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ee o t6 tf d 5' err*r strr. ANDHRA PRADESH 643137 s. r.ro. -Qd,fi ir- 100/=*ot&o I os I ao 8 t .,ANircA SRINIVAS Viroyoadf LtcENCED srAMP vENDoR \) / / Lic. No.0621-001i2017, Rl. No. 27nu8 For Whom Plot No. 165, New P&T Colony,Patamata, . FORM 26 VIJAYAWADA-1O, Ph : 9346641586.

(See Rule 4A)

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO THE HOUSE OF THE PEOPLE ( NAME OF THE HOUSE) FROM VIJAYAWADA PARLIAMENTARY CONSTITUENCY &'i (NAME OF THE CONSTITUENCY)

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PART-A

I DILEEP KILARU **son/da*ghte#rvife of MADHAVA RAO Aged 48 years, resident of 59A- g-7141A3, Flat No.l, First floor, Aruna Residency, RTC Colony, Ist Road, Near Sai Baba Temple, Vijayawada-520008, a candidate at the above election, do hereby solemnly affirm and

state on oath as under :-

(l) I am a candidate set up by BHARATIYA JANATA PARTY (** name of the political party)/** (**strike out whichever is not applicable) Gr- (Z) My name is enrolled in Assembly constituency Vijayawada East, Andhra Pradesh (Name of the constituency and the State), at Serial No 632 in Part No 72.

(3) My contact telephone number (s) isiare 93102911 19 and my e- mail id (if any) is [email protected]. And my social media account(s) (if any) is/are

(i) Facebook Id: DILEEP KILARU

(ii) Face book Page: DILEEP KILARU

(iii) WhatsaPP :9310291119

(4) Details of Permanent Account Number (PAN) and status of filing of Income Tax return.

S.No Names PAN The financial Total income shown year for which in Income Tax

the last Return (in Rupees)

income tax for the last five

return has financial years

been filed completed (as on 31't March)

ADOPK6OO5A 2017-18 (i) 488s l0 L. {+ 2016-17 (ii) 1289790 J &kKILARU \J ;\ 'lzt $l< t{.1 lyw ffiq&MM-EPu "q€m .!

20ts-16 (iii) 1077240 2014-15 (iv) 10s0000 2013-14 (v) I 100000

2 Spouse AGUPKO944K (i) Not applicable AMARESWARI KILARU (ii) Not applicable NIL (iii) Not applicable (iv) Not applicable (v) Not applicable

J HUF (lf Candidate is Not Applicable Not (i) Not applicable Karta/Coparcener) Applicable (ii) Not applicable (iii) Not applicable (iv) Not applicable (v) Not applicable

4 Dependent I NO PAN Not (i) Not applicable SARUHA LAKSHMI ALLOTED Applicable (ii) Not applicable KILARU (iii) Not applicable (iv) Not applicable

(v) Not applicable

5 Dependent 2 NO PAN Not (i) Not applicable RAJA SARVAGNYA ALLOTED Applicable (ii) Not applicable KILARU (iii) Not applicable (iv) Not applicable (v) Not applicable

6 Dependent 3 Not Applicable Not (i) Not applicable Applicable (ii) Not applicable (iii) Not applicable (iv) Not applicable (v) Not applicable

is mandatory for PAN holder to mention PAN and in case of no PAN it should be \ # T}d.'NO PAN ALLOTED'" ,lrt '( d;W.,,r-# W ry ,s

(5) Pending Criminal cases (i) I declare that there is no pending criminal case against ^"r,/ (Tick this alternative if there is no criminal case pending against the candidate and write NOT APPLICABLE against alternative (ii) below). 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

(a) FIR No. with name and address of Not Not Not police station concerned the Applicable Applicable Applicable

(b) Case no. with name of the Court Not Not Not Applicable Applicable Applicable

(c) Section(s) of concerned Acts/Codes Not Not Not involved (give no., of the section, e.g. Applicable Applicable Applicable section...... of IPC, etc.) (d) Brief Description of offence Not Not Not Applicable Applicable Applicable

(e) Whether charges have been framed Not Not Not (mention YES or NO) Applicable Applicable Applicable

(0 If answer against (e) above is Yes Not Not Not give date on which charges then the Applicable Applicable Applicable were framed. (e) Whether any appeali application for Not Not Not revision has been liled against the Applicable Applicable Applicable proceedinss (mention YES or NO)

(6) Cases of conviction

(i) I declare that I have not been convicted for any criminal of"n""./ (Tick this alternative if the candidate has not been convicted and write NOT APPLICABLE against alternative (ii) below.) OR ,ffi" been convicted for offences ntentioned below: NOT APPLICABLE #\Y.sns\A o/rt bW iiiffi.i5i'7 'ffir':'$$qk',a5 r:.

