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FORM26 (See Rule 4A)
AffidaJt to be filed by the candidate along with nomination paper before the returning officer for election to Legislative Council of Telangana (name of the house) from Waranlal- Khammam- Nalgonda Constituency (name of the constituency) ",'" PART-A i I, EEDA BHASKAR Son of DE VA SWAMI Aged 37 years, resident ofH.No. 6-127 Ji NAMPALLYVILLAGE & MANDAL, NALGONDA DISTRICT ( mentioned full postal address) a candidate at the above election, do hereby solemnly affirm and state on oath as under.~
1) ~ am a candidate set up by INDEPENDENT ( Name of the Political party) am fontesting as an Independent candidate ( strike out whichever is not applicable)
~ ftI '4 ~ ~-' NOTARY
r \ AltHAM (IIANDRA SElHAI ~ B.Com.,I.t... ADVOCATE g AppoInted bVG4wt. gI A.P.. tNOlA III G.O' ••••8. No. 380,2011-2018 Vldya Nagar. NALGOHOA-50S 001, 2) My name is enrolled in Munugode Assembly-93 Telangana State (Name of the constituency and the state)at serial No. 248 in Part No. 510
3) My contact telephone number(s) is 9492868208 and my e-mail id (ifany) is Nil
4) Details of Permanent Account Nubmer (PAN)and status of filing of Income tax return.
S.No. Name Pan The financial year Total income for which the last shown in Income tax return income tax has been filed return(in Rupees)
l. Self APUPE8500E Nil Nil
2. Spouse Nil Nil Nil
3. Dependent -1 Nil Nil Nil
4. Dependent -2 Nil Nil Nil
5. Dependent-3 Nil Nil Nil
5) I ami am not accused of any offence(s) punishable with imprisonment for two years or more in a pending case(s) in which a charge(s) has/have been framed by the court(s) of competent jurisdiction.
If the dependent is accused of any such offence(s) he shall furnish the following information ;-
i) The following case(s) is/are pending against me in which charges have been framed by the court for an offence punishable with imprisonment for two years or more '- (a) Case/First information Report No.y Nos together with complete details of concerned police Nil station / District/ State
b) Section(s) of the concerned Act(s) and short Nil description of the offence(s) for which charged --:-
ii) The following case(s) is/are pending against me in which cognizance has been taken by the court (Other than the cases mentioned in item(l) above) :
a) Name of the court, case No. and date of order Nil taking Cognizance
b) The details of cases where the court has taken Nil cognizance, section(s) of the Act(s) and description of the offence(s}for which cognizance taken c) Details of Appeal(s) / Application(s) for revision (if Nil any) filed against the above order(s)
6) I have been/have not been convicted of an offence(s) [other than any offence(s) referred to in Sub section (1) or sub-section (2) , or covered in sub-section (3), of section 8 of the Representation of the people Act, 1951 (43 of 1951) 1 and sentenced to imprisonment for one year or more.
If the dependent is convicted and punished as aforesaid, he shall furnish the following information : In the following cases, I have been convicted and sentenced to imprisonment by a court of law: a) The details of cases, section(s) of the concerned Nil Act(s) and description of the offence(s) for which convicted b) Name of the Court(s) case No. and daters) of Nil order(s) c) Punishment imposed Nil
d) Whether any appeal was/has been filed against Nil the conviction order. If so, details and the present status of the appeal :
7) That I give herein below the details of the assets (movable and immovable etc) of myself, my spouse and all dependents. A. Details of movable assets. Note: 1) Assets in joint name indicating the extent ofjoint ownership will also have to be Given Note :2) In case of deposit/Investment, the details including Serial Number, amount date Of deposit the scheme, Name of the Bank/Institution and Branch are to be given. Note 3) Value of Bonds/Share Debentures as per current market value in Stock exchange in respect of listed companies and as per books in case of non-listed companies / ..: ·.:?~should be given. .' NOt~~~~~Dependent here has the same meaning as assigned in explanation (V)under . _', "'\-,'JUHlE ~ section 75A of the Representation of the People Act, 1951.. ~( ~~1 ~ etails including amount is to be given separately in respect of each invk>t¢erit. ~-4'. ,"'." ~t;' ONC~ - !IV_ - l' t: escnption Self Spouse fependent- A~ir N RA~m*nt-
