FORM 28
NoMI$i;.$iI4]APER Election to the l,egislative Assembly of Andha Pradesh (State) Recenl strmn I S\No'".. tt .Q {rnJt .*nn9 \)'" -fih\^r\
STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE PAIIT I (To be used by candidate set up by recognised political party) I nominate as a candidate fbr election to the Legislative Assembly fron the 115- Atmakur Assembly Constituency.
Candidate's name Mekapati Srikirti Fat+€rhlnto$€rl#husband's name Mekapati Goutham Reddy His postal address 2-23-A, Bramhannapalli, MarriPadu Mandal' SI'SR.Nellorc Dist / IIer name is entered at Sl. No323 in Part NoS ofthe electoral roll ibr I ls-Atmakur Assembly constituency. My name is Kausalyamms Koduru and it is entered at Sl. No. 941 in Part No 128 ofthe el Date 25.03.2019 Sigrature of the Proposer TII We herebv nominate as candidate ction to the Legislative Assembly from 1he...... )\...... ,...... Assemb1y ituency. Candidate's r'Vhusband's n.rme...... )1...... 1 lis po'tal address ...... His i,a entered at Sl. No...... in Part No...... o electoral roll tbr ...... Assembly constituency. we declare that we are electors of this Assembli tuency and our ntunes are en ir: thc clectoral roll for this Assembly constituency as indi and we appcnd our s below in token oIsubscribing lo this nomination: - Prrticuhrs proposers xnd their signatures S.N\ Elcctor Roll No. of Prop\er FullName Signature Date Part No.of S.No.in th\ Electoral Roll Dart 6 1 2 \ ) 1. ) 3. 4. OT APPLICA.B 5. 6. 7. 8. 9. 10. N.B.- There should bc ten electors ofthe constituency as PART III l, the candidate mentioned in Part VPart-+I (Strike out which is not applicable) assent to rhis nomination and hereby declare that- (a) I am a citizen oflndia and have not acquired the citizenship ofany foreign State; (b) that I have completed 47 years ofaBe; [STRIKE OUT c(i) OR c(ii) BELOW WHICHEVER IS NOT APPLICABLE] (c) (i) I am set up at this election by the Yuvajana Sramika Rythu Congress party, which is recognized Natioaal*ary/State Pa(y in this State and that the symbol reserved for the above party be allotted to me. OR is-€ @ (d) my name and my father'Vflre+h€f.s/+tlsband+name have been correctly spelt out above in English (name ofthe language); and (e) That to the best ofmy knowledge and belief, t am qualified and not also disqualified for being chosen to fill the seat in the Legislative Assembly ofthis State. * I further de€lare that I am a mem **easte,/tribe efthe State ef,,,,,,,,,,,,,,,,,,,,,,,,,in rel&tion te,,,,,,,,,,.,,,,,,,,.,,.,,,,,(area) in tha'State- Carididate Datc 25.03.2019 ;36Eiut tt it pu.ag.aph, ifnot applicable. ** Score out the words not applicable. bY the Election N.B.-A "recognised political party" means a political party recognised Commission under the Election Symbols (Reservation and Allotment) Order, 1968 in the State concerned PART IIIA (To be frlled bY the candidate) ( I ) Whether the candidate- (i) has been convicted- (a) of any offence(s) under sub-section (l ); or Yes,No (b) for contravention ofany law specified in sub-section (2) of section 8 of the Representation of the People Act, I 95 I (43 of l95l); or has been (ii) has been convicted for any other offenae(s) for which he sentenced to imprisonment for two years or more' ,'Yes',. information: Not Applicable lfthe answer is the candidate shall furnislr the following (i) Case/First information repofi No /Nos Nil (ii) Police station(s)NllDistrict(s) NlLstate(s)!!! ofthe offence(s) for which iiiil Sectionlsl of the conc€med Act(s) and briefdescription he has been convicted $! (iv) Date(s) ofconvictioD(s) Ni! (v) Coun(s) which convicted the candidateli! and/or quantam of (vi) punisnmentG) irnposed [indicate period of imprisonment(s) fine(s)l Nil (vii) Date(s) of release from prison!! No YeeNo (nlii) WuJ*"," uny uppeal(s)/revision(s) filed against above conviction(s) for revision^filcd Nil iixl Dat. and paticulars ofthe appeal(s)/application$) i*iNu.. ofth" before which thc appeal(s)/application(s) for revision filedli! "or.t(s) disposed ofor (xi) Whlther the said appeal(s)/application(s) for revision has/have been is/are Pending{!! been disposed of- (xii) tf the said appeal(s)/application(s) for revision has'/have (a) Date(s) of disposalni! (b) Nature of order(s) Passednj! Govemment oflndia or (2) whether the candidate is holding any office ofprofit under the State Goverrnnent? No (YesNo) lf Yes, details of the office held!!! No (Yes/No) (3) Whether the candidate has been declared insolvent by any Court? JfYes, has he been discharged from insolvency Nil foreiSn country? No (Ye&4''lo) (4) Whether the candidate is under allegiance or adherence to any -lfYes, give detailsM said Act by an order of (5) whether the candidate has been disqualified under section 8A ofthe the President? No (YesA''lo) -lfYes, the period for which disqualified !!! holdirg office (6) whether the-candidate was dismissed for corruption or for disloyalty while No (YesNo) under the Govemnent oflndia or the Government of any State? -lfYes, the date ofsuch dismissal $!! either in (7) Whether the candidate has any subsisting contract(s) with the Goverrunent share for supply of individual capacity or by trust or partnership in which the candidate has a by that any goods to that Government or for execution ofworks undertaken Govemment? Yes (YesAle) Enclosed -lfYes, with which Government and details ofsubsisting contract(s) ' Secretary ofany company or (8) Whether the candidate is a managing agent, or manager or ofwhich the Central/ Corporation (other than a cooperative society) in the capital percent share? No Government or State Government has not less than twenty-five (Yes/no) lfYes, with which Govemment and the details thereofNi! under section l0A ofthe (9) Whether the candidate has been disqualified by the Commission Said Act No (Yee4"lo) lfyes, the date ofdisqualification Ni! / /// Place: Atmakur ?" /0' Signafre oi the candidate Date:20.03.2019 PART IV (To be filled by the Retuming Officer) paper.Pf,...... Serial No. ofnomination r-s- g.ldl . L(aate) uy This nomination was delivered to me at my office at tl' \$ 1hour) onl l the *candidate/Plopdrr (Name), oate.2..5.93fJRetuming offl cer rscore out the word not applicable. PART V Dccisiod of Returning Officer Accepting or Rejecting the Nomioation Paper I have examined this nomination paper in accordance with section 36 of the Represeltation ol the People Act, 1951 and decide as follows: - Dalc Returning Otficer FORM A NAMES OF CANDIDATES SET TO AUTHORISED PERSONS TO INTIMATT COMMUNICATION wlTH REGARD P.LITI.AL ooi''*t PARTY oR REGISTERED up By REcoGNtsED NAT'.NAL oR ttn'i 'N-R[.,GNISED PARTY. lhe Eleclion Svnrb'rh iS' par agraph 13{' ) (Ll) an'l tt'}')l " Order' 1968 1 tRe(ervalion dnd Allolnr(nl) To 1. 