FORM 2A (Sec RULE 'l) f t'r.ro.6z-) NOMINATION PAPER Election to the House of the PeoPle o,L: Lrq PY"
.ts4. es l"r lr I Ro
BELOW IS NOT APPI-ICABI,E STRIKE OFF PART I OR PART II 'il,'I]ICHEVER PART I (To be used by candidate set up by recognizcd' political party)
I nominate as a candidate for election to the House of ttre People from the Not Applicable
Parl i arnentary Constituency.
Candidate's narne ...... NA...... , Father's name ...... Not Applicable...... His postal address ...... Not Applicable
His name is entered at S.No ...NA... in PartNo ...NA... of the electoral roll for ...NA...... NA..... (Assembly constituency comprised within)...NA... Parliamentary Constituencl' lVIy Nameis ...... NA...... anditisenteredatS.No....NA... inPartNo....NA... olrhe electoral roll fbr ...NA... *(Assembly Constituency comprised within) ...NA... Parliamentar"r' Constituencl,.
rRKJ, & Date: 25-03-2019 Signature of Proposer
-l- PAR-t-]I
(To be used by candidate NOT sct up by recognized political party)
We hereby nominate as candidate for election to the House of the People from the I l-Machilipatnam Parliamentary Constituency
Candidate's name Yarlagadda Rama Mohana Rao Father's Name (Late)Yarlagadda Neelachalam. IIis postal address 19/289-8, Chilakalapudi, Machilipatnam-521002 Krishna District, Andhra Pradesh.
Ilis rrame is entered at S.No 747 inPart No 42 of the electoral R.oll for 75 -Machilipatnam (Assembly constituency comprised within) I l-Machilipatnam l)arl ianrentary constituency.
We de'clare that we are electors of the above Parliamentary Constituency and our names are entered in the electoral roll for that Parliamentary Constituency as indicated below and we ;11.rpend oui signatures below in token rl, subscribing to this nomination. PARTICULARS OF 111i] PROPOSER AND THEIR SIGNATURE
5.No Narne of Elector Roll ull Narne S ignature Date
C'omponent No.of ['roposer I
Assernbly I Constituenc Part No.of S.ldo iir Electoral tLat Roll l'a rt tl ) J 4 5 6 7 a 75 Machilipatnam 42 ]i3 Y Krishna Mohan rl 5 Machilipatnam 42 372 Y Chandra Kumar Ll-.'^J* 25BrLl 42 6t0 R Ratna Rao I -J 75 Machilipatnarn I 617 R Ganesh Babu 4 75 Machilipatnarn I R Somesr.vara Rao ( 5 Machilipatnam 42 1 62) 25 s t-i7 6 175 Machilipatnam 42 60q R Srikrishna zs I 7 75 Machilipatnam 374 Y Gowtham Kumar Ls Ir1 I 75 Machilipatnam 12 7l Y Jaswanth sls l !1 2, 75 Machilipatnam 42 354 P Nageswara Rao UJU/ 2-s 13/ t1 l0 75 Machilipatnam 36+ D- =\r1 N.B 'l'here should be l0 electors of the constituenuy as proposers'
_)_ / (^,**, k^?'" PART- III
I, th6 Candidate mentioned in PART 1/Part II (Strike out which is not applicable assent) ro this nomination and hereby declare : -
(a) That I am a citizen of India and have not acquired the citizenship ofany foreign State / Country.
(b) That I have completed 56 years ofage:
ISTRIKE OUT c (i) OR c (ii) BELOW WHICH EVER IS NOT APPLICABLEI
(c) (i) That I am set up at this election by the ...NA.., which is a recognized National party /State Party in this state and that the symbol reserved for the above party be allotted to rne.
OR
(ii) That I am set up at this election by the Bahujan Maha Party, which is a registered unrecognized political party that I am contesting this election as an independent candidate (Strike our which is not applicable) and that the symbols I have chosen, in order preference are:
i) Helicopter ii) Pressure Cooker tii) Whistle
d)'lhat my name and my father's/mother's/husband's name have been correctly spelt out above in English;
e) That to be best of my knowledge and belief, I am qualified and not also disqualified tbr beine chosen to fill the seat in the House of the people. * I turther declare that I am a member of the NA * *Caste/tribe ** Which is a scheduled caste / tribe of the state of NA in Relation to NA ...... (area) in that state.
