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Z4qn G^^ Z-'Ttya Z[Hr\-Rr\Ro E STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE

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Z4qn G^^ Z-'Ttya Z[Hr\-Rr\Ro E STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE FORM 2A' (See rule 4) NOMINATION PAPER Election to the House of the People z4qn G^^ z-'ttya z[Hr\-rr\ro E STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE PART I (To be used by candidate set up by recognised political party) I nominate as a candidate for election to the House of people from the!fu BAPATLA(SC)Parliamentary Constituency. Candidate's niune SURESH BABU NANDlcAMFatheT's/nretherhAusbandh namePOULUHis postal address YILLAGE. TULLURU Mandal. GUNTUR District. Andhra Pradesh Hisnameis entered at Sl. Nol! in Part Nol9of the electoral roll fo@ CONSTITUENCY OF ANDHRA PRADESH STATEAssembly constituency. My name is ..S.r.idhol'.T.urarl.c vrtla-. ..and it is entered at Sl. No. .122-.in Part 0 No....216..... of the electoral roll for the. .VBrrz{ rx.l.Asembly constituency. -T. Date 25.03.2019 Signature of the Proposer PART II hereby no as candidate for election to the Assembly m the .Assembly ..........F s/mother's/husba nd's name ....His postal address name is sl. of the ral roll for ....Assembly w lare we are electors o this Assembly and our nam are en in the el roll for \his Assembly co as in icated below we append \ur signatures below in of ing to this no on: - Particulars of the p rs and their signatures Elector Roll No. of Proposer Sl. No. in the Part N.B.- There should be ten electors of the conitituency as proposers PART III I, the candidate mentioned in Part I/Pa#II (Strike out which is not applicable) assent to this nomination and hereby declare that- (a) I am a citizen oflndia and have not acquired the citizenship ofany foreign State/Country; (b) that I have completed !! years ofage; ISTRIKE OUT c(i) OR c(ii) BELOW WHICHEVER IS NOT APPLICABLEI (c) (i) I am set up at this election by the YUVAJANA SRAMIKA RYTHU CONGRE-SS PARTY, which is recognised FJ@/State Party in this State and that the symbol reserved for the above party be allotted to me. OR (ii) am set up election by the.........) i.........................party, which lsa litical party/that I ani ine this election as an candidate. (S out which is not le) and that the symbols I have in order of (D...............................\... (iD....................\........... (iiD...................)............. (d) my name and my father'shetherh,lhusbandh name have been correctly spelt out above in Enelish (name of the language); and (e) That to the best of my knowledge and belief, I am qualified and not also disqualified for being chosen to fill the seat in the Legislative Assembly of this State. * I further declare that I am a member of the Madiea**Caste/tribe which is a scheduled **caste/tribe of the State of Andhra Pradesh in relation to Tullur (area) in that State. I also declare that I have not been, and shall not be nominated as a candidate at the present general election/thegye+leetiens being held simultaneously, to the House of the People from more than two Parliamentary Constituencies. Ms "'-h Date..21-:.0J,..293 Signature of Candidate * Score out this paragraph, ifnot applicable. ** Score out the words not applicable. N.B.-A "recognised political party" means a political party recognised by the Election Commission under the Election Symbols (Reservation and Allotment) Order, 1968 inthe State concerned. PART IIIA (To be filled by the candidate) (l) Whether the candidate: - 1i) has been convicted: - (a) ofany offence(s) under sub-section (l); or (b) for contravention of any law specified in sub- section (2) of section 8 of the Representation of the NO People Act, l95l (43 of l95l); or (iD has been convicted for any other offence(s) for which he has been sentenced to imprisonment for two years or more. If the answer is "Yes", the candidate shall fumish the following information : (i) Case/First information report No.A.Ios. Not Applicable. (ii) Police station(s) Not Anplicable District(s) Not App.Licable State(s) Not Applicable. (iiD Section(s) ofthe concerned Act(s) and briefdescription ofthe offence(s) for which he has been convicted Not Applicable (iv) Date(s) of conviction(s) Not Applicable (v) Court(s) which convicted the candidate. Not Applicable (vi) Punishment(s) imposed [indicate period of imprisonment(s) and/or quantum of fine(s)l Not Applicable (vii) Date of release from prison ![9!!pp!!g[!9. (viii) Was/were any appeal(s)/revision(s) filed against above conviction(s) NO Not Aonlicable (ix) Date and particulars of the appeal(s/application(s) for revision filed Not Applicable (x) Name of the court(s) before which the appeal(s/application(s) for revision filed Not Applicable (xi) Whether the said appeal(s/application(s) for revision has/have been disposed of or is/are Not Applicable (xii) Ifthe said appeal(s/application(s) for revision has/have been disposed of NO (a) Date(s) of disposal Not Aonlicable. (b) Nature of order(s) passed !lglSppl!