'Ihu Chief Electoraloficer' Andhra Pradesh (State/U{i6n4errit€ry) 2. The Returning officer for the cy t 15 _ Atmakur Ass€mbly Constitue ' ftorl Isdcillslol"/u$€f,f+Fd€ry) Gencml Elc'1ionslo kgislot'veA $cmbly Aulhl Subiect nanes of candidales' _ uf p*rson' t intimate Allolment ol Symbots Authorisation tn and Allotment) 0rdcr' (() (d) and..le)(el of *:the Election s)T nbols [Reservatio' in'r,o*n." o[ parasraph 13 'd ' :1']'l"ll "J5;""'';; ;urhorised hy wvAlANA 1968'lherehyCommunicatethatthefollowlngporsonl,has/havebecnaupartv in the stot€ of fdfuglu!!fi pemv' rs d*o}+Giso* RYTIIU coNcncss wrrlcri be set up hy rh. SMMIKA t" ttd"-;;i;; of d'" candidates Propced to $egis$4+an-'"€ag&i**+'4' -n'"t District(s)/area [s) constituerrcy'/ Name of office held in the conslituencies in respect ol Name of Person authorised to party has been authoriscd' send notic€ whict he 3 115 - Atmakur AssemblY PARIY PRTSIDENT Con*ituenc1, Andhra Pradesh 1. Y.S.IAGAN MOIIAN REDDY The specim c I sig natu res of the above mentioned person ( s) so a utho rised a re Sive n below:_ 1. sperinxjr signatures of Shri y.S. rAGAN M0HAN REDDY \\\") ...... 1\.-- (ti) u\"4..... (iii) ...... d=...... t0 u\q*---*. (G...... :...... 2. Spe( irr)eD signatures of Shri tD ...... -...... (i, ...... [iiD :t. Sl)( rrx'r srljllaturcs of Shri i0 tii) ''..,',..-,..-,...,...,..,...,,',.. (iiD r\\Youlr;faithfully, \\,_\v) (v.s. lnear koxln aroovl hr*ia.nt Yuvajana Sramika Rrthu Congress Party Place: Hyderabad, .,..:-*;;,,:;.:,, Dat€: 18.03.2019 /i1ir-'- \r\. il.'l,r,otul? ll li'r':+,9 !-\ tb it (Seal of thc Party) NB, 1. This must be delivered to the Returning Officer and the Chief Electoral0fncer not later than 3 p.m. on the lastdate formakihg nominations. 2. Form must bc signed i n ink by the offi ce bearer (s) mentio ned above. No facsim ile signature or signatureby means of rubber stamp, etc., ofany omce bearer shall be accepted. 3. No form traosmitted by hx shall be accepted. FORM B SET UP BY THE POLITICAL PARTY NOTICE AS TO NAME OF CANDIDATE Allotment) (e)and l3aofthe Election symbols (Reservation and Isee paragraphs l3 {b}, (c) and Order 1958) To The Returning Officer for the 115 - Atmakur ConstituencY' from AssemblY constituencY subiect:_ General/bYe tlection to Leeislatlve Assemblv 1l!9:_l\!I!4!g! '""'"''" o"li."'"*o*n (state/uf,ie'6+ei+itoq) -sellrn8 up of Landrdate' t'J the I le(lion symbol}-(Reservation and ou,rr"nr" of purrg,"phs 13 {b), (c} and (e) and 13A ol SRAMIKA RYTHU coNGREss li,l,.""ii",a"i. ,r?t.'t herebv sive notice on behalt of YUvAJAt'lA PARTY in columns [2] to [4] below is the ^" thar lhe person whose partr(ulars are furnished the partv ihove named' and approved candidate of r\ lhe particuldrt u'l rnention"O rn column' l5l to l7l bPlow 'uo5htule {'r) lne perso^ whose b'rnF relected on Lt'u (androdte s nomrnnt'on Ldnd,date ol the partY wtto "pproved '^'irr 'Lp 'n rf the substitute (andrdatt r5 ltrll a contesting on scrutinY or on his withot""'ng iJrn tft" tont"it' this €ongtitu9nc'v: .rndrd.:le, at lhe ensulng general/ bYebY€ ePct'onelection nlfrom 'rr')'"-r+: rua."ort'e I YJil"[Tf ,;.,;.,""," J',i,'"orTT-:*iyI .pproved I u.s€+a/ I' ':,*i,'"i};'oi apptoved I .l'ia,a"" I Hssbisd+ I c'ndrdrrc lrandidalewnow'u ;;;;i I I step-in ;;;rd; I I on drc app'w'n candidateisstilla 2 23-,-, 1-23 A, l .2 rhe norke,n rorm B' siven ealrhry' ravoi" or shl,i'l 11"1 .1 .' . ;; rty's substitute candidate palty's approved candrdate/Shr'/Smt/Sushri "" ", .lltiscerriliedihateachofthecandidateswhosenameismentionedaboveisamembelofthispolitical this partY' pany and his name is dulv borne on the rolls of members of Date: 18 03.2019 ISeal of the Pirrvl 'Score otl, rl nor rPplkable. N8 r.-rtrismustuedetivereototheReturninso,ficernotlaterthan3p,m-onthelastdatelormakinS facsimile eignatur€ or sianan're by iliorln.u.t t".,an"a ink bythe office bearer lslmentioned above' l'lo 'n accepted' means ofrubber siamp, etc., of anY office bea'er shallb€ l. No form transmitted by fax shallbe accepted' ;;;,;;i;;;",..,;tbe3coredorr,irnotapplic'ble'ormustbeproperlvrilled'ifappricabre' €roLqG56d ANDTIRA PRADESH *stzi J!-:!:B/r-_3Trfl^TEvr uZ iV;i/A'4'-cD. 264522' s1' s'* 6z-:t" s"4'*"- Zr, .-Al * Z';, J'fl ,,*,un-:#-'ffX*--'^' *i io. , o*,* ot "tt''o'ooi'L - - ;il,iirR, sPsR Nelrore ;,*,.",, -Et 4 gL -/ xt-*s-fr )t",aa #g; lioaras:asr --+---?-Z'ClhJU^$,-gU- t Irorm 26 (Sec rule 4A) I Please aflix vour re I si: he I AEI'IDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION PAPER s#onr rHE RrruRNrNc oFFrcER r oR ELE( uoN rdLEcIsL,nrtvt: nssEunLy oFonrnoo,oor.su ste're r ou tts - ltltlxutt coNsTITUENcY I li- L\*r.