
other debts
73. Other
List any other debts, including N/A
obligations that are relevant to a claim
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PART - VIII
GENERAL INFORMATION RELATING TO THE STATUS,
STANDARD OF LIVING AND LIFESTYLE
S. No. Description Particulars
74. Particulars of residential accommodation 45 Sq. Feet
where your are presently staying (in sq. feet)

75. Who is the owner of the residential Tarun

accommodation? In case of rented
accommodation, specify the monthly rent

76. Number of part-time/full time domestic N/A

helpers and their wages

77. Average monthly withdrawal from bank(s) ONLINE PAYMENT

78. Mode of travel in city/outside city Metro, Auto, By Bus, Taxi

79. Membership of clubs/health clubs/gyms, N/A

societies and other associations. Specify
the membership fee and subscription

80. Particulars of credit/debit card(s), its limit N/A

and usage

81. Particulars of frequent flier cards N/A

82. Frequency of foreign travel, business as N/A

well as personal

83. Category of hotels ordinarily used for stay, Medium Class

official as well as personal

84. Category of hospitals opted for medical Semi- Private

treatment including type of rooms

85. Brand of vehicle, mobile and wrist watch, Hero bike Hunk , I Phone 14
pen, sunglasses, wallet/bags.

86. Expenditure ordinarily incurred on family 4000/- P/M

functions including birthday of the children
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87. Expenditure ordinarily incurred on festivals 8000/- Per Festivals

88. Expenditure incurred on marriage of family 3000/-

members

89. Status of the deponent and his/her family:

- High
- Upper Middle
- Middle Middle
- Lower Middle
- Low
- Below poverty line

PART - IX
DOCUMENTS RELATING TO ASSETS, INCOME AND EXPENDITURE
PART A
DOCUMENTS RELATING TO PERSONAL INFORMATION

S. No. Description

1. Ration Card N/A

2. Voter ID Card

3. Aadhar Card 5884 9861 4046

4. Driving Licence

5. PAN Card

6. Passport

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 YES
and Demat accounts for last 3 years
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N/A
8. Income Tax Return(s) along with
Statement of Income and Annexures
for last 3 years

9. In case of Salaried Persons

(i) Appointment letter along with
salary structure at time of N/A
appointment.
(ii) Last Salary Slip N/A

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

(iv) Cost to Company Certificate
and CIBIL Certificate, N/A
wherever applicable
(v) Copies of TDS certificates N/A

10. In case of self-employed persons

(i) Balance Sheet and Profit & N/A
Loss Account
(ii) Balance Sheet and Profit &
Loss Account of the
proprietorship firm, if the N/A
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 N/A
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 N/A
in which the deponent is a
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Director
(v) Balance Sheet and Profit &
Loss Account of the
Association of Persons, HUF,
Joint Family business or trust N/A
in which the deponent has
share
(vi) Copy of account of the
deponent in the books of the N/A
business
(vii) Copies of TDS certificates N/A
11. In case of Income from other
sources:
(i) Lease Deed(s)/Rent
Agreement(s) /Licence
Agreement(s) in respect of the N/A
rental income
(ii) Interest Certificate in respect
of the interest income on N/A
deposits and investments
(iii) Dividend Certificates in
respect of dividend income N/A
N/A
(iv) Demat holding Statement
(v) Sale Deed(s)/transfer
documents in respect of the N/A
profit on sale of
property/properties

12. Other relevant documents relating to N/A

Income/Assets

13. Other relevant documents relating to N/A

liabilities
PART C
DOCUMENTS RELATING TO EXPENDITURE
(i) Documents relating to the N/A
14.
expenditure on education of
children including tuition fees
(ii) Rent and maintenance receipts
N/A
(iii) Electricity, water, security and
YES
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gas bills
(iv) Documents relating to the
N/A
salary paid to the employees
including domestic helper(s)
(v) Documents relating to N/A
expenditure on conveyance
(vi) Debit and Credit Card N/A
statements of all cards
(vii) N/A
statements
(viii) Mobile and landline phone YES (Mobile
bills 900/-)
(ix) Internet and TV cable/ Set -
Top Box bills YES (Internet
500/-)
(x) Documents relating to the re- N/A
payment of the loans
(xi) PPF, EPF and other
superannuation fund receipts N/A
(xii) Receipts of premium of N/A
insurance policies
(xiii) Receipts of payments in
respect of mutual funds N/A

(xiv) Documents relating to

payment of interest on bank N/A
and other loans
(xv) Documents relating to the
payment of taxes, including N/A
Income Tax and Property Tax
(xvi) Other relevant documents
relating to Expenditure N/A
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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 upto seven years and fine, and Section 209 of
Indian Penal Code punishable with imprisonment upto 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 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
therefrom, 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