I Cash in Hand 20,000 Nil Nil Nil ADVOC ., G.O. M.S. NO. 380, 2011-2018 Vldya Nagar, NALGONDA-Soa 001. 1 II Details of Deposit Nil Nil Nil Nil Nil in, Bank accounts I (FDR's Term Deposits and all other types of deposits including saving accounts). Deposits with fmancial Institutions, Non- Banking financial Companies and Co.operative societies and the amount in each such deposit. III Details of investment in Bonds debentures Nil Nil Nil Nil Nil / shares and units in Companies /Mutual funds and others and the amount. IV Details of investment in ~"SS, Postal Saving, Insurance Nil Nil Nil Nil Nil Policies and investment in any Financial instruments in Post office or Insurance company and the amount. V Personal loans / advance given to any person or entity Nil Nil Nil Nil Nil including firm, company Trust Etc., and other receivables from debtors and the amount. VI Motor vehicles / Aircrafts/ Yachts /Ships (Details of Nil Nil Nil Nil Nil Make, registration number etc. year of purchase and amount VII Jewellery, Bullion 30grms and valuable thing(s) Gold (givedetails of weight Nil 86000/- Nil Nil Nil and value) VIII Any other assets such as value of claims/interest Nil Nil Nil Nil Nil
IX Gross total value .. 20,000 86,000 Nil Nil W Nil NOTARY ARTHAM CHAND RA SEKHADt B. Details of Immovable assets : B.Com., B.L ADVOCATE Appointed by Govt. of A.P., INDIA G.O. M.S. No. 380.2011-2016 Vldva Nagar, NALGONDA-S08 001. • Note : 1) Properties in joint ownership indicating the extent of Joint ownership will also have to be indicated. Note :2) Each land or building or apartment should be mentioned separately in this format
Sl. Description Self Spouse Dependent- Dependent- Dependent- No. 1 2 3 i) Agricultural land : Location(s) Nil Nil Nil Nil Nil Survey number(s) Area (total measurement ill Nil Nil Nil Nil Nil acres) Whether inherited property (Yes or No) Nil Nil Nil Nil Nil Date of purchase incase of self- Nil Nil Nil Nil Nil acquired property Cost of Land (in case of purchase ) at Nil Nil Nil Nil Nil the time of purchase Any investment on the land by way of Nil Nil Nil Nil Nil development, construction etc.
Approximate current market Nil Nil Nil Nil Nil value
ii Non- Agricultural land: Nil Nil Nil Nil Nil Location(s) Survey number(s) Area (total measurement in Nil Nil Nil Nil Nil Sq.ft) Whether inherited property (Yes or No) Nil Nil Nil Nil Nil Date of purchase incase of self- Nil Nil Nil Nil Nil acquired property Cost of Land (in case of purchase ) at Nil Nil Nil Nil Nil the time of purchase Any investment on the land by way of Nil Nil Nil Nil Nil development, construction etc.
Approximate current market Nil Nil Nil Nil Nil value
iii) Commercial Buildings (including apartments Nil Nil Nil Nil Nil .- ':"'-::"•,..:Location(s): "1\ .~~.. 1,,1 "-<.'.,. :5\.Vrveyno.tsi IA/ ~v "'J(tilji\~ a . (total Nil Nil Nil Nil NC T~Y '~c1",",1"\Ci", ~ surement ill sq.ft] ·'I..(lOI-l P...UJ. t up area (total ••••••• M I • t· /~asurement in Sa.ft) Nil Nil Nil Nil BijJ:Com .• B. L ~=~====~~~--~=----~7-~------~~~--~~~~~141.1 .•.--~•._ ..• I~ ~~ Appointed by Gov. of A.P.• INDIA G.O. M.S. No.~. 2011-2016 Vldya Nagar. NALGONDA·508 001. . , . Whether inherited - property ( Yes /No) Nil Nil Nil Nil Nil
Date of purchase in case of self acquired property. Cost of property (incase of purchase at Nil Nil Nil Nil Nil the time of purchase) Any investment on the property by way of Nil Nil Nil Nil Nil development, construction etc. Approximate current market value Nil Nil Nil Nil Nil iv] Residential Buildings (including apartments Nil Nil Nil Nil Nil
Locations Survey number(s) Area (total Nil measurement in Sq.ft) Nil Nil Nil Nil Built up area (total measurement in Sq.ft) Nil Nil Nil Nil Nil Whether inherited property ( Yes or No) Nil Nil Nil Nil Nil Date of purchase in case of self acquired 14- Nil Nil Nil Nil property 04- 2010 Cost of property ( incase of purchase at 50000/- Nil Nil Nil Nil the time of purchase ) Any investment on the land by way of llakh Nil Nil Nil Nil development, construction etc. Approximate current market value 2lakhs Nil Nil Nil Nil V Others ( such as interest in property) Nil Nil Nil Nil Nil VI Total of current market value of [i] of 21akhs Nil Nil Nil Nil (v) above
8)