*= rl-'.5 5. Cr,lnne ReooY' h'.o - 6' ,f'il' NOTABY & ADV")' ^TE i c.ll : 9aaoc3629t Nrllorc Ot Af,lAlIR'Mro!09r 8FBR PART - A I Mekapati Srikirti **seCdoughtet/wife of Mekapati Goutham Reddy Aged 43 Years' resident of2-23-A, Brahmanapalli, Marripadu Mandal, SPSR.Nellore District, a candidate at the above election, do hereby solemnly affirm and state on oath as under:- (1) I am a candidate set up by Yuvajana Sramika Rythu Congress Party @ ('* strike out whichever is not applicable) (2) My name is enrolled in ll5 Atmakur Assembly Coostituency, Andhra Pradesh, at Serial No 323 in Part Nos (3) My contact telephone numbe(s) is/are 6281559373 and my e-mail id (ifany) is [email protected] And my social media account(s) (if any) is/are (D Nil (iD Nir (iii) Nil (4) Details ofPermanent Account Number (PAN) and status offiling oflncome Tax Retum: Sl.No. Nanles PAN The financial Total income year for uhich shown in lncome- the lasl Incon'te- tax retum (in tax retum has rupees) for the last been filed liv€ Financial Yeals completed (as on 3I" March) Mekapati Srikirti AKFPM539OQ 2017- 18 (i) 3,92,603 ( ii) 2,78,632 (iii) 2,91,805 (i\') 3,12,808 (v) 8,44,1 I I ). Mekapati AGPPM]3I77 201'1-18 (i) 18,35.147 Goutham Reddy (ii) I7..12.610 (iii) 16.52,386 (iv) 15.58.421 (v) 58,52,821 HUF Of AANFIM9382E Nil (i) Nil Candidate is (ii) Nil Kana/Coparcener) ( iii) N (iv) N (v) N \-\i * +.,*-, l No =-S. Citnne x.ooY, e.,.o.., 1- /il t- IiOTARY & ADVOCATq I Ccll : e,440935296 I ATIAXUR, SPSR llllor. OL RQd- l.o. tt68 ?'r i::.::{:.7^":::, l. Mekapati Sai DISPM2 }69P Nil (i) Nil Ananya Reddy ( ii) Nil (Daughter) l Nil (iv) rr- il (v) Nil 5. Mekapati Krishna PAN Not NiI I Nit Arjun Reddy Allotted (i ) Nil (Son) I Nil liv ) Nil (\' Nil 6. Dependent-3 . Nil Nil I NiI (i ) Nil (iii) Nil (iv) Nil (v) Nil Note: It is pAN mandatory for PAN holders to mention and in case ofno pAN it should be clearly stated "No PAN allotted', ..v(8/Pcnd ing criminnl cases that there is perding no criminal crse against me (Tick this arternative if there "-'(tffieclareis no criminal case pending against the Candidate ard write NOT APPLICABLE against alternative(ii) bctow) OR (ii) The follorving criminal cases are pending against me: NOT APPLICAITLE (lf there are pending criminsr cases againsa the candidate, thcn tiok this alternative and score offaltematiye (i) above, and give dctails ofall pending co.". in ,1","tf. f.f."; Table (a) FIR No. with Nit Nit name and address \it of Police Station concemed (b) Case No. with- NiI Nit name of the Cout (c) Section(s) of \ir concemcd Acts / Nit Codes Involved (give No. of thl) Section, e.q. /--,-r\ S-- \-^--r * - N)- *-y S. Crlanr xoooy, e...o.-L ' / )/1, NOT/rRV & AI)VC-ICAI+ 6;EU Cclt : 94aO93S293 f (/'(" lei i ATXAXUR, '- ''''-'ito'\,.,7'S SPSR Nctlo; Or. 9,1a, RAd. ,ro, ESSa \o.;W Section...... Of IPC. etc). (d) Brief descdption Nil Nil Nil ofoffence (e) Whether charges 1\"o t\_o No have been framed (mention YES or NO) (t) lf answer against Nil Nil Nil (e) above is YES, then give the date on which charges were framed (s) Whether any No No Appeal I Application for revision has been filed against the proceedings (Mention YES or NO) (6) Cases ofconviction \,{tideclare that I havc not been convicted fbr any criminal otl'ence. (Tick this alternative, ifthe candidate has convicted and write NOT APPLICABLE against altemative (ii) below) OR (ii) I have been Convicted for offences mentioned below: Not Applicable (lf the candidate has been convicted, then tick this alternative and score off altemative (i) as bove, and give details in the Table below) Table (a) Case No. \-il r-il \il (b) Name of tlrc Court \il \it Nit (c) Sections of Nit \it Nit ActVCodes involved (give no. of the Section, e.g. Section..... of IPC, ect.). (d) Brief description of Nit Nil Nil offence for which < // rrv Ir\ a-- \r-*- .* rl\-- -r^ ' l,.//+,{^\.',i'\ '' L \.4r ,. ':.-'. rr r- I i.'6uo t,[, 1i,..' ',... \ I N()rAR\ & \lrv(r('i,E I / Cell : 9440335295 '.'""'r;'111 It":-,' . , A AXU& SPER ia.llor. 01 R.rA l{o. 88ll ?'r xi;W convicled (e) Dates oi orders oi Nil Nit Nil conviction (t) Punishment Nil Nit Nit Imposed (s) Whether any Nil Nit Nit Appeal has been filed against conviction order (Mention YES) (h) If answer to (g) \il Nit Nil above is YES, give details and present status ofaDpeal (6,4) t have given lull and up-to-date information to my political pany above all pending criminal cases against me and about all cases of conviclion as given in paragraphs(s) and (6). NOT APPLICABLE ICandidates to !vhom this Item is not applicable should clearly nrite NOT APPLICABLE rN VIEW OF ENTRIES IN 5(i) and 6(i), abovcl Note: l. Details should be entered clearly and lcgibly itr BOLD lettcrs. 2, Dctails to bc givcn scparately for erch case undcr different columns agrinst cach item. 3. Details should be given in revcrse chronological ordcr, i.e, the latest cltse to be mentioned first and backwrrds io the order ofdrtes for the othcr cascs 4. Additional sheet may be added if required. 5. Candidate is rcsponsible for supplying rll information in compliance of Hon'ble Supreme Court's judgment in w.P(C) No.536 of20ll (7) That I give hercin below the details ofthe assets (movable and immovable etc.) of myself, rny spouse and all dependents: A. Details olmovable assets: Note: l. Assets in joint name indicating the extent ofjoint ownership will also have to be given. Note: 2. ln case ofdeposit{nvestment, the details including Serial Number, Amount, date of deposit, the Scheme, Name ofthe BanV Institution pnd Branch are to be given. )t/[, ''E-,,-*-4iffi,?'o (: fry,fXUn, SPSA x'lr'rs OL ' i{d. lio. 8E5E Note: 3. Value ofBonds/Share/Share Debentures as per curent market value in stock exchange in resp€ct oflisted companies and as per books in case ofnon-listed companies should be given. Note: 4. 