PROFORMA

I. SERVICE DETAILS:

1) NAME : Katari Venkata Ramana

2) FATHER's' /HUSBAND's NAME : K.Venkataiah

3) DATE OF BIRTH : 5/5/1961

4) PLACE OF BIRTH : Neerabdullayapalli, Gopavaram

(Mandalam) kadapa (DT)
5.(a) EMPLOYEE I.D. No. : 12442

(b) PAN No. IF INCOME TAX PAYEE : AHA PR 4243 B

6) DESIGNATION AND DATE OF ENTRY : Assistant Executive Engineer

INTO SERVICE 11.2.1986

7) PRESENT DESIGNATION AND PLACE : Deputy Executive Engineer,

OF WORKING S.SL.C & SB Sub division No:3
K.R.Dam
8) ZONE ALLOTTED : III

9. PROMOTIONAL PARTICULARS

S.NO: Designation Date of Date of joingning Remarks if any

Promotion in the post
1) Deputy 23.8.2004 1.9.2004 ---
Executive
Engineer

II.SPOUSE PARTICULARS :

1 Name of the spouse : K.Lashmi

2. Date of Marriage : 13.6.1985
3. Status : House Wife
4. If employed, details of employment : ----
a. Designation and place of Working : ----
b. Name of employee : ----
c. Annual Income : ----
5. Pan No. If income tax assesses : ----
 PROPERTY DETAILS
A) IMMOVABLE PROPERTY (ACQUISITION OR DISPOSAL)

Name of Situation of Property Held in Date and mode Price and for Source or I incumbency Total worth of
property and Extent whose name of acquisition acquisition or payment designation and property as on
or disposal obtained for place of the day 1.6.07 In Rs.
disposal or acquisition of
property

1 2 3 4 5 6 7 8
1.House Plot No:91,SNo:1892/part K.Venkata 23.12.1999 Rs: 11,100 Salary Assistant.
Gadam Rosaiah Ramana purchased from savings Executive
Nagar,Kothur, Gadam Engineer(Tech)
Nellore Rajasekar S.P.Division No:6
Builder Nellore Rs : 4,50,000

2) Flat No: 104,Dheeraj K.Venkata 22.1.2001 Andhra

Heights, Magunta Ramana purchased from Rs: 3,60,000 Bank Loan
layout ,Nellore M/S Sunitha No 540
Rs: 6,00,000
Builders RS:3,75000 ---- Do---
Dhreeraj
Heights
Apartment
 PROPERTY DETAILS
B) MOVABLE PROPERTY

Name of Held in whose Date and Name form Price paid for Source of Incumbency Total worth of
property name mode of Which property acquisition or Payment designation and property as on
acquisition or is aquired Obtained for place on the day 1.6.07 In Rs
disposal disposal of acquisition of
property
1 2 3 4 5 6 7 8
Jewellery K.Lakshmi Purchased Acquired from Rs: 22,000 Presented at Not Emplyed in Rs: 90,000/-
110 grams during 6/1985 Sridhanam the time of the Dept.
Marriage
Jewellery K.Lakshmi Purchased Purchased from Rs: 6,000 Salary savings Assistant Rs: 18,000/-
20 grams during 4/1992 jewelery shop at ExecutiveEngineer
Nellore T.G.P Sub Dn:
No:3 K.R.Dam
Jewellery K.Lakshmi Purchased Purchased from Rs: 8,000 Personal loan Assistant Rs: 18,000/-
20 grams during 7/1996 jewellery shop at from Bank ExecutiveEngineer
Nellore SP Dn: No:6
NELLORE
Jewellery K.Lakshmi Purchased Purchased from Rs: 20,000 Personal loan Deputy Executive Rs: 22,000/-
25 grams during 2/2007 jewelery shop at from Bank Engineer
Nellore S.S.L.C & S.B
Sub Division No:3
K.R.Dam
 PROPERTY DETAILS
B) MOVABLE PROPERTY

Name of Held in whose Date and Name form Price paid for Source of Incumbency Total worth of
property name mode of Which proposed acquisition or Payment designation and property as on
acquisition or is aquired Obtained for place on the day 1.6.07 In Rs
disposal disposal of acquisition of
property
1 2 3 4 5 6 7 8
Silver 250gr K.Lakshmi Purchased Purchased from RS: 4200/- Salary Deputy Executive Rs:4300/-
during 2/2007 jewelery shop at Savings Engineer
Nellore S.S.L.C & S.B Sub
Division No: 3
K.R.Dam
Computer K.V.Ramana Purchased purchased from Rs: 22,000 Personal loan Deputy Executive Rs: 16,000/-
during 8/2005 Sivani computers from LIC Engineer
at Nellore S.S.L.C & S.B Sub
Division No: 3
K.R.Dam

B) SOURCES OF INCOME FROM DEPENDENTS

The year from which name is Total income from all sources
NAME Relationship
added
---- ---- NIL
----

CERTIFICATE

This is to certify that the service particulars furnished are verified from S.B. and found to be correct

Signature