(If the candidate has been convicted, then tick this alternative and score off alternative (i) above, and give details in the table below.) Table

(a) Case No. Not Not Not Applicable Applicable Applicable

(b) Name of the Court Not Not Not Applicable Applicable Applicable

(c) Sections of Acts/Codes Not Not Not involved (give no. of the Applicable Applicable Applicable section, e.g. Section ...... of IPC, etc.) (d) Brief description of Not Not Not for which offence Applicable Applicable Applicable convicted (e) Dates of orders of Not Not Not conviction Applicable Applicable Applicable (0 Punishment imposed Not Not Not Applicable Applicable Applicable (g) Whether any appeal has Not Not Not been filed against the Applicable Applicable Applicable conviction order (mention YES or NO) (h) If answer to (g) above is Not Not Not YES, give details and Applicable Applicable Applicable present status of appeal

(6A) I have given full and up-to-date information to my political party about all pending criminal cases against me and about all cases of conviction as given in paragraphs (5) and (6).- NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above

(Candidates to whom this item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above)

Note: l:i;'l,i?-*. l. Details should be entered clearly and legibly in BOLD letters. : ( :r;ji;-;;;.'i\ft[,\,,3,""T',':"::: , ^-"-i'r'1l,}Y, Dofoils fn re}ronirran given separatervsonorqfolrr forfnroqah each casepqsa underrrndordiffcrpnf different corumnsr.n against .\each item.

t/zt 3. Details should be given in reverse chronological order, i.e. the latest case to be mentioned first and baclrwards in the order of the dates for the other cases. 4. Additional sheet may be added if required. 5. Candidate is responsible for supplying all information in compliance of Hon'ble Supreme court's judgment in W.P (C) No. 536 of 2011.

(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: l. Assets in joint name indicating the extent of joint ownership will also

have to be given

Note:2. ln case of deposiVlnvestment, the details including Serial Number, Amount, date of Deposit, the scheme, Name of the Bank/lnstitution

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.

Note:4. 'Dependent' means parents, son(s) of the candidate or spouse and any other person related to the candidate whether by blood or marriage, 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 of each 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 of all deposits or investments in Foreign banks and any other body or institution abroad, and details of all assets and liabilities in foreign countries' I by $.. (.: .-..I r u/, t S.No Description Self Spouse HU Dependent I Dcpen Dcpen F dent 2 dent J (i) Cash in hand Rs.10,00,000/- Rs.2,00,000/- NA NIL NIL NA

(ii ) Details of deposit VIJAYA BANK HDFC Bank NA NIL NIL NA in Bank accounts Savings A/c No. Savings.A/c No.

(FDRs, Term 41940101 1000738 08r 1 153005961 1 Deposits and all Rs.8.00 lakhs Rs.5,00,000/- other types of deposits including ICICI Bank NIL NA NIL NIL NA Savings No. saving accounts), A/c 42820 I 50003 1 Deposits with Rs. 16.89 lakhs Financial lnstitutions, Non- HDFC Bank banking financial Savings A/c No. NIL NA NIL NIL NA cooperative and 08111530049604 cooperative Rs.3.l2lakhs societies and the amount in each LAKSHMI VILAS such deposit BANK Current A/c No. NIL NA NIL NIL NA 0801 360000005216 Rs.20.00 lakhs (ii i) Details of Madhava Hytech Madhava Hytech Madhava investment in Engineers Pvt. Ltd. Engineers Pvt. Hytech Bonds debentures Ltd. NA Engineers PW. NIL NA /shares and units 3,78,137 shares Ltd. inCompanies/mut 61,485 shares ual funds and Value 60,000 shares Rs.3,78, 13,7001- others and the Value Rs.61,48,500/- amount. Value Rs.60,00,000/-

SLS Infrastructure SLS Infrastructure SLS (India) Pvt. Ltd. (India) Pvt. Ltd. Infrastructure I1,010 shares I 1,010 shares NA (lndia) Pvt. NIL NA Ltd. Value Rs.l1,01,000/- Value Rs. I 1,01,000/- 20 shares