'Dependent' means parents, son(s), daughters(s) ofthe candidate or spouse and any other person related to the candidate whether by blood or marriage, who have no separate means ofincome 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 ofoffshore assets' Explanation, - For the purpose ofthis Form, the expression "offshorc assets" includes, details of all deposits or investments in Foreign banks and any other body or institution abroad, and details ofall assets and liabilities in foreign countries' ; Sl.No. Description Self (M.Sri Kirti) Spouse HUF Depend Depen Del (M.Goutham ent- I dent-2 del Reddy) Daughte Son - r-M. M. Sai Krishn Ananya a Reddy Arjun Reddy (i) Cash in hand Rs.,l5-000/- Rs.63.000/- NI NIL Nlt- NII (ii) Details ofdeposit in IDBI Banjard Nil ICICI TCICI Ntl Bank accounts (FDRS, ICICI Bank. Hills: Savings Bank, Bank, Term Deposits and all Jubilce Hills : Account: Jubilee Jubilee other types of deposits Savings A"/c Hills : Hills: including saving No.00?60151195 No.02810400007 Savings Saving accounts), Deposits 2, Rs.9,10J02/- 7598 Nc.007 s with Firrancial Rs.8,10,950/- 601560 A./c.00 lnstitutions. Non- Oriental Bank of 905, 76010 Banking Financial Comnrerce. State Bank of Rs.96,8 l84l 8, Companies and Banjara Hils : India Secretariat 33/- Rs.40, Cooperative societies Savings A-lc No. Branch: Savings 699t- and the amount in 5264210000165 Account (MLA eaclr such deposit 0, Rs.?,29,000/- salary A/c) A,/c No. 522088r14s2 Rs.1,76,390/- Andhra Bank, Atmakur (Nellore) Branch A/c No. F=-.L g. Lx^; S. Ctrnn, ,reooy, 8.,,6n.1 h.. " l, z-..lQ\'Q. tioTARY & f)vocAT* / ll o/ \ ,, C.ll : 8a4o93623r / *' AIIAXUR, SPSR xo o,..'Of, - Lr- RacC, tro. tart- w# 0701 l0r00l56l 20, IFSC Code : ANDB000070l (Only for Election Expenditure Pulpose) Rs.10,00,000/- Andhra Bank Credit Card No. 4373 7820 0062 301 l. Credit Limit Rs.9,00,000/- American Express Platinum Card No.3769- 106239-24004, Credit Limit: r5,00,000/- (iii) Details ofinvestme[t 100 Shares in 29,36,690 Sharcs Nil Nil Nil Ni in Bonds. KMC in KMC debenturevshares and Constructions Constructions units in companies/ Ltd. At a value Ltd. At a value Mutual funds and of Rs.l0/- per of Rs.l0/- per others and the amount. Share. Shate Rs.1,000/- Rs.2,93,66,900/- 5000 Shares in 99300 Shares in Mekapati Kirthi KMC Road Realtors Pvt Ltd. Holding Pvt Ltd. At a value of At a value of Rs.lO per Share Rs.10/- per Share Rs. 50,000/- Rs,9,93,000/- 5001 Shares in 2500 Shares in Dream to Fly Pvt Mani Manjari Ltd. at a value of Builders Ltd. at a Rs.l0 per Share value of Rs.l0 Rs.50,010/- Per Share Rs.25,000/- l0 Shares in KMC Inlratech 5000 Shares in .Q- \^,--r S. Crrrnns xoooy, B.uoo.. a,l NUTAnY & Arrv(x.. .E I CGll :94/tog35295 1 A AXUR, SPSR NellorG DL imd. ,.0. Et6l fttt Limited at a Andaman value of Rs. l0 Angling Agency Per Share Rs. Pvt Ltd. at a 100/- (As a value oi Rs.l0 nominee of KMC Per Share Conslruclions Rs, 50,000^ Limited) 5000 Shares in I Share in KMC Mekpati Kirthi Infratech Road Realtors Pvt Ltd. Holdings at a value of Limited at a Rs.l0 Per value of Rs. l0 Share Per Share Rs. Rs. 50,000/- l0/- (As a nominee of K,llC 4000 Shares in Infratech Raja Mohan Limited) Developers Pvt Ltd. at a value of I Share in North Rs.l0 Per Malabar Share Expressway Rs. 40,000/- Limited at a value of Rs. l0 10 Shares in Per Share Rs, KMC Infratech l0l- (As a Limited at a nominee of KlvlC value of Rs. l0 Infratech Per Share Rs. Limited) 100/- (As q nominee of KMC Construclions 1 Share in South Limited) Malabar Expressway Pdvate Limited I Share in at a value of Rs. Thrissur Expressway Share Rs. l0A Limited at a (As a nominee of value of Rs. l0 KMC Infrotcch Per Share Rs. Lihited) l0l- (As a nominee oJ KMC UCO Bank - 300 Infralech shares @ Rs Liniteel) 18.65/- per share -Rs I Share in North Malabar S-t-*-* *- - N'--\ S. Clt/Das:*eoox r,.n.r. rl n of^Ry &,'.t)vo.-, ,[ / C.fl:94.aos3g23r /IIIA,(UR. [frt, SPSR rtuo.r Or ,W.re.4* 7 Expressway Nestly lndia Ltd Limited at a 187 shares at value of Rs. 10 Rs 10.639.'15/- Per Share Rs. per share f0/- (As a Rs 19,89,633^ nominee of KMC Infiotech Reliance Limited) Industries 142 shares at Rs t Share in South 1231.05 per Malabar share Expressway Rs 1,74,809/- Private Limited at a value of Rs. Reliance Capital l0 Per Ltd 3 shares at Share Rs. 10/- Rs I72.75 per (As a noninee of sharc KMC Infratech Rs 518/- Linited) Reliance Home I Share in AB Finance Ltd 3 Expressway shares at Rs Limited at a 26.50 per share value of Rs. l0 Rs 79l- Per Share Rs. 10/- (As a Reliance nominee of KMC Comminications Watech Ltd 7l shares at Limited) Rs 6.50 per share Rs 461/- Reliance Infrastructure Ltd 5 shares at Rs 122.80 per share Rs 6l,lA Reliance Power Ltd 17 shares at Rs 10.75 per share Rs 183/- (iv) Details ofinvestment LIC Policy No. Nil Nit-dit- Nil NI J.. u-,s*- NF*-: S. Chrnar ,{odoy, g.u.6.. LJ "f"rrffi I\'OTARY^& ADVOCAfE I Coll : I ArrAxuR, 'a4rr9352r5sPsn xdbr. Dr. BatC. lte. 8tt8 in NSS, Postal Saving, 640703696, Sum Insurance Policies and assured investment in aoy Rs.25,000/- Financial Instruments Premium Paid in Post Office or Rs.18,840/- Insurance Company and the amount Bajaj Alliance Life Insurance Policy No. 0151539795, sum assured Rs.5,25,0001 Premium Paid Rs.3,00,0001 Bajaj Alliancc Life Insurance Policy No. 0151536824. sum assured Rs.5,25,000/- Premium Paid Rs.3,00,000^ (v) Personal Nil Unsecured loan Nil Nil Nil Ni loans/advance given to to M/s. Raju any person or entity Mohan including firm, Developers Pvt. company, Trust etc., Ltd. and other receivables Rs.6,00,000/- from debtors and the amount- (.,i) Motor Vehicles/ Nil Bentley-AP 09 Nil Nil Nil Nit Aircrafts/YachtVShips BN 0009 -2007 - (Details ofMake, Rs.1,83,02,89r/-, registration number ctc., year ofpuchase Audi W12-AP and amount) 09 BU 4599 - 2008, Rs.1.62,48,530/- (\ ii) Jeuellery, bullion and 8336 gms Cold Nit Nil NiI Nil Nil valuable thing(s) (give with stones Rs details ofweight and 2,09,17.900 value) (viii) Any othcr assets such Capilal Account Capital Account Nil Nil Nil Nil as value of in Krishna in KMC 10 S. (,ntnna '/ )l =\.l-)-,.'*--,. Chtnna Xc1oy,xcctov. &tat\. b.. k 6,s NOTAfiY & AIxrOCrrE C.ll : 9a{Oa35295 (*f A AKUR, SPER |l.Tort ot. R.gd. t{o. i6t 1 clainls/intcrcst Arjuna Properties, a Entelprises firm: Rs.22,75,000/- Rs.44,97,900/- (As per the (As per the audited accounts audited accounts for the financial for the financial year ended 3l- yearended3l- 03-2018) 03-2013) Current Account Current Account in Krishna in KMC Arjuna Properties, a fiml Enterprises Rs.22,32,117 Rs.2,1 1,41 ,3221- (As per audited (As per the accounts fbr the audited accounts financial year for the financial ended 3l-03- year ended 3l - 2013) 03-20t 8) Capital Account and Current Account in Tulip Peftol Pump, a proprietary concem Rs. 67,98,545/- (As per audited accounts fbr the financial year ended 3l-03- 2018) Capital Account M/s.Peachlree Developers LLP, Sbarc 32.67Yo Rs. 163350L Capital Account M/s.Peachtree Projects LLP, Sharc 32.67Yo Rs. 163350/- Capital Account M/S \li *- =- o. t.l|ntit. i'(rJ!