I also declare that I have not been, and shall not be nominated as a candidate at the presenl general election / by - election being held simultaneously, to the House of the people fr.ont more than two Parliamentary Constituencies.
Y L,*.,Ion (Yarlagadda Ra ma Mohana Rao) I)atc 25-03-2019 Signature of Candidate ''Scora out the words " assembly c onst ituency compris ed w ithin" in the case of Jammu and Kashmir A ndaman and Nicobar Islands, Chandigarh . Dadra and Nagar Haveli , Daman trnd Diu and Lakshadeep.
--l- * Score out this paragraph, ifnot applicable. ** Score out the words not applicable.
N.B.A"r'ecognized poritical party" means a poriticar parry recognized by the Election cornmission under the Election Symbols (Reservation and Allotment) order, l96g in concemed the state
PART _IIIA (To be filled by the candidate) I ) Whether the candidate i) Has been convicted NO a) Of any offence (s) under sub-sectiorr ( l) or NA b) For contravention of an), law specified in sub _ sections (2) ofsection 8 of the Representation people ofthe Act, f lif 1+: of l95l) ; NA or
iil Has been convicted for any other offence (s) for which he has been sentenced to imprisonment for two y"u., o, ,o.". NO If the answer is "yes", the candidate shall fumish the fbllowing information. ii) Case / first information report No. / Nos NA ii) Potice Station NA
iii) Secti on of the concerned Act(s) and briefdescri ,(s) ption ofthe offence which he has convicted been
NA NA ir,) Date (s) of conviction (s) ...... NA
v)Court(s) which convicited the candidate...... NA vi) Punishment(s) imposed {Indicate period of imprisonment and / or quantum of fine(s) ...... NA ...... vii) Date(s) ofrelease from prison NA viii) Was were any appeal (s) revision (s) field against above convicrion(s) ... NA
-4- 1il",nOm0 L*0- ir ) Sate and pafticulars of appeal(s) application(s) for revision fleld NA x) Name of the court(s) before which the appeal (s) application(s) for revision filed: . . . . NA xi) Whether the said appeal(s) application(s) for revision has have been disposed ofor is are pending NA xii) Ifthe appeal(s) application(s) forrevision has/have disposed of... NA......
a) Date(s) of disposal NA b) Nature oforder'spassed ...... NA
2) Whether the candidate is holding any office of profit under the Government of India or
State Govemment ? No
If Yes. details of the office held NA
3 ) Whether the candidate has been declared insolvent by any Court? No
IfYes, has he been discharged from insolvency...... NA
4) Whether the candidate is under allegiance or adherence to any foreign country? NA..
5) Whether the candidate has been disqualified under section 8A ofthe said Act by an order
Of the President ------No
If Yes, the period fbr which disqualified NA
6) Whether the candidate was dismissed for comrption or for disloyalty while holding office under the Govemment of India or the Govemment of any State? No
If Yes, the date of such dismissal NA
(7) Whether the candidate has any subsisting contract (s) with the Govemment either in supply of any good to that Govemment or for execution of works undertaken by that Government ? No
I f Yes, with which Government and details of subsisting contract (s) NA
1Q-H\Oarnok"Q-"
-5- (8) Whether the candidate is a managing agent, or manager or Secretary of any companyYr Corporation (other than a cooperative society) in the capital of which the Central Govemment or State Government has not less than twenty -five percent share? ..... \g
lf 1'cs. with which Govemment and the details thereof NA
9) Whether the candidate has been disqualified by the Commission under section 10A of the said Act No
lfyes, the date ofdisqualification NA
{o Y [LmolY? t,
(Yarlagadda Rama Mohana Rao) Place : Machilipatnam Signature of Candidate Date : 25-03-2019
-6- t PART-IV
( To be filled by the Returning O{Iicer)
Serial No . of nomination paper This nomination was delivered to me at my office at (hour) on (date) by the candidate/propose (name ofproposer )
Date : Returning Officer
PART-V
Decision of Returning Officer Accepting or Rejecting the Nomination paper
I have examined this nomination paper in accordance with section 36 of the Representation ol the People Act, 195 I (43 of 1951 ) of and decide as follows.