Value Rs.2.000/- (iv) Details of Insurance policy NIL NA NIL NIL NA investment in ICICI NSS, postal PRUDENTIAL LIFE Saving, insurance INSURANCE policies and roI furcstment in any Rupees l0 lakhs .*;1,- ""\, ' . ,i 0,. \.,,;tl .;t "f ,/rt I G +' ..)' .*: I, vi*t;,; ,ffi vy '-i\ -i-, \ x?i *w ff4rffi.,:. Financial Insurance policies - instrument in 2Onos. post office or INSURANCE lnsurance LIFE CORPORATION OF Company and the INDIA amount

Rupees 1.00 crore NIL Personal loans/ advance given to any person or entity to anY person or entity including firm, company, Trust etc. and other receivables from debtors and the amount Motor Motor car Vehicles/Aircrafts Mercedes Benz / Yachts/ShiPs - NA (Details of make, c220D registration number etc. Year HR51BU1234 of purchase and amount) 2018 Rs.45,00,000/- Motor car

HYUNDAI - CRETA

TS07FQ4599

2016 Rs. 16,50,000/- Motor car

MARUTISUZUKI CIAZ

HR875578

20L7 Rs.l 1,00,000/- '!i;F'.:""'w" ,/rl L)r ( TOYOTA - INNOVA NIL NA HR518D4567 NIL NA NIL

20t5 Rs.17.00.000/- NIL NA (vii) Jewellery, bullion Jewellery wt. Jewellery wt. NA NIL and valuable 402.33 gn 3903.90gm thing(s) (give details of weight Total value Total value and value) Rs.22,74,4961- Rs.1,56,21,151/- NIL NA (viii) Any other assets NIL NIL NA NIL such as value of claims / interest Rs.60,02,000/- NIL NA (ix) Gross Total Value Rs.6,69,40,196/- Rs.2,!5,70,6511- NA

B. Details of lmmovable Assets joint will also have to be Note: 1. properties in joint ownership indicating the extent of ownership indicated. in this format' Note:2. Each land or building or apartment should be mentioned separately Note:3. Details should include the interest in or ownership of offshore assets'

HUF Depe Depe Dep S.No. Description Self Spouse nden nden end t1 t2 ent 3 NIL NIL NA (i) Agricultural R.S.No.46213, R.S.No.291-1, NA land 473/7 Poranki Kanuru Gram Location(s) Gram panchayat, panchayat, Survey no(s) Penamaluru Penamaluru mandal, Krishna mandal, Krishna district. district. R.S.Nos.162-3 NA 2. R.S.No.49l2, &150-3, Ganguru NA NIL NIL 491t,3714, 43/L, Gram panchaYat, 2311,2L414, Penamaluru Penamaluru mandal, Krishna Gram panchayat district. & mandal, R.S.No.150-5 & Krishna district. 150-4, Ganguru Gram panchayat, NA NIL NIL NA 3. R.5.No.22312,225 Penamaluru .l mandal, Krishna rd\7ts. Ganguru Gram s panchayat, d istrict. l'a ji Er 'j"-,*t t/rt ($, : I i +l r..vt (t \o\$' ..s' bq \( $% Nrqsrm!> 0

Penamaluru R.S.No.150-38 & mandal, Krishna 150-44, Ganguru NA NIL NIL NA district. Gram panchayat, Penamaluru mandal, Krishna district. NIL R.S.No.149-1, Ganguru Gram NA NIL NIL NA panchayat, Penamaluru mandal, Krishna d istrict. ). R.S.No.150-4, 152 NIL & 150-3, Ganguru NA NIL NIL NA Gram panchayat, Penamaluru mandal, Krishna district. NIL R.S.No.150-3B & 150-4A, Ganguru NA NIL NIL NA Gram panchayat, Penamaluru mandal, Krishna d istrict. NIL R.S.No.150-2, NA NIL NIL NA Ganguru Gram panchayat, Penamaluru mandal, Krishna district. NIL R.S.No.149-2, NA NIL NIL NA Ganguru Gram panchayat, Penamaluru mandal, Krishna d istrict. NIL 0. R.S.No. 155-2, NA NIL NIL NA Ganguru Gram panchayat, Penamaluru mandal, Krishna d istrict.