- t.rY. b.!!'' e NOTARY &,lDV(!C "'E "/ Ccll : 9.40035 295 )l,l' Af AXUR, SPSR Nolrorc it:, .Br!d. io. l8tE 1"il e:,;1 7 PEACHTREE NARSINGI DEVELOPERS, Share 25% Rs. 12500/- Capital Account I,US PEACHTREE MUSI DEVELOPERS, Share 25% Rs.48530/- Capital Account M/S SAI NIHARIKA PROPERTIES, Share 20% Rs.48530/- Capital Account M/S SAI ASHVIKA PROPERTIES, Share l7% Rs.348530/- Capital Account t\,S SAI ANANYA PROPERTIES. Share 20% Rs.485301 Capital Account \4/S KRISHNA ARJTIN PROPERTIES, Share 25% Rs.48530/- (ix) Gross Tottl vtlue lLs. 5,53,72,556/- Rs. 8,21,37,21-31 Nil Rs.96,8 Rs..l0, Nil 33/- 699/- S* \-rr..-: S. Chrnnt xeooY, B.Loi' b'' I NOTAR\'& APC'C:ITE I Ccll:9aJO935?95 I "h[/ ATIAXUR, SPSR Ncllotr Dt Rcad. |aP' 8858 7 R Details of lmmovable assetsz- Note: l. Properties injoint 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. S.No. Description Self Spouse HTIF Depel,I Depen Deper denl-l denG2 dent-. (i) Agricultural Land Himayat Sagar, Saparlapally Nil Nil Nil Nil a: Location(s) Survey Rajendra Nagar Village,Anantha number(s) Mandal. Sagara Mandal, R.R.Dist. Nellore Dist. S.No.6l SNos.68-1,69, 67-2,64,579, 566,562,572, 5'19 , 569, 5'1 1 , 568,580,561- Area (total Ac.4.30 guntas Ac 30.00 Nit Nil Nil Nil measuement in acres) Whether inhcritcd No No Nil Nil Nil Nil DroDertv (Ycs or No) Date of purchase in 28-07-2006 2',1/09/1995 Nil Nil Nil Nit case ofself- acquired DroDerty Cost of Land (in case Rs.77,67,800/- Rs.1,05,000/- Nil Nil Nil Nil ofpurchase) at the time ofpuchase Any investment on the Nit Nil Nil Nil Nil Nil land by way of development, construction etc. Approximate current Rs 1,66,25,000/- Its.36,00,000L Nil Nil Nil Nit markel value b: Nil Madanapally L"vil Nil r'.il Nil Location(s) Survey Village, number(s) Shamshabad, Mardal, RR Dist. Sy.No. 85/3 Area (total Nil Ac 9.28 guntas h'il Nil Nil Nil measurement in acres) Whether inherited r.\il No Nil -tiir Nil Ni. S. \r*-: S, Cr,,nra ,re{rcry, 8.e, r , E.- i lroTA}(i' & ;.ovc,l^ rE / C.tl : 9d0935:95 ATf, XlrR, SPSR Ncllo,! OL RtCd, o' ItoS Droperty (Yes or No) Date ofpurcbase in Nil 2911212004 Nil Nit Nil Nit case of self- acquired DroDertv Cost of Land (in case N-il Its.27,01,-185/- NiI Nit Nil NiI ofpurchase) at the time of Durchase A[y investnent on the Nit Nil Nil Nil Nil Nil land by way of developnrent, construclion etc. Approximate current r.wil Rs.1,85,60,000/- Nil Nit Nil Nil markgt value c: Nil Narsingi Village. Nit Nit Nit Nil Location(s) Survey Rajendranagar number(s) Mandal, RR Dist. Sy.Nos. l4l (Part), 142 (Part), 143 (Part) Area (lolol Nil Ac 10.00 Nil NiI Nil Nil measurenlent in acrcs) Whether inherited Nil No Nil NiI Nil Nii proDerty (Yes or No) Date ofpurchase in Nil 21 2/20t0 Nil Nil Nit Nil case ofself- acquired property Cost ofLand (in case NiI Rs.9.1,50,600/- Nil Nil Nil N-il ofpurchase) at the time of purchase Any investment on the Nil Nit Nil Nil Nil Nil land by way of development, constnrction etc. Approxi0mte cunent Nil Rs.15,00,00,000/ r.\il Nil Nil Nil market value d: Nit Narsingi Village, Nil Nil Nil Nil Location(s) Survey Rajendranagar number(s) Mandal, RR Dist. Sy.No. 139 Area (totitl Nit Ac 5.00 Nil Nil Nil Nil mcasurelnent in acres) Whether inherited Nil No Nil Nil Nil Nil property (Yes or No) Date ofpurchase in Nil 25/03t2010 Nil Nil Nil Nil --.i:::=\^ S *Ul^.*-. 74 :i. Chrnna Keooy, b\,ar ... I{OTARY & AOVOC 1rE ,ll,L, Cell ; 94.|O93S29S B+.- ATXAXUR, SPSR ta. oru DL v1 4 R.ed. No. 8!Gt : case ofself- acquired DroDerty Cost of Land (in case Nil Rs.51,27,500^ Nil Nit Nil Nil ofpurchase) at the time ofpulchase Any inveslment on the Nil Nil Nil Nil Nit Nit land by way of development, construction etc. Approximate current Nil Rs.7,50,00,000/- Nil Nil Nit Nil market value e: Nil Kerala, Palakkad Nil Nil NiI Nil Location(s) Dist.. Althur Survey number(s) Taluk, Vadakkenchery Village, Sy.No.5/3 Area (total Nil Ac 0.840 Nit NiI Nil Nil measurement in Cuntas acres.) Whether inherited Nil No NiI Nil Nil Nit property (Yes or No) Date ofpurchase in Nil '7 n/2011 Nit Nil Nil Nil case of self- acquired property Cost of Land (in case Nil Rs.27,21,600/- Nil Nil Nit Nil ofpurchase) at the time of purchase Any investment on the Nil Nil Nil Nil Nil Nil land by way of development, construction etc. Approximate cu'rent Nil Rs.27,21,600/- Nil Nil Nil Nil market value f: Nil Kerala, Palakkad Nil Nil Nil Nil Location(s) Dist.. Althur Survey number(s) Taluk, Vadakkenchery Village, Sy.Nos.3/1, 3/2 Area (total Nil Ac 0.512 Guntas r.\il Nil Nil Nil measureme[t in acres.) Whether inherited Nit No Nil NiI Nil property (Yes or No) ^-il Date ofpurchase in Nil 7 t1/201I Nil 1.Nil Jil Nil S-1^^^^ N**1, "fffli'"I"^"sil'.:Tk* / @'.;>,-a7-,, a( I ^*ffr-:r1f^'iff*; (.N ,, Q*+7* casc ol self- acquired orooeflY Cost of Land (in case NiI Rs.21,57,6001 r-il Nil Nil Nil of purchase) at the time of Durchase Any investment on the Nil Nil Nil Nil Nil Nil Iand by way of development, construction etc. Approxinrate cuuent Nit Rs.21,57,600/- Nil NiI Nil Nil market value Nil Kerala, Thrissur Nil Nit Nil Nit Location(s) Dist.. Survey number(s) Mukundapuram Taluk, Kodakara Village Sy.No.l4l7 Area (total Nil Ac 0.420 Guntas Nil Nil Nil Nil measurcnlcnt ir acres.) Whether inherited Nil No Nit Nil NiI NiI Droperty (Yes or No) Date ofpurchase in Nil 23t'1t2013 Nil Nil Nil Nit case ofself- acquired DropertY Cost ofLand (in case Nit Its.l1,90,000/- Nil Nil Nit Nil of purchase) at the time of purchase Any investment on the Nit Nil Nil Nil Nil Nil land by way of development, constuction etc. Approximate currcnt Nil Rs.l1,90,0001 Nil Nil Nil Nil market lalue h: Nil SPSR Nellore Nil Nil Nil Nil Location(s) Dist. A.P Survey number(s) Venkatachalam mandalam, Survepalli, Village Sy.No.21l3lB, 2tt3/c & 2113/D Area (total rr* il Ac 22.68 Cents Nil Nil Nil Nil measurement in acrcs. ) S- \-,,,-,1* - l'.l.