IN THE COURT HON’BLE ADDL.

SESSIONS JUDGE, BORIVIALI

DIVISION, AT DINDOSHI, MUMBAI

SPECIAL CASE NO. 257 OF 2017

The State of Maharashtra

(Through Powai Police Station

vide C.R. No. 164/2017) …Complainant

Versus

Sandip Ramkumar Gautam @ Maurya,

Age: 24, R/at. Ambedkar Nagar,

Uday Nagar, Machchi Market Gali,

Sakinaka, Andheri (E) … Accused

I, Rekha Devi Ramkumar Gautam the Surety hereby solemnly affirm and

state as follows :

(1) I beg to offer myself as a Surety for the Accused above named who

has been acquitted under Section 235(1) of the Code of Criminal

Procedure for Sections 376, 376(2)(i), 377 of Indian Penal Code,

1860 and Section 3 punishable u/s. 4 and 5 of the Protection of

Children from Sexual Offences Act, 2012 and has been directed to

furnish surety bond of Rs. 15,000/- with surety / sureties in like

amount by your Worship on 28/02/2023.

(2) I give below certain particulars concerning myself :

(a) Full Name of the Surety : Rekha Devi Ramkumar Gautam

Qualifications, if any : Illiterate

 Full Residential Address : Saki Naka Post Office, T-221, S.V.

Road, Pipeline, Ambedkar Nagar,

Saki Naka, Kurla, Mumbai - 400072

Period for which the Surety has

been residing at above address (for the last 6 (Six) years)

Rent paid for residence NIL

Whether the rent / maintenance NIL

Bill of the residence stands

in the name of Surety :

(b) Occupation of Business : NIL

Full Business Address : NIL

Nature & extent of the Business NIL

and the Surety’s share therein NIL

Rent Paid for place of Business, NIL

Whether the Rent Bill of Business NIL

Stands in the name of the Surety. NIL

(c) Name & Address of Employer if Rajasthan Cranes Service

the Surety is in Service

Full Address of Place of service Near Ansa Industrial Estate,

Block D, Saki Vihar Road,

Saki Naka, Andheri – 400072.

Amount of the monthly Pay and Rs. 16,000/-

 allowance Drawn by the Surety NIL

Length of service with employer 8 Years

Amount of Provident Fund, if any NIL

at the Surety’s credit;

(d) Full Particulars of house / property House admeasuring 15 X 9

situated at Saki Naka Post

Office, T-221, S.V. Road,

Pipeline, Ambedkar Nagar,

Saki Naka, Kurla, Mumbai -

400072

owned if any, it’s location, rateables The property is owened and

value of the property is Rs.

50,000/-

value & Surety’s share or interest

therein & whether it is encumbered in any way NO

Amount of income-tax paid during No income tax paid

each of the last three years.

(e) Banking account if any & the amount Bank A/c. No.

102001519518

now lying in each Banking account. Rs.5,000/-

(f) Length of time for which the Surety

has Known the accused personally

Whether the Surety is related to the

Accused, if so, how? YES, Mother

 (g) Whether the surety has stood for any Surety has not stood

surety for any other

person

other Person, if so, state the names of

the parties, amount for which Surety

has stood Surety for them, the court

and the number of the case against

those accused & whether the case or

cases against those person are still

pending or have conclude.

(h) Whether the surety has at any time No

had his surety bond forfeited thereof

if so, give particulars.

(i) Whether the Surety has at any time No

made an application for suretyship

which has been rejected, if so give

particulars thereof.

(j) Whether the surety is or has been No

involved in any Civil litigation.

(k) Whether the surety himself has No

been concerned in any case as

an accused person, if so give the

particulars thereof.

(3) Any other particulars in regard of the status of the Surety, or his

Income and assets, which the surety may desire to give : NIL
(4) I produce the following proof in support of my statement and give

particulars of the same as below :

i. Rent bill of the Place of Residence NIL

ii. Ration Card Yes

iii. Rent Bill of the Place of Business

iv. Deed of Partnership or other

documents relating to business

v. Certificate from the Employer Yes

vi. Certificate of the amount in the

Provident fund

vii. Title deeds of properties Agreement for sale

viii. Municipal Bills of properties

ix. Bank Pass Book Yes

x. Income Tax payment Receipt

xi. Other Proofs.

(5) I pray that I may be accepted as a Surety for the abovementioned

Accused Sandip Ramkumar Gautam @ Maurya in the Sum of Rs.

15,000/- (Rupees Fifteen Thousand Only).

SOLEMNLY AFFIRMED AT MUMBAI ON

this 20th day of April, 2023.

 Signature of the surety

Before me

Identified by me

Advocate, High Court

Addl. Sessions Judge, Boriviali

Division, At Dindoshi,