NIL 1.. R.S. No.21, Eedupu NA NIL NIL NA gallu Gram pa nchayat, l+l kankipadu ,,1'*; ./ ri' \ ",1 mandal, Krishna / ,\J' d istri ct. i

a, i' panchayat, i).."_ Y+ Penamaluru mandal, Krishna t..r${ district. # a9' M ir:\'nrs'ry "j ,'lfzt 3. ",L\", tlof,*..' by a,',a ".+>"tr ^

NIL NA NIL l0. R.S.No. 15712, NIL NIL Ganguru Gram panchayat, Penamaluru mandal, Krishna district. NIL NA NIL 21. R.S.No. 15912, NIL NIL Ganguru Gram panchaYat, Penamaluru mandal, Krishna district. NIL NA NIL 22. R.S.No. t62/7 & NIL NIL 1,6212, Ganguru I ctm panchayat, I penamaluru I I mandal, Krishna I district. NIL NA NIL lzs. n.s.No. rorls NIL NIL I Ganguru Gram I panchayat, I Penamaluru I I mandal, Krishna I district. NIL NIL NA NIL lzo. *.s.'tto. t+0, NIL I eedaparupudi I Cram panchayat, I cuoivada mandal, I Krishn. district. NA NIL NIL NA Area (total 2.67 Acres Ac. 33.97cents measurement in acres)

NA NIL NIL NA Whether No Yes inherited propertY (Yes or No) NA NIL NIL NA Date of 2002 Not Applicable purchase in case of self- acquired n rnnp rtv NA NIL NIL NA Cost of Land (in Rs.8,64,7451- Not Applicable case of ,c purchase) at {* ^rt ' ihe time of *"'''J, ,1 \ ,' cF-!fa's*^- -ot ,'d/ .Hl ,r/rl 2 l-< L aQ' Q, tf. 'ir*t,'ffiiS/ A \/ ffioFbi Any investment NIL NIL NA NIL NIL NA on the land by way of development, construction etc. Approximate Rs.4,75,00,000/- Rs.118,84.60 ,000/- current market value (ii) Non- Nil Nit NA NIL NIL NA Agricultural t- Land Location(s) Survey number(s) Area (total Nit Nil NA NIL NIL NA measurement in sq.ft.) Whether Nil Nil NA NIL NIL NA inherited property (Yes or No) Date of Nil Nil NA NIL NIL NA purchase in case of self- acquired property Cost of Land (in Nil Nil NA NIL NIL NA case of purchase) at the time of purchase

Any investment Nil Nil NA NIL NIL NA on the land by way of development, construction etc. Approximate Nil Nil NA NIL NIL NA current market value Commercial Nil Nil NA NIL NIL NA Buildincs :__l (including 'it\ "ePartments) 'ri\ -##i'"' ::, a ,r/rl +lru iK,ot$' l[C \( N"W 'aTSNME number(s NIL NIL NA NIL NIL NA Area ( total Nil Nil NA NIL NIL NA Measure - ment in sq.ft.)

Built-up Area Nil Nil NA NIL NIL NA (total measurement in so.ft.) Whether Nil Nil NA NIL NIL NA inherited property (Yes or No) Date of Nil Nil NA NIL NIL NA purchase in case of self- acqu ired property Cost of Nil Nil NA NIL NIL NA property ( in case of purchase) at the time of purchase Any lnvestment Nil Nil NA NIL NIL NA on the property by way of development, construction etc. Approximate Nil Nil NA NIL NIL NA current market value (iv) Nil NA NIL NIL NA Residential Flat No. 59A-9- buildings 714/A3, (First (including floor), Aruna apartments) Residency, near Location(s) Sai baba temple, Survey no(s) Vijayawada, Krishna district.