---f " fff,fli["iffi].H;f "[fi \\ , Cell : 9.lr()936295 7 :':] A AKUR, SPSR ndlof- ' -tti .aGgd. .xr. {lS ffi L!-zfzl \",Xvlla - \'7/ whethcr inherited Nil No Nil Nil Nit Nil DroDertv (Yes or No) Date ofpurchase in Nir 29^2t201,8 Nil Nil Nil Nil case ofself- acquired DroDerty Cost ofLand (in case Nil Rs.1,57,52,{00/- Nil Nil Nil Nit ofpurchase) at the time of purchase Any investment on the Nil Nit Nil Nil Nil Nit land by way of development, constuction etc. Approximate current Nit Rs.1,57,52,{00/- Nil Nil Nil Nil market value (i') Non-Asricultural Nil Raidurga, NiI Nit Nit Nit Land: Serilingampally. a: RR Dist. Location(s) Sy.No.5/3 Survey numbe(s) Area (lotal Nil 13500 Sq.Ft Nil Nil Nil Nil measurenent in sq.ft.) Whether inherited Nil No Nil Nil Nil Nil DroDertY (Yes or No) Date of purchase in Nil t3/02/1995 Nil Nil Nil Nil case ofself- acquired proDerty Cost ofLand (in case Nil Rs.l,67,52lL Nit Nil Nil Nil ofpurchase) at the time ofpurchase Any investment on the Nil Nil Nit Nil hwil land by way of ^-il development, construction etc. Approximate current Nil Rs.3,00,00,000/- Nit Nil Nil Nil market value b Nil Road No. l, Nil Nil Nil Nil Banjara flills, Location(s) Hyderabad Survey number(s) 6-3-354t8 Area (total Nil 1507.50 Sq.Ft Nil Nil Nil Nil measurement in sq.ft.) Whether inherited Nil No Nit Nit Nil Nit proDerty (Yes or No) Date ofpurchase in Nit 3l/L0t2001 Nil NiI Nil Ni case ofself- acquired * . 17 S, l-*^* LIY--\ +" 1, J. Cntnna fleuoy, a.uo," o.. j NOTARY & ADVOC" fE I \. C.ll : 9.HO9352g5 AIXAXUR, SASR rblto.. Lg4fc,La Dt t I-M ffi Droperty Cost of Land (in case Nil Rs.16,20,61l/- Nil Nil Nil Nil ofpurchase) at the time of Durchase Any investment on the Nil NiI Nil Nit Nil Nil land by way of developmenl, construction etc. Approxirnale current Nil Rs.1,08,87,5001 Nil Nil Nil Nil markel valuc (iii) Commercial Nil Triveni Nil Nil Nil Nil Buildings Complex, Abids. (including apartments) Hyderabad, a: D.No: 4-l-971 to - Location(s) 9'14 - Survey numbe(s) Area (total Nil Undivided share Nil Nit Nil Nil measurement in sq. ft.) ofland of450 Sq.Ft DuilFup Area (total Nit 1072.5 Sq.Ft NiI Nil Nit Nil measurement in sq. ft.) Whether inherited NiI No Nil Nit Nil Nil property (Yes or No) Date of purchase in Nit t8t09t1997 NiI Nil Nil NiI case ofself- acquired prooerty Cost of property (in Nil tls.5,-lI,.151/- Nil Nil Nil Nit case ofpurchase) at the time ofpurchase Any investmeot on the Nil Nil Nil Nil Nil Nil property by way of development, corlstruction etc. Approximate current Nil Rs.tl,93,l75l- Nil Nil Nil Nit market value Nit Shilpa Homes Nil Nit Nil Nil - Location(s) Layout, Hitech - Survey number(s) Citi, Gachbowli. Hyderabad, Sy.Nos. 40, Plot No. 58 to 65 Area (total Nil Undivided share Nil Nil Nil Nil measuement in sq. ft.) ol land of7500 Sq.ft Built-up tuea (total Nil 13912.47 Sq.Fr Nil Nil Nil Nil measurement in sq. ft.) (- r. , ,\- r\ L\r-rt ,,} ZIP-\ S. Ch,,n. r(eary, B,.(,-. I l{oTARY "., ga.O936:re6& ADVO('^TF- | (f("-:,.r.,id C.lt: I n#"' {TXAKUR, aPER }a.tioft Ot q \;, i.ed. io. EEO8 .,'. -r,t "i*"!J Whether inhedted Nil No Nit Nil Nil Nil property (Yes or No) Date ofpurchase in Nit r 2/08/2010 Nil Nil Nil NiI case ofself- acquired DroDerty Cost of property (in Nil Its.16,66,6661 Nil Nil Nil Nil case ofpurchase) at the time of purchase Any investment on the Nil Nir Nit Nil Nil Nil propeny by way of developnrent, construction etc. Approximate current Nil I1s.6,95,62,3501 Nil Nil Nil Nil market value (iv) Residcntidl BuildiDgs H.No.3A, CHS Flat 4-702. True Nit NiI Nil Nil (including Thokatta Friends Co-op apartments); Village, Society, - Location(s) Kharkhana, Dwaraka, New - Survey number(s) Secunderabad, Delhi, Sector Sy.No.l59 (50% No.6, Drvaral 'e-(,,"\'oJre,-,'R -i *i :m,I".ry#" [r'/fi 9{$ir1li'lrii' l=r \-ls*i7t<1? measurement in sq. ft.) Whether inherited Nil No Nil NiI Nil Nil Drope(y (Yes orNo) Date olpurchase in Nil t3t8t200t Nil Nit Nil Nil case olsclf acquired Drope(y Cost of property (in Nit Ils.19,00,000/- Nil Nil Nil Nil case of purchase) at the time of purchase Any investment on the Nil Nil Nit Nil Nil Nil land by way of development, conshuction etc. Approximate current Nil Rs.6,{3,12,850/- Nil Nil Nil Nil market value c: - Location(s) Nil Nellore Bit-1, Nil Nil Nil Nil - Suney nunrber(s) Gandhi Nagar Interior, Ward No.26l2, D.No. 2755. S.No.l944 Area (total Nil Land property of Nil Nil Nil Nil measurement in sq. ft.) 5445 Sq.Ft. wherein l/4rl' share of2l780 Sq.Ft. Built up area (Total Nit 4750 sq.ft. Nit Nil Nil Nil measuement in sq. ft.) wherein l/4rh share value. Whether inherited Nil No Nil Nil Nil Nil propeny (Yes or No) Date ofpuchase in Nil 0l-02-20 Nil Nil NiI NiI case ofself- acquired DroDertY Cost ofproperty (in Nil Rs.18,15,000/- Nil Nil Nil Nil case ofpurchase) at fie time of Durchase Any investment on the Nil Rs.l 1,22,500/- Nit Nil Nil Nil land by way of development, construction etc. Approxinute curent Nil Rs.56,60,000/- Nil Nil Nil Nil market value (r) Others (such as Nil Nil Nil Nil Nit Nit interest in DroDertv) (vi) Total of cunent Its.2,17,25,0001 Rs.46,01,97,?75/ Nit Nil Nil Nil market value of(i) to t \- r-"-:^-. t\'-\ 20 J. LhntE ,teuoy, blq a..l NOTARY& ADVOCATE / C.tt : 94.tO93829S l ATIAXUR, SPSR l{rflor! Or iUd. llo. 8S5E (8) t give herein below the details of liabilities/dues to public fina[cial institutions and goverunelt:- (Note: Please give separate details ofname ofbank, institution, entity or individual and amount before each item) S.No. Description Self Spouse(s) HUF Depcn Depe Depend dcut-l ndent ent-3 -2 (D Loan or dues to Andhra Bank Andhra Bank Nil Nil Nil Nil llank/financial Credit Card Credit Card lnstitution(s) Rs.97,458.92 Rs.