Date Retuming Officer
Perforation
PART_VI
Receipt for Nomination Paper and Notice of Scrutiny
(To be handled over to the process presenting the Nomination Paper ) Serial No. of nomination paper...... -l'he nomination paper of Shri Yarlagadda Rama Mohana Rao, a candidate for election liom the I I - Machilipatnam Parliamentary constituency was delivered to me at my otlice at (hour) on_ (date) by the candidate/ proposer. All nonrination papers will be taken up for scrutiny at _(hour) on (date) at (place)
Date : Retuming Offlcer
*Score out the word not applicable
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I YARLA(;ADDA RAMA MOHANA RAO Son ol'(LATE) YARLAGADDA NEELA(;HAL,\\I. r\ged 56 r'sars. resident of D.No:- 191289-8, Chilakalapudi, Machilipatnam-S2 1002, Krishna l)istrict. ,\n rl hra l)radesh, a candidate at the above election, do hereby solemnly allrm and stale on oath as untlcr.
l ) l,atn a candidate set up b1'Bahujan Maha Partr rvhich is registered and un-recogniserl I)urtr ) My nanle is cnrolled in 75 - Machilipatnam Assembly Constituency, Andhra Prarlesh , at Scr.irrl No 747 in Parl No 42. $) MY contact telephone number is (Moobile number) 9866221522 and my e-mail id is .. NtL antl nry social Media account (s) (if any ) is / are : - i) No I ii) NO iii) NO o 1P" fi}o,.(no A !:t t (:ll :t 1
I I iI ,:)) it ,rr, s'lf E$ ;/, a. ,:. (1) Details of Permanent Account - Number (PAN) and status of filing of Income Tax return The Financial Total income sholvn in which year for Income Tar Return (in the last Rupees) for the last five S.No Name s PAN Income Tax financial years comPlcted has return (as on 3lst March) been filed I
I (i) NII-
I (ii) Nil. Yarlagadda Rama Mohana Nli. l Rao AHZPY 6753A NIL (iii) (Self) (ir) NII-
( ) Ntr_ (i) NII, (ii) Nil Yarlagadda Lakshmi (iii) NII, 7 NIL NIL ( Spouse) (iv) NII- (v) NII-
I (i) (ii)
/ I HUIr (lf Candidate is Karta NA NA (iii) NA Crlparcener) (iv)
( ) (i) I ( ll) I 4 Dependent I NA NA (ii i) NA (iv) (v) (i)
I (ii) I i [)cpcndent 2 NA NA (iii) NA I (iv)
( ) (i) (ii) 6 [)ependent 2 NA NA (iii) NA (iv) ( ) Note : It is mandatory for PAN holder to mention PAN and in case of no PAN it should be clearly stated "No PAN allotted".
(s) pnding criminal cases \/ti) I declare that there is no pending criminal case against me. (Tick this alternative if there is no criminal case pending against the candidate anrl write NOT APPLICABLE against alternative (ii) below) i o 2 6 Y, OR
(ii) The following criminal cases are pending against me : NOT APPLICABLE
( If there are pending criminal cases against the candidate, then tick this alternative and score off alternative (i) above , and give details of all pending Cases in the Table below) Table
J FIR of Policc No. with name and address NN NA NA I Stalion concerned I
(b) ('asc No. u ith Name of thc Court NA NA NA I
! Scction(s) of concerned Acts/Codes involved (O (give no. ofthe Section, e.g. Section...... of NA NA NA IP(i, etc.).