/\ House no.581, NIL NA NIL NIL NA {\, w Sector-21A, 'e ft\ +lr l< 'o/zt uy ,f,i)\.r q/ $ >/ "{erut}nE}ffi Faridabad - NIL NA NIL NIL NA L2700L

Area (total .. UD share 369 sq.ft Nil NA NIL NIL NA measurement for the flat in sq.ft) 2. 4688.01sq.ft

Built up area 1. 1190 sq. ft (flat) Nil NA NIL NIL NA (total 2. 2344 Sq.ft measurement in sq.ft) Whether NO NO NA NO NO NA inherited property (Yes or No) Date of 1. ln the year 20OZ Nil NA NIL NIL NA purchase in 2.23.08.2007 case of self- acquired property Cost of 1. Rs.6,58,000/- Nil NA NIL NIL NA property (in 2. Rs.32,00,000/- case of purchase) at the time of purchase Any investment NIL Nil NA NIL NIL NA on the land by way of development, construction etc. Approximate 1. Rs.65,45,000/- Nil NA NIL NIL NA current market 2. Rs.3,00,00,000/- value (v) Others (such as NIL Nil NA NIL NIL NA interest in property) (vi) Total of current Rs.8,40,45,000/- Rs.118,84,60,0001- NA NIL NIL NA market value of (i) to (v) above

(8) I give herein below the details of liabilities/dues to public financial institution and government:-

give separate details of name of bank, institution, entity or individual and amount

) W "lzt Ly 2

s. Description Self Spouse HUF Depen- Depen- Depen- No. dent-1 dent-2 dent-3 (i) Loan or dues to 7. HDFC Bank NIL NA NIL NIL NA Bank/financial institution(s) Outstanding Name ofthe Bank loan amount or financial Rs. 8,54,947.18 institution, Amount outsta ndi ng, Auto loan Nature of Loan . Daimler NIL NA NIL NIL NA financial services lndia Pvt. Ltd.

Out standing loan amount

Rs.34,07,175.38

Auto loan Loan or dues to NIL NIL NA NIL NIL NA any Other individuals/entity other than mentioned above.

Name(s)Amount

outstanding , nature of loan Any other liability NIL NIL NA NIL NIL NA

Grand total of Rs.42,62,122.56 NIL NA NIL NIL NA Iiabilities

(ii) Government (A) Has the Deponent been in occupation of accommodation YES/NO Dues: Dues to Provided by the Government at any time during the last (Pl. tick the departments ten years before the date of notification of the current appropriate dealing with election ? Alternative) government (B) if answer to (A) above is YES, the following declaration accommodation may be furnished namely:-

(i) The address of the Government Accommodation

Nil

..:lI' ..rXo) k;;,r1ffi 'u/rl caq Ly "\ .ii$-'# (ii) ;; i; ;; ;;;; ;;;;;i;,1::'*" ;il;;;;;;;; NO accommodation, towards- (a) rent; (b) electricity charges; (c) water charges; and (d) telephone charges as on ...... NA...... (date) [the date should be the last date of the third month Prior to the month in which the election is notified or any date thereafterl. Note-'No Dues Certificate' from the agencies concerned ln respect of rent, electricity charges, water charges and telephone charges for the above Government accommodation Should be submitted. Spouse HUF Depen- Depen- Depen- Self dent-1 dent-2 dent-3

(iii) Dues to NOT APPLICABLE NOT NOT NOT NOT NOT department APPTICABTE APPTICABTE APPLICABLE APPLICABTE APPLICABLE dealing with Government tra nsport (including aircrafts and helicopters) (iv) lncome tax dues NIL Ntt Ntt NIL Nrt NIL

(v) GST Dues Ntt Ntt NIt Nlt NIL Nlt

(vi) Municipal/Property Ntt Ntt Ntt N!L N!L Ntt Tax dues

(vii) Any other dues Ntt Ntt Ntt Ntt Nrt NIL

(viii) Grand total of all Ntt Ntt Ntt NtI Ntt Ntt Government dues

(ix) Whether any other NOT APPTICABI.E NOT NOT NOT NOT NOT liabilities are in APPTICABLE APPLICABLE APPLICABTE APPTICABLE APPTICABTE dispute, if so, mention the amount involved and the authority bqfore which it is periaine. ,, /rt lyy

(a) Self: Advocate, Director of Madhava Hytech Engineers Pvt. Ltd, and SLS lnfrastructure lndia Pvt. Ltd.