@!9. (2) Whether the candidate is holding any office of profit under the Govemment of India or State Govemment? (YesAtro) NO -If Yes, details of the office held !q!!pp!!g!!9. (3) Whether the candidate has been declared insolvent by any Court? (YesA.Jo) NO -If Yes, has he been discharged from insolvency Not Applicablp (4) Whether the candidate is under allegiance or adherence to any foreign country? (YesA{o) NO -If Yes, give details Not Applicable (5) Whether the candidate has been disqualified under section 8A of the said Act by an order of the President? (YesAIo) NO -If Yes, the period for which disqualified Not Applicable (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?. (YesA.lo) NO -If Yes, the date of such dismissal Not Applicable (7) Whether the candidate has any subsisting contract(s) with the Govemment either in individual capacity or by trust or partnership in which the candidate has a share for supply of any goods to that Govemment or for execution of works undertaken by that Govemment? (YesA{o) p -If Yes, with which Govemment and details of subsisting contract(s) \g! Applicable (s) Whether the candidate is a managing agent, or manager or Secretary of any company or Corporation (other than a cooperative society) in the capital of which the Central Govemment or State I Govemment has not less than twenty-five percent share? (Yes/no) NO -If Yes, with which Government and the details thereof Not Applicable (9) Whether the candidate has been disqualified by the Commission under section l0A of the said Act (Yes/\lo) NO -If yes, the date of disqualification Not Applicable Place: OnTole NS*-n Date: 15. 03.1-ol3 Signature of the candidate PART IV (To be filled by the Returning Officer) Serial No. of nomination pup", .flHl.ff tr1m This nomination was delivered to me at my office at.?.111.Pf(hou0 * .U'f aate) by the candidate/prepea. "r..Xl.".f (Name). Date..4.EtX.. Returning Officer *Score out the word not applicable :' , 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 of the People Act, 1951 and decide as follows: - Date.......... .... Retuming Officer I Tl'.rq/State Andhra Pradesh frtrn qrnffiq fa/Assembty Vemuru (SC) Constituency ;ilri/Narne 8d5 do.$ofuoS SRIDHAR TUNUGUNTLA Bq/Gender M TEqIq qfrfrIiIdl/EPIC NO AP14C930207214 fr"'f,T,/,TR el {rrT/Father's/H usband's o"$:3:"i:.5oD$ Narne RAMMOHNRAO qm $iqrlPart Number 218 t t{lT tFI flri/Part Nanre Bhattirprolu a a qiKfAT mmc/Serial No 222 1 q.rEFT iirqlPott i ng Station Damnrana Mallikarjuna Rao High Scl-rr.rol room No.15 qilff{ at erfttqlPolling Date 11t 041 2019 $n ff,fuiPrinted on 3123t2419 3:11:11 PM 'ltis llde l : cr-tput b corp.tr gerszned ad b pwided af fcr tlr it'sndim to fE v'cter. trtxe 2 : Ti$s is rpt an identty danrrent IAffffi['l'1 '[tillti,'iliTf[T, ardrS $?$ rbooig )c;:"o i;o;.r ,A Unique ldentification Authority of lndia ero"5 dJd)tuo* !66 O();rir: S/O Ramamohanarao, 1 3-20A. TunugunIa Sridhar s./ o o.5rar"iP$o.d;, or:oo, |IIAIN ROAD, NEAR LIBFIARY, {r*$ 66/ DoB: 12,zoEl196a a:o:cS 6'6,, 0o6t'cro1:o 6f d, iD6r:!dr / MAIE ogter:, tuocud.:, Bhattiprolu, Guntur, uogp6l - 522256 Andhra Pradeslr - 5?2256 4889 7618 9685 4BB9 76 1 B 968 5 m E'< Iml r)..]p { i/ialar il.rv rr r,r,w LIUdr.qO! ir ?,ry"fu-\\ %ilK f.fan@l Fanshad Development otllcer parishad, Mandal Praia Bhattiprolu t ;l $tbu$r : AD14ffi312o7x4 13-20A poer $od r3oros, 6$ger, a$S'er;5oodo o$U* d$$u:'tt"o:'o: ELIiC'IION CON{I\,IISSI0N (}I Ii\DI I\ Address: IDENTI'I'Y CARI) 13-204 1247 To 13-103, Bhattiprolu, A'J14W3A?07214 Bhattiprolu Mandal , BhattiProlu Bhattiprolu,Guntur Dtte: 12l1OfN12 4rd,)ri) Facsinrile Signature of Elector's Name : Srldhar Tunugutrtla Electora I R egistratton Officer 208 - Vemuru (SC) Assetnbly Constituency 6o@ tcb : os$Jpxr';5o"O OAns'd 5rd)J.$l*oJJt 5,6s sd;mnrd $t6 !.ornd dqpp taar: ct noo*d rp Father's Natne :Rantnrohnrao lbd$I$oDood ililoclt t'. t'Is 6oD& ao$sBsl jtr In case of clnrge in adtLr:s<, ltratliort dris (hrd l'lo the inc'lurfuig yr-,ur t}lue in the Rc'll st IIU 0r:t{Sr> u M relever{ tianr t'ot clunged ad<lress antl kr tlbhilt Lhe card itith sutre ltttttltl't 0S$ dA i Date of Birth 12fi8fi%4 196/ 20S t-NI.S t\ 6$r' fu*Orfi ce' Mandal Prrshad lhdop{ncrit Mandal Prala %rishad.
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