(d) llrief description of offence NA NA NA
Whether charges have been framed (mention NA NA NA YES or NO)
lf ansner againsr (e) above is YES, then give r r.r NA NA NA " thc datc on which charges tere framed I I Whether any Appeal / Application for revision u has been filed against the proceedings NA NA NA I (Mention YES or NO) I
(6) Cases of conviction
rti,l I declare that I have not been convicted for any criminal offence'
(Tick this alternative, if the candidate has not been convicted and write NoT APPLICABLE against alternative (ii) below) OR NOT APPLICABLE (ii) I have been convicted for offences mentioned below : (lfthecandidatehasbeenconvicted,thentickthisalternativeandscoreoffalternatir'c i) above m and give details in the Table below
3 flatfio [, 1 Table
(a) Case No. NN NA NA
(h) Name of the Court NA NA NA
I Sections of Acts/Codes involved (give no. of the 1 NA NA NA I Seclion, e.g. Section...... of IPC' etc.).
(d) Brief description of offence for which convicted NA NA NN
I I
(c) Dlte s of orders of conviction NA NA NA
(t) Punishment imposed NA NA NA
Whether any Appeal has been filed against conviction I (e) NA NA NA order (Mention YES or No) I
to (g) above is YES, give details and present I (h) If answer NA NA NA status of appeal
(6A) I have given full and up-to-date information to my political part) about all penrling (lrinrinal cases against me and about all cases of conviction as given in paragraphs (5) and (6).
I candidates to whom this ltem is not applicable should clearly write NOT APPLICAI]LE lN VIEW OF ENTRIES IN 5(I) AND 6(I), ABOVE] Notc:
l Details should be entered clearly and legibly in BOLD letters 2. Details to be given separately for each case under different columns against Each item
3. Details should be given in reverse chronological order, i.e., the latest case to be Mentioned first and backwards in the orrler of dates for the other cases
.1. Additional sheet may be added ifrequired, 5. Candidate is responsible for supplying all information in compliance of Hon'ble Supreme Court's .Iudement in W.P @ No.536 of 201l.
(7) That I give herein below the details of the assets (movable and immovable etc) fM yself, my spouse and all dependents.
4Y ',na.rYb A. Details of movable assets : v Note : 'l Assets in joint name indicating the extent ofjoint ownership will also have to be Given.
Note : 2 In case of deposiVinvestment, the details including Serial Number, Amount date of deposit. the scheme, Name of the Bank / Institution aild Branch are to be given
N6te : 3 Value ofBonds / Share Debentures as per current market value is Stock exchange in respect oflisted companies and as per books in case ofnon-listed companies should be given
Nole : 4 'Dependent means parents, son(s), daughter(s) ofthe candidate or spouse and any
Other person related to the candidate whether by blood or m:uriage. who have no separate means of income and who are dependent on the candidate for their livelihood.
Note : 5 Details including amount is to be given separately in respect ofeach investment.
Note : 6 Details should include the interest in or ownership of offshore assets
Explanation: For the purpose of this Form, the expression "offshore assets" includes. Details ofall deposits or investments in Foreign banks and any other body or institution abroad., and details of all asscts rnd liabilities in foreign countries' :
Yarlagadda Yarlagadda Rama Dependent Dependent Dependent s.No Description Lakshmi HUF Mohana Rao I 2 I (Spouse) (Self) (i) (lash in hand 250000 70000 NA NA NA NA
Details of deposit I in Bank accounts (FDRs, Term Deposits and all other lypes of
deposits including I saving accounts), Deposits with (ii) 3.70,000 I .10,000 NA NA NA NA Financial Institutions. Non- Llanking Financial Companies and Cooperalive societies and the amount in each I suc h srt
Details of I
investment in I Bonds. Debentures/Shares NO NA NA NA and units in N() I companies / \I I Funds and 1I t:, nd the I I I 1 5 Y0^fivrv16 )* {} Fi Details ol investment in NSS. Postal I Saving. Insurance I Policies and investment in any N;\ (ir NO No NA NA NA ) Iinancial instruments in Post office or Insurance ('ompany and the amount. Personal loans / advance given to any person or entity including NA NA (\') iirm, company, NII, NIL NA NA l'rust etc. and I other receivables liom debtors and the amount. Motor Vehicles / Aircrafts / Yachts Honda shine /Ships (Details of Motor Cycle NA NA (r'i) Make. registration Make 2014 NIT, NA NA nurnber. etc. year AP16CN1589 I of purchase and Rs.86,000 I amounl. ) 150 Gms Gold Worlh 300 Gms Gold .leweller-v. bullion Rs 4.50.000 Worth and valuable Approx Rs 9.00.000 NA thing(s) give & Approx NA NA NA details of weight 900 Gms of & 3 100 Gms of and value) Silver Silver
worth Rs worth Rs 90,000 I l 30.000 Any other assets I NA NA NA NA 1r'iii ) such as value of NA NA l claims/interest
(ix) Gross Total value r 1,86,000 r l,70,000 NA I NA NA Nr\
li. l)ctails of Immovable Assets
Note : I Properties in joint ownership indicating the extent ofjoint ownership will also have to be indicated.