{0,2J3.51 Nane ()1'the llank or financial Institutior- Amount outstanding, Nalure ofLoa[ Loan or dues to ally Nil Nil Nil Nil Nil Nil other individuals/entity other than mentioned above Name(s), Amount outstanding, nature of loan Anv other liabilitv Nil Nit Nil Nil Nit Nil Crlrnd totnl of Its.97,158.92 Rs {0,2{-1.51/- Nil Nil Nit \il liabilitics (ii) Government dues: (A) Has the Deponent been in occupation of Y€S/N( Dues to departments accommodation provided by Govemment at any time (Please dealing with during the last ten years before the date ofnotification Tic the government ofthe cunent election? No appropr accommodation (B) lfanswer to (A) above is YES, the fbllowing ate declaration may be furnished namelyi alternati (D The address ofthe Covernment accommodation \ "\' .\\ \ \' (ii) There is no dues'payable in respecr ofabove Government accomnodation towafds - (a) Rent; Not Applicrble (b) Electricity charqes Not ADDlicnble S. Chtnna , [the date should be the last date ofthe third month prior to the month in which the election is notified or any date thereafterl Note- 'No Dues Certificate' from the agensies concerned in respect of.ent, electricity charges, water charges and telephone charges for the above Govemment accommodation should be submitted. (iiD Dues to department Nil Nil dealing with govemment transport (including aircralis and hclicoDters) Sclf Spouse(s) HUF Depen Depe Depcnd dent-l ndent ent-3 (i!) lnconre Tax Dues Nil N Nil Nil Nil Nil (v) GST dues Nil Nil Nil Nil Nil Nil (ui) Municipal/Property Nil Nil Nil Nit r."il Nil Tax dues (\ i) Anv olher dues Nil Nil Nil Nil Nil N-il (viii) Grand lotal ol'all NiI Nil Nil Nit Nil Nil Goveurment dues (ix) Whether any other Nil Nil Nil 1.Nil Nil -Nit liabilities are in dispute, ifso, mention the anrount involved and the authority before which it is Dendins. (9) Details ofprofession or occupation: (a) Self: Business (b) Spouse: Business (9A) Details of source(s) ofincome: (a) Self!u!!!gs! 5- Lr*-l N.* r- ^*-^ E 22 s- Cfunn. t (c) Source of income, if any, of dependents Nil (98) Contracts with appropriate Govemment and any public company or companies (a) details of contmcts entered by the candidate Nil (b) details ofcontracts entered into by spouse Nil (c) details ofcontracts entered into by dependents Nil (d) details ofconkacts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have intrest Nil (e) details ofcontracts, entered into by Partnership firms in which candidate or spouse or dependents are partners Nil (0 details ofcontracts, entered into by private companies in which candidate or spouse or dependenls have share...Details are furnished in all Antrexure. (10) My educational qualification is as under: - MBA Finance ftom St Anne's College (Mendipatnam) Afliliated to Osmania University Year 1999 (Give details ofhighest School / University education mentioning the full form ofthe certificate/ diploma./ degree course, name ofthe School/ College/ University and the year in which the course was completed.) (-\,i ,/,t -\. ^.- / S. Cr,rnnt neoll, a'r' 'l' riorARY & Agvo( a rE / Coll:9a409352s5 / 7r* AflAXUR' SPSR Xcllo't Ot' R.gd. ,{o' t!'t 23 PART _ B (I I). ABSTRACT OF THE DETAILS GTVEN IN (I ) TO (10) OF PART - A: I Name ofthe candidate Smt.Mekapati Srikirti 2. Full Postal address 2-23-A, Brhamanapally, Marripadu Mandal, SPSR,Nellorc Disarict Number and name ofthe 115, Atmakur, Andhra Pradcsh constituency and State L Name ofthe political party which set Yuvajana Sramika R1(hu Congress I'tr0 up the candidate (otherwise write 'lndependent') )- Total nunrber ofpending cases \il 6. Total Number ofcases in which Nit convicted '7. PAN of Year for which last 'l otal income shown Income Tax retum filed (a) Candidatc AKFPM539OQ 2017-18 3,92,603 (b) SDouse AGPPMJ3I TF 2017-18 r8,i5,147 (c) HUlj AANI IM9382E Nil Ni (d) Dcoendcnts DISPM2369P Nil Ni 8. Dctails ofAssets and Liabilities (lncluding offshore assets) in Rupees Dcscription Self Spouse HU Depende Depe De F nt- l [dent- pe nd cllt -III Moveable Asseas Rs, Iis. Nil r\-il Nil NiI (Total valuc) 5,53,12,556t- 8,2L,f,1,213 B, lnrnlol'xbl0 Asset I Purchase Price of Rs.77,67,800/- Rs. Nil Nil Nil Nil self-acquired 4,94,76,451 immovable DroDerty II, Development/constru Nit Nil Nil Nil Nil Nit ction cost of immovable property alter purchase (if apolicable) lll Approximale Cunent Rs.2,17,25,000 l{s.{6,01,97 Nil Nit Nil Nil market price of - (a) selt'-acquired assets (Total Value) (b) Irfie ted assets S- \.i-_ r {\F5_\ .{t-.-,av. 24 t*' r,tyttt,)).- E .*' d-l il NOTARY { /LDvoc^ |r l ':': Cell : 94.a{r931t295 I ATIAXUR, SPSR Nrlorc Dt I ,ro. /,, &!d. ltEE f. ,-*, (Total Value) 9. t.itlbilitic\ Nil Nil (i) Govemment dues Nil Nil Nil Nil ('l otal) Nil (ii Loans liom Bank, Rs.97.158.921 lls..l0,2-13.5 Nil Nil Nil ) Finarlcial Institutions |- and others (Total) l0 Liabilities that are under dispute (D GoYernme[t dues Nil Nil Nit Nil Nil Nir (Total) (ii Loans l'rorn Bank. N'-il \ir \il Nil \il \il ) Financial Institutions and others (Total) lt Highest educational qualifi cation: MBA Finance from St Anne's College (Mendipatnam) Affiliated to Osmania Uriversity - Year 1999 (Give details ofhighest School / University education mentioning the full form oflhe certificate/ diploma,/ degree course, name ofthe School/ College/ University and the year in which the course was completed.) VEzuFICATION I, the deponent, above named, do hereby verify and declare that the contents ofthis aflidavit are true and conect to the best ofmy knowledge and beliefand no part ofit is false and nothing material has been colcealed there from. I futher declare that:- (a) There is no case ofconviction or pending case against me other than those mentioned in items 5 and 6 of Pan A and B above: (b) l, my spouse, or my dependents do not have any asset or liability, other than those mentioled in items 7 and 8 ofPart A alld items 8, 9 and 10 ofPart B above. verified at Atmakur this the 25th day of March 2019 x \ \.