PROFORMA FOR PRIOR INTIMATION

Particulars to be furnished by TSNPDCL employee while giving prior intimation or seeking

prior sanction, under Regulation 5 of Andhra Pradesh State Electricity Board (Revised)
Conduct Regulations
*** *** ***
1. Name and Designation :: D.NARSIMHASWAMY
Line Inspector/Enugurthy
o/o AE/OP/ENUGURTHY
2. Scale of Pay and Present Pay ::
122255=00

3. Purpose of application/Sanction for transaction/ :: ---

Prior information of transaction

4. Whether property is being acquired or disposed of:: ---

5. Probable date of acquisition/Disposal of Property :: ---

6. Mode of acquisition/Disposal :: ---

7. (a) Full details about location viz Municipal No. :: ---

Street/Village/Mandal, District and
State in which situated ::

(b) Description of the property, in the case of

Cultivable land, dry or irrigated land :: ---

(c) Whether free hold/or lease hold :: ---

(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) ::
---
(e) In case the transaction is not exclusively in the
Name of the APNPDCL employee particulars of
Ownership and share of each member :: ---

8. Sale/Purchase price of the property

(Market value in the case of gifts) :: ---

9. In the case of acquisition, source or sources from

Which financed/proposed to be financed :: ---

(a) Personal savings :: ---

(b) Other source giving details :: ---
10. In the case of disposal of property, was requisite
Sanction obtained/intimation given for its :: ---
Acquisition a copy of the sanction/
acknowledgement be attached
11. (a) Name and address of the party with whom
Transaction is proposed to be made :: ---

(b) Is the party related to the applicant? If so,

State the relationship :: ---

(c) Did the applicant have any dealings with party

In this official capacity at any time or is
The applicant likely to have any dealings
With in the near future? :: ---

(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):: ---

12 Any other relevant fact which the applicant

May like to mention :: ---

DECLARATION

I, D.NARSIMHASWAMY hereby intimate the proposed acquisition/disposal of property

by me as detailed above. I declare that the particulars given above are true.

Station: ENUGURTHY Signature:

Date: Designation: Line Inspector

Note: 1 In the above form, different portions may be used according to requirement
2. Whether previous sanction asked for, the application should be submitted at
Least (30) days before the proposed date of transaction.
 ANNEXURE -I
Statement of Immovable property possessed acquired and disposed of the NPDCL
employee Sri D.NARSIMHASWAMY any other person on his behalf or by any member of his
family during year ending 1993 to 2018 under Regulation 5 (7) of APSE Board (Revised)
Conduct Regulations.
Situation of property Date & mode
Nature of Held in
Calendar Year (Survey/Municipal Number of acquisition/
Property whose name
with extent) disposal
1 2 3 4 5
2018 ---- ---- ---- ----
2015-2017 --- --- --- ---
D.Narsimhaswamy
2014 House HNO. 3-9-326/1 02.05.14
& Wife
2011-2013 --- --- --- ---
Sy No.760/1 &760/3
2010 Land D.Narsimhaswamy 17.03.10
Warangal
1993 to 2009 --- --- --- ---

Annual
Price Source of Whether information given or Sanction obtained
Income from
paid/obtained Payment (with reference No and date)
property
6 7 8 9
--- -- -- --
Housing loan &
Rs26.0Laks NO Nil
Savings
--- -- -- --
By cash &
Rs 80,000.00 NO Nil
Savings
--- -- -- --

Station: ENUGURTHY Signature:

Date: Designation of the NPDCL employee: LI

Note:- 1. Details of acquisition of properties standing in the name of Hindu undivided family
Or partnership in which the officer holds a claim or share should be separately
Shown in the statement
2. Immovable Properties: a House b. Flat, c. shop d. House Flat, e. Agrl Land
(Dry or Wet) f. Any other (Immovable property)
 A N N E X U R E – II
Statement of Movable property possessed, acquired and disposed of by NPDCL employee of Sri
D.NARSIMHASWAMY or any other person on his behalf or by any member of his family during
year ending 1993 to 2018 under Regulation 5(7) of APSE Board (Revised) Conduct Regulation
ship

Held in Date and mode Name & Address of person from

Nature of
Calendar Year whose of acquisition/ whom acquired/to which
Property
name disposal disposed of
1 2 3 4 5
2018 --- --- --- ---

1993-2017 --- --- --- ---

Whether transaction done

Price paid/obtained Source of Payment
within the limits of jurisdiction
6 7 8
--- --- ---
--- --- ---

Note: Details of acquisition of properties standing in the name of Hindu undivided family or
Partnership in which the officer holds a claim or share should be separately shown in
the statement.

Station: Enugurthy Signature:

Date: Designation of the NPDCL Employee: LI

Note:- Movables (whose value exceeds Rs.100000.00)

A) Vehicles: Motor Car, Motor Cycle. Scooter any other vehicle
B) Electrical Goods, Air conditioner, VCR/Television, Refrigerator, Any other goods
C) Jewellery: Ornaments, Vessells etc.,
D) Investment & Cash: Bank Deposits Debentures/Shares. Bank Balances etc.,
E) Furniture
F) Livestock’s
G) Any other goods