Note : 2 Each land or building or apartment should be mentioned separately in this format
Note : 3 Details should include the interest in or ownership of offshore assets.
6 r A**f^Q^ Yarlagadda Yarlagadda Rama Depcndent Dependellt Dependent s.No Description Lakshmi HUF Mohana Rao I I ? 3 (Spouse) (Selfl
I ,\gricultu ral I-and I NIT, NIL NA NIL NA NA Location(s) Surr numb s
Area (total I I I I measurement Nil_ NII- I NA NIL N,,\ NA in I acres) Whether inherited I property (Yes or Nil_ I NII, NA NIL NA NA No) I
Date of purchase I in case of self - NII, NIL NA NII- NA NA (i) acquired property Cost of Land (in case of purchase) NII, NIt, NA NII, NA Nr\ at the time of i
purchase 1 Any Investment on the land by way of NII, NII, N,,\ NIL NN N:\ development, construction etc. ,\pproximate Current Market N]I, NIL NA NII- NA l NA value Non-Aqricultu ral l,and Machavaram, Machilipatnam NIL NA NIL Nr\ NA I-ocation(s) 16n97 A
Survov nurnber(s) I
Area (total I I measurement in 6957 t'r- lt. NA NIL NA NA sq. ti.) Whether inherited prope(y (Yes or NC) NIL NA NIL NA NA I No) ( ii) Date of purchase NA in case of self- 19.1 0.2009 NIL NA NII, NA acquired proPertY Cost of Land (in case ol purchase) NII, NA NII, NA I I a1 the time of ln'.r+.r+,ooo urchase Any lnvestment on the land bY Nil. NA NA NIL NII, NA I tl c ol' pment. I I 7 fiarfi0 (i 1 FI I construction ctc.
I
I
Approximate I current market 77.30.000 NIL NA NII, NA NA
I I value (lomme rcial Iluildinss I I (including NIL NIL NA NII, NA NA apartments) - I I Location(s) - Survey number(s) I
Area (total I measurement in NIL NIL NA NII, NA NA sq. ft.) Built-up Area (total NIL NIL NA NII, NA Nr\ measurement in sq.ft.) I inherited Whether I property (Yes or NIL NIL NA NII- NA NA (iii) No) I Date of purchase I in case of self - NIL NIL NA NII- NA NA acquired property Cost of property
(in case of I NIL NIL NA NIt, NA NA purchase) at the L time ol purchase Any Investment on the property by way of NIL NIL NA NIL r'.{A NA I development, construction etc. I Approximate
current lnarkct NIL NIL NA NII, NA I NA value Rcsidential I Buildines
(includine I I NIL Ntt. NA NII, aDartments) : - NA NA Location (s) - I I Survey number(s) I (ir ) Area (Total measurement in NIL NIL NA NII, NA NA .ft I)uilt up Area ( fotal NIL NIL NA o turcr.r.rcnt in I NII, NA NA I
1 awp,tno -:s Whether inherited I property (Yes or NIL NIL NA NIL NA NA No) Date ofpurchase I NIL NA NA in case of self- I Nlt- NII NA acquired property Cost of property I (in I case ol NIL NIL NA NIL NA NN purchase) at the time of purchase Any Investment on the land by way of NIL NIL NA NII- I NA development, I construction etc Approximate current market NIL Ntt. NA NIt, NA NA value (such Others as I I lnterest rn NIL NIL NA NIL NA NA
property) I Total of current market value of NIL NIt, N,T NtL NA NA (i) to (v) above I l
(8) I give herein below the details of liabilities / dues to public financial institutions and Government:-
(Note Please give separate details ofname ofbank, institution, entity or individual and amount before each item)
Yarlagadda Rama Yarlagadda Dependent Dependent Dependent IIUF I)escription Mohana Lakshmi I ) Rao (Spouse) -3 1,...1 (Self) Loan or dues to BanV Financial L Institution(s) Name of Bank or Financial NIL NII- NIL NIt- NIL NIL lnstitution. Amount outstanding, (i) l Nature of loan I Loan or dues to an.v other enlity NIL Ntl- menlioned above. NIL l NIL NIi, NIL I Nante(s). I outslandin loan Any other NII, Nll- Nlt- NIL NII- NII, Sxttitv I