}*^- ''s:+lff"xT3r,H;. I f,/':".,., boll : 9'"0936295 - SPSR Nolloto uL ^fIAKUR,Rced' f'o' 885E 25 ----z+ AnP/t nominations' Note: l. Affidavit should be filed latest by 3.00 PM on the last day ofliling ofthe First Note: 2. Arldavit should be sworn before an oath Commissioner or Magistrate Class or before a Notary Public. Note:3. Allcolumns should be filledup and no colurm to be left blank lfthereisno as the case may information to furnish in respect ofany item, either "Nil" or "Not applicable"' be. should be mentioned. Note. 4. The affidavit should be either typed or written legibly alld neatly' by the deponeot and Allidavit should Note. 5, Each Page of the Affidavit should be signed before bcar on each page the stamp ofthe Notary or oath Commissiooor or Magistrate whom the Affidavit is sworn. (Ministry oflaw & Justice Notification No. H I I019 (4)/2018-Leg ll, Dated 10d October'2o18 and Notification No.Hl l0l9/13/2016-Leg.tl, Dated 26d February, 2019) / ^/,1 "Hii:,ffi 7', 26 xrE. ol Prol..t / worL r\,b-"r Hisrpav rod sBr' ra" b a w;;;. G;ffii"6i.n'rr.s (NHAIl, r,* r.". ",'dX. rOoO-rO.X- rol3oo,NslbsrioBr)nrrtionof H ll on Eqrt Autbrity ol lndia *-, c"*lJ* .*- m"*'rr pmslmn' or NHoP conuaci Pack's' Ewll(^s' or n EPc .ontut tor 4 Lnins of cuddapFh - xu@r cen (i ludinB Au$onty ollhdr lNllAll, i. LOz.zso ,o o."ign i. os6 5o2 in th. s6t of Andhra had'sh cost w'd;t'*;-N*"v-p* P,lL_Bmu, Fed Lnd'r L'$'E sE, PlrD, Y6!.r circlc. '-*;*d ,-,-" i/. Hridsc! & culwro k n' I7o Roo b k o )19600 - i.*^r """ iuoao.n or.ie., lud., dBin. cD *ods swD d ;;;""*.,- *-"*s.,". i.-"gh"@ suLr.* K?tuhdapud, Ks'rL s..gah!tu, iodirehalli, Mlngomhdn, Rdssdra) Peka[e l R.fitr,bG*e ups-d"rt .I NHr4e tmn xn o'oo b I(m 6a 230 CN.l [email protected] Nalion.l " TT'^ in ,"-ir"r'"*. --, *,;, . -u utr $irh pdt.d .hourd4s undn NHDP oro;s on El{ b:.F (Rl(D I(Mc JV: Rl!D sl%' xMc 4o"d 'h..bt. oldd TmBpon R.h,bll("ri." ,pend;; R,'dh"t' b ilatti sd' rppMh oI chr3hE Mini.ry "r No a hisEvay. lMoRfH), nd BridF fri,n ""dlxE. as.sTo b xE. lz)+27olotNH'13'l in UE Pmddh b N I,tr r,!h Dav.d 3hould.r @ Erc sod. urds NHOP PlEr ;;ffi;d.. o l,,nnr sth Dovld .houlr'r or AsdrEr8 Udaipur Ministry of rcel'IrmsPort (M( )R1 s), Nry *J*" ,-- n. o.aro . L. ss ooo or NH 44 und.r s RDP \E Ph,r '^' in .r'' & higlway! Slatc orfripu'a on Erc Mod. T;ffi" R-d R."d s*d p-F.r ll Upsr.dha RaFpavalT san}@k'il' b a2)aoo' Tideh€li tsH 4l) frod h lraoo b ld 2aiooo 6rd tE 3+aoo ;;q tnvibtion ru Bids No. tNRsP lll2ora 20ls/EPclo {F\rnrLd bv dr worltl Barll lsPK-xMc JvisPx-al%i xMc-19ryd \r/l'lc-;."."d s-.R'n."t"{ .",{t,s srn8ir I lnr'rmdarr lsn' b r}o lrc chicl Ensrn cr, Natio.al ,*,q.*.v *'r' patc'l rhoud.r"l rnludins B'um.rri' rmp'seo'nt fron *m lls/4:oo; rzl4.o orNrl se lEBuhn Kh 2641000 ro319/oo0 orNll217) in ih. sbc or Odkha on EFC Mod. (KMC'Rlo JVI KMC s I%; Rv'D_agglql nrl.ry-.""^ . u"-]",.arc r,*qnalDlh MUtr rrcr kE o'0o ro kh sdr. H{heay D.wloPmnr Rt(h., m x3n kpura T'lul^' {UrldpEv'm"b ro Chmmpaum b Sathnur MOR non kb 5.$ ro ki r95o li' *l'ckd xcrtrcs) l" ctun*pataru ratrk and cl.cha!@pdtu to NidML MDR Road vie e&r rrcm kn o.oo b kn 17-20 lin *hcEd Rca.h.s) in Chd'paune Trluk oI R imsua Dirt in th. s6t oI x6rutlk! c;;;G;;i R;d" M. s"1". Parr, PavssBda Pts _ 1 2.3,4 I(@bla sEt Pomr Ic.Bmctbn oi 2 LE"t dd with or *1. dIU' ,1, Ko.: cdttulion of D*iop6.nr C.rpoEtion ;krnd Roadra3 v@3, Auxncn6ion or airdng nns,' laft b M L" l2 Erc*Au1 i;iti;;.s;r v'd"I-'h*v _Thrisur sttion oI Nll 47 lxo Authoriyoflndis 24o.OOO To Kn 27OOOo)in rh. Siab of K.lala {Conksct Packqe: NS2/BOT/K' lNHNl, 3) b b. .rccur.d as BoT (Toll) on D.sisn, tsuild, Financ., op'ratc & TroNf'r ffi;Gfi;n ch*k P*d(}h in ludins PBndoh Bvpqf,! s"tion or NH' 2r ' Il'B in rlE SlaG ol Autlsrity ol Indi! (NH^ll, lPoceaSF.l t(E lgo.OOO b l(o 22riOS) und.r NIIDP ifiii ;;;-"p-s..d"rb*r*1"d4 2_r.e lo rour or Koih l(r.206.200l b R6idund! 1km.2594531etpn of NH 2ls lNtu NH 5l0l n rlE sbhofodistE Autho.iry or lndia INH^I), o;[]t nod. und.r NIIDP Pha* lll. Pack X. II il{MC RKD Jvi xMC Sl%i R(D 49%l $6rl"r s.D.-.t ud* b xlnip.tbi rrcn xh. 37.000 b xn. 7 r '01s oI or Lndil (NHAIl, H'4 (N.w NH.4S)"r in th. !lr,. ol Tmir Naiu urd.r rc3iddl NIIDP {Ph@_\4 Audority Ed.r BhaEEsla Panyoj@ on EPC Mod. {KMC_JSR Jv; xMc_ 14%; JsR-36%) F.-.,* dt"ld.d Hi*h*6v rmn M.lu lo'.is, km .;h;6; ll, o.ooo/Exirins "Ikn. 09.920 ot NH 3a) b r.dikldi (D..tsn tn 45 ass /Elistin8 Auth.nly of lndi.lNlI kE. 12 9OO oa NH-3S3 Ex!] lD.sign L.4th' 45.a5s tm) in tE Ss& ol Tmil Nadu und.. Bharahsh P*iyoiam on EPc nod. ((MCJSR JV: l(MC-51%: ffiffi;-d fi..s.*y L.dits F*ilirv on Natioer Hishwavs - ,{urhoriw ot lndh tr.v.loph.nt of Ed.tg.trcy Landins Facili.v on Ur s&.bh rmn kn r27 r'mo b INHAI), kn.l2i7.6oo on.hirsrrlunFl N.lloa Grion of NH' l6 in tn. Sbc ofA'dhB Itad"* on Erc 6odr rct.r lR..Irlflro!, *l \ . \_rj+ S. Chrnna He.roy, B.t oo.. B-l NOTARY & ADT'OCATE Coll : 94.{0935295 ATIAXUR, SPSR N.llor! Dt R.gd. lto. 8858 f"/,u OUR DEPOSIT SCHEMES AT A GLANCE 8. \lr- Ro-"lcred tu6d o.p6( x.D.tato o"g.'!'A8t E;D"...i-6iffiD"p-.a andhra Bank is merelve * iiiobilizer / taol alor lortho lns(me and 6 no way r6bre ror any ctam For the ;4;!cid!i;' name or lt)e rnsuEr & appti@bte toms a.d @nditions *- Fo.thoapptk-breEr€sorinieia:1j::,:::."-!::llTl]'[email protected]!w€bsre dlacltleBEndro €tera""iiii;iiffitro lloh I r@d hordd! n Eq4*d b Mt i sttid Brl;l d Gpo.Ear. - !. h Er {IgI /Branch 3fl4fi d4' Comp. o. iti02 ' t?d: .rTi^ruR imftnii ar tc BrFh :36?? 2?03 3: Andhra Bank IFSC CCDE: ANDB0000?Il wrrere lndia sanks IIC[ CCDE flf,lh*gl ortr$i|lr pl?,u . ,rrnarun . r 524011:4: UaCTClSrodhrcbar!_ lNDHn,lpS,lDES[ _600020 glg giD PA5S BOOK cc_ irI TNS HEf,1IP'1TI SRr ltk[qTrl rEI3Ft orA/c r$!g rfi6,.tF,,1.rrFcotxTMrr cl :ita 070110100t 5659j 'ams n[DDy Rt liYDBntBln ^ddd. &ilf:i,.:0.;,iiii;, ,r'.-* l!}?fl,lij*asR-iooo3i ncErDst iL,n neEirtrieil c6n /tylode?j,0l-r01g atr i&rured u! r*,3:,t:i,, to Rs 1,00,000 rqr rI{tdq, israll, - llqttri t Online Application Status olo40821 6874 .-+() ?(, -+( ) Submitted 't8-03-2019 [, BLO Appointed Field Verified Accepted / Rejected First Name: sri killl Last Name: mekapati Stale: Andhra Pradesh AC: Atmakur Folm Type l lormS httpsrnvsp in/Foms/Forms/t ackstalus