escription Self Spouse Dependent- Dependent- Dependent- 1 2 '. 3 Loan or dues to Bank/financial Institution(s) Name of the Bank or Nil Nil Nil Nil W Nil financial institutions, Amount NOTARY outstandin , Nature of Loan. B.Com., S.L ADVOCATE Appointed by Govt of A.P., INDIA G.O. M.S. No. 380, 2011-2016 Vldyl Nagar, NALGONOA·508 001. - Loan or dues to any other individuals/ entity other than Nil Nil Nil Nil Nil mentioned above name(s) amount outstanding, nature of loan Any other liability Nil Nil Nil Nil Nil
Grand total of Liabilities Nil Nil Nil Nil Nil
Nil Nil Nil Nil Nil ii) Government dues: Dues to departments dealing with Nil Nil Nil Nil Nil Government accommodation Dues to department dealing with supply of water Nil Nil Nil Nil Nil Dues to department dealing with supply of electricity Nil Nil Nil Nil Nil Dues to department dealing with supply of telephones Imobiles Nil Nil Nil Nil Nil Dues to department dealing with government transport ( including Nil Nil Nil Nil Nil aircrafts and helicopters) Income tax dues Nil Nil Nil Nil Nil Wealth tax dues Nil Nil Nil Nil Nil Service Tax dues Nil Nil Nil Nil Nil Municipal/property tax dues Nil Nil Nil Nil Nil Sales tax dues Nil Nil Nil Nil Nil Any other dues Nil Nil Nil Nil Nil iii) Grand total of all Government dues Nil Nil Nil Nil Nil iv) Whether any other liabilities are in dispute, if so, mentioned the Nil Nil Nil Nil Nil amount involved, and the authority before which it is pending
8) Details of profession or occupation: 9) a) Self : Ration Dealer
b) Spouse: House wife
10) My Educational qualification is as under:
sse ZPHS Nampally- 1994 year MBA Nethaji Institute of Engineering & Technology Toopranpet JNTU- 2010-12 Roda Mistry college of social work and research center Gachibowli, Hyderabad, Osmania University - 2012-14 d) MJG College of Education Marrigudem Mandal, Nalgonda.pistrict, Osmania University- 2014-15 V (Givedetails of highest school/University education mentioning ttJcDfU4.\~ of the .certi~cate I,diploma/ degree course, name of the school ~/oti\~ftcTo~'r.~ m the year ill which the course was completed.) ADVOCXTE .. ~ AppOlntedbyGoYt.o4 .••.P.. INDIA ~ <"" G.O. M.S. No. 380. 2011·201 S r \ Vid¥e Hagar. NALGOHOA-508 001- PART-B
11) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART -A
1 Name of the Candidate Sriy Smr/Kum E.BHASKAR
2 Full Postal address H.No. 6-127, Nampally Village & Mandal, Nalgonda District 3 Number and name of the constituency and state Munugode -93, Telangana State
4 Name of the political party which set up the INDEPENDENT candidate ( otherwise write Independent 5 i) Total number of pending cases where charges have been framed by the court for offences Nil punishable with imprisonment for two years or more ii) Total number of pending cases where the court(s) have taken cognizance [ other than the case Nil mentioned in item (i) above 1 6 Total number of cases in which convicted and sentenced to imprisonment for one year or more [ Nil except for offences referred to in sub-sections (1), (2) or (3) of section 8 of Representation of the people Act, 19511 PAN of Year for which Total income shown last income tax return filed a) Candidate ABUPE 8500E Nil Nil b) Spouse Nil Nil Nil c) Dependents Nil Nil Nil
8. Details of Assets and Liabilities in Rupees
Description Self Spouse Dependent- Dependent- Dependent- 1 2 3 A Movable Assets 20,000 Nil Nil Nil Nil (Total Value) B Immovable Asset Nil Nil Nil Nil Nil I Purchase price of self - 50,000 Nil Nil Nil Nil acquired immovable property II Development / Construction cost of immovable property llakh Nil Nil Nil Nil - after purchase ( if ~~ ~ ~ applicable) kI ~ut. \~ Approximate 2lakhs Nil Nil NilNOTAH :J: O\S ~\C1 Current market price of .16M ~~~t
VERIFICATION
I, the deponent above named, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief and no part of it is false and nothing material has been concealed there from. I further declare that :-
a) there is no case of conviction or pending case against me other than those mentioned in items 5 and 6 of part A and B above
b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 7 and 8 of part A and items 8,9 and 10 part B above
Verified at N~~ this "b1..±-±h day of '-::::'~b~~,20 15 tV NOTARY AlTHAM c AND A SEKHAI m ADVOclfe .• B.L Appointed by Govt. of A.P..INDIA G.O. M.S. No. 380 2011-2011 'I' • . ''1Va Nagar. NALGONDA-50S 001.