9 1 Q-*'" \^a I Grand total of I NIL NIL NII, NII, NII, NIL liabilities -i
(A) Has the Deponent been in occupation of accommodation provided by the Govemment at any time during the last ten
years before the date ofnotification ofthe current election ? i (B) If answer to (A) above is YES. the following declaration may be furnished namely:- (Jovernment (i) The address of the Govemment accommodation: (ii) There is no dues payable in respect of above Government I)u es: accommodation. towards- (a) rent; Dues to ( ii) (b) electricity charges; NO dcpartmcnts (c) water charges; and dealing with (d) telephone charges as on24.03.2019 Govemment l date should be the last date ofthe third month prior to the accommodation [The month in which the election is notified or any date thereaflerl.
Note- 'No Dues Certificate'from the agencies concerned tn respect ofrent, electricity charges, water charges and I telephone charges for the above Govemment accommodation
i should be submitted.
Yarlagadda Rama Yarlagadda Dependent Dependent Dependent Description I Mohana Lakshmi HUF ,, I I 3 Rao (Spouse) I (Self) I t I)ues to department dealing with tiovernment (iii) NII- NIL NA NIL NA NA transport I (including aircrafts and helicopters) 'fax (iv ) lncome dues NII- NIL NA NIL NA NA ( r,) GST ducs NIL NIL NA NII, NA NA Municipali Property (vi) NIL NIL NA NIL NA NA tax dues ( vii) Any other dues NIL NIL NA NII- NA NA Grand total of all (viii) NII- Ntt. NA NII- NA Government dues NA Whether any other
liabilities are in I I dispute. il so. mention the (ix) NIL aniount involved NIL NA NIL NA NA and the authority before which it is ndi j
* 10 G1 1p. ,ramo -t (e) Details of profession or occupation :
(a) Self : Cultivation (b) Spouse : Housc Wife (9A) Details of source(s) of income :
(a) Self : Agriculture Income (b) Spouse : NIL
(c) Source ofincome. ifany " ofdependents : Not Applicable (98) Contracts with appropriate Government and any public company or companies
a) Details olcontracts entered by the candidates : No b) Details ofcontracts entered into by spouse : No c) Details of conlracts entered into bl,dependents : Not Applicable d) Details ofcontracts entered into by llin,Ju Undivided Family oftrust in which the candidates or spouse or dependents have inlerest.; Not Applicable
e) Details of contracts entered into b_"- Partnership ['irms in which candidate or Spouse or dependent are partners : Not Applicable 1) Details ofcontracts entered into by private companies in which candidates or spouse or dependents have share : Not Applicable
(10) My educational qualification in as under :
Passed Intermediate at Hindu College, Machilipatnam in the year t985-86. (Give details of highest School/University education mentioning the full form of the certificate diploma / dcgree
course. name of the School/College / University and the Year in which course was
ctlnrpleted)
Y N Or M-*
11 PART-B
(I I) ABSTRACT OF THE DETAILS GIVEN IN (I) TO (X) OF PART-A :
Name of thc Shri Yarlagadda Rama Mohana Rao Candidate
DoorNo. 19-289-8. Chilakalapudi. Machilipatnam - 521002.