(b) Spouse: Unemployed

(9A) Details of source(s) of income:

(a) Self: From Madhava Hytech Engineers Pvt. Ltd, and SLS lnfrastructure lndia Pvt. Ltd.,

(b) Spouse: NIL

(c) Source of income, if any, of dependents: NIL (98) Contracts with appropriate Government and any public company or companies

(a) details of contracts entered by the candidate : NIL

(b) details of contracts entered into by spouse: NIL

(d) details of contracts entered into by Hindu Undivided Family or trust in which

the candidate or spouse or dependents have interest: NA (e) details of contracts, entered into by partnership Firms in which candidate or

Spouse or dependents are partners: NA

(f) Details of contracts entered into by private companies in which candidate or

Spouse or dependents have share: NIL (10) My educational qualification is as under:'

B.E.(Civill/Mysore University/1992 and [1.B./Osmania University/2017

(Give details of highest school/U niversity education mentioninB the full form ofthe certificate/diploma/ degree course, name ofthe School/College/U niversity and the year in which the course was completed.)

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L.\+.... jD r! \[r *:

,r/t_t PART B

11. ABSTRACT OF THE DETATLS GIVEN rN (1) TO (101 OF PART - A : t Name of the Candidates Sh./Sm+lXurm- DILEEP KILARU 2 Full postal address 59A-9-714143, Flat No.l, First floor, Aruna Residency, RTC Colony, Ist Road, Near Sai Baba Temple, Viiayawada-520008 3 Number and name of the constituency and SerialNo 632 in Part No 72 Vijayawada East state assembly constituency. 4 Name of the political party which set up the BHARATIYA JANATA PARW candidate (otherwise write'lndependent') 5 Total number of pending criminal cases NIL

6 Total number of cases in which convicted Nlt

7 PAN of Year for which last Total income shown income Tax return filed (a)Candidate ADOPK6OO5A F.Y 2017-18 Rs.4,88,510/-

(b) Spouse AGUPKO944K NIL NA

8 Details of Assets and Liabilities ( including offshore assets ) in Rupees

Description Self Spouse HUF Depen- Dep Depe dent-1 en- n- dent dent- -2 3 A Moveable \s.6,69,4O,L96f - Rs.2,35,70,65L/ NA Rs.60,02,000/- NIL NA Assets (Totalvalue) B lmmovable Assets

I Purchase Price Rs.47,32,7451- NIL NA NIL NIL NA of Self-acquired lmmovable Property

ol,'t /rl i " i -{_ by 1 uu:ffiff &r ".-d$s'I il Development/ NIL NIL NA NIL NIL NA Construction cost Of immovable Property after Purchase (if Applicable) lil Approximate Current market price NA NIL NIL NA a) self-acquired Rs.8,40,45,000/- NIL assets ( Total Value)

b)inherited NIL Rs.118,84,60,000 NA NIL NIL NA assets (TotalValue) 9 Iiabilities

I Government NIL NIL NA NA NA NA dues (Total) ii Loans from Rs.42,62,L22.56 NIL NA NA NA NA Bank, Financial lnstitutions and Others (Total) 10 Liabilities that are under dispute i Government NIL NIL NIL NIL NIL NIL Dues (Total) ii Loans from NIL NIL NIL NIL NIL NIL Bank, Financial lnstitution and Others (Total)

1.1 Highest educational qua lification: B. E.(Civil)/Mysore University/1992 and L[. B./Osma nia U n ivers ity | 2OL7 (Give details of highest School/University education mentioning the full form of the certificate/ Diploma/degree course, name of the School/College/University and the year in which the course Was completed.)

tvY

,olrl VERIFICATION

I, the deponent above named, do herby 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 to 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 l0 of Part B above.

verined ..v.(*{* *.L. thisthe day of . 9i..t1 ", e/ M.[tctL

Solemn[ Affirmed a utgDod Before me

Note l. Affidavit should be filed latest by 3.00 PM on the last day of filling nominations.

Note 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public.

a Note J. All column should be filled up and no column to be left blank. if there is no information to furnish in respect of any item, either "Nil" or "Not applicable". as the case may be, should be mentioned,

Note:4. The Affidavit should be either typed or written legibly and neatly."

Note: 5. Each page of the 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.

(Ministry of Law & Justice Notification No. H I l}lg(4)l2}l 8-Leg.ll, Dated lOth October, 20 I 8 and Noti l0l9l13/2016-Leg. II, Dated 26n February 2019. *

\j.-- M. Seetha Rama Swant,' --*-+lv\ ' ts.Com.,B.L. uul3 h-^s\ 2L Advocate I NotarY No.59-1 2'9, GaYatri Nagar' \il-!AYA,WADA-8. (A.P} \1 Lf,,",.r\ ,\{/n2 $fur"*rnd\A 1".'(f t,, illrt ft