) Full Postal Address I Krishna District, Andhra Pradesh. Number and name of 1 I - Machilipatnam, Lok Sabha Parliamentary Constituency. Andhra J the constituency and Pradesh. State Name of the political party which set up Bahujan Maha Part"v the candidate l ( which is registered and recognised parQ) (otherwise write 'lndependent')
Total number ol
l ) pending criminal NIL CASCS Total Number ol 6 cases in which NIL convicted
Year for which I I the last lncome Total PAN of Tax return has income shown been filed
Yarlagdda Rama Mohana Rao AHZPY 675JA NII, NIL Sel0 Yarlagadda Lakshmi NIL NIL (Spouse) NIt,
I IIJF (If Candidate is NA NA Karta / Coparcener) NA
Dependent NA NA N,A
I 8 Dctails of Assets and Liabilities (including offshore assets ) in rupees
Yarlagadda Yarlagadd Rama a Dependent S.No Description HUF Dependent I)epc ndcnl Mohana Rao Lakshmi I 2 .-r (Sel0 (Spouse)
.! 2 12 s-l 'l'L*ruI^Q-
'! .-: I Moveable Assets I I I I
I (rotal value) I 1 1.86.000 l 1.70..000 NA NIL NII- NIL
|
I] lmmovable Assets
II Purchase Price of I I I self-acquired 14.14.000 NIL NA Ntt. NIT, NIT- I immovable property i I
Development/ construction cost of I
II immovable property NII, NIL i N-A NIL NII- NIL afier purchase (if
applicable) I l
Approximate I IIII Current Market NIL t..,-lL I }IA NII- I Ntr_ NIL I Price
(a) Se[1'-acquired I 77.30.000 NII- n\A NIL NII- I NII- assets (Total Value) I I
(b) Inherited assets NIi- NIL NA NIL NIL NII, (Total Value)
9 Liabilities
(i) Govemment dues I (Total) NII- NIL NA NII- NIL NII-
(ii I-oans fiom Bank, Financial Institutions NII- NIL NA NIt- NIL NIL ) and others (Total) I
0 Liabilities that are undcr dispute -.1 Government dues I (i) NIL NIL NA NII, NIL NII- (Total) I
Loans from Bank. I ( I Financial Institutions NIL, N[. I }'IA NII, NIL NII- ) and others (Total) I
H ishcst educational qualification : - Passed Intermediate at Hindu College' at Machilipatnam , in the year 1985-86. l1 (Give deiails ofhighest School funiversity education mentioning the full form ofthe certificate/ the course diplorna/ degree course, name ofthe School /college,' University and the year in which was completed.) I
..'. L. \.4 C
4, ,! (,1 ti 10"fiflo14 13 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 materials has bcen concealed there from, I further declare that : -
(A) There is no case ofconviction or pending case against me other than those mentioned in itenrs 5 and 6 of Part A and B above ;
(B) I, my spouse ofmy dependents do not have any asset or liability, other than those mentioned in items 7 and 8 ofPart A and items 8,9 and l0 of Part B above.
Vcrifled at Machilipatnam. this the 251h day of March, 2019.
,fionO [^ Y
DI]PONLN'I
Note : I Af'fidavit should be filed latest by 3.00 PM on the last day of filing nominations.
Note : 2 Affidavit should be swom before an Oath Commissioner or Magistrate of the First Class or belore a Notary Public.
Note : 3 All column should be filled up and no column to be left blank. lf there is no information to fumish in respect of any item, either "Nil" or "Not Applicable".
As the case may be. should be mentioned.
-the Note : 4 Affidavit should be either typed or written legibly and neatly
Note : 5 Each page ofthe Affidavit should be signed by the deponent and the affidavit should Bear on each page the stamp of the Notary or Oath Commissioner or Magistrate before whom the Affidavit is sworn. MY Commissicn, s L Nor \-Do xpires ., 2d-1 i:#:z++f,i,r,,il3' .f (Ministry of Law Jusrice & Notification No. H I l0r 9(4) 201g-Leg II, dated r 0rr, October'201 8 and Notification No . H - llo19l1312016 - Leg u. iated 261h February. 201 9)
\ LS .3' ) , BHA U PHAKAShY Q-,*,,\(/r\ B.Coh{., 8.L., ADVO'ATE A NOTARY APPOINTEO BI CENTRAL GOV\, OF INDIA MACHII |PATiIAM KRIShNI OiSt., (AP)