0
I !
o/7 oL6 I Llcenced StanP Vendor Cei"rie, K1 I'INADA I Bher)uqudi 1"1 I 12u91 I toRM 26 I (Sce rule lAl I
AFFIDtrVIT'tO B1] FILED BY THE CANDIDATI ALoNGWITH NOMINATION PAPER I}EFORE THE RfTURNIN(; oFFICf,R FOf ILICTION 'r'0 HdJsEoF PfoPLE (NAME OF TIIE IIOUSI) FITOM (> K{KNIADA PARUA]\4INIARY CONSTITUENCY (NAMf, Of TIIE CONSTITT]E\('Y) PARl]A -1, I'cddimsetti Venkateswara Rao, S/O, Peddimsetti Veeranna. aged'16 )ears. h-is postal aorlresf is D.No. 2-f5, Ramalayam street, Goddatipalcm, Karapa Mandal, East Godavari District, Andhra Pradesh. a camdidatc at thc above election, do herebl solernnll' aflinn and state on oath usf-rnder': - (l){ l) I Jll]auj a candrdalecandidate selupsetup byb} JaraJana JagrulnrJagruthi Partyl'arq (*+nr{ ol rhe political pan) I **arn conlcstine a. an lnrlcpendcnt candidate. ij-srr*! out is not appliuahlc) \\. 'rhichcver s])r ATTESTED
'' ((l,L mclh#..6rdalq A1-"r '' Pet.* Andhra Pradesh (Name ofthe 38- Kakinada Rural Mardal' 12) MY name is eruolled in 50s in Paa No 202 at SeriarNo pvraoso smail'c'rm ::.:,'i**;-a;t;StaLet' id(ifany)is '4 telepttont n'*u"'r i'i'i'n'uii r I r Mv contact 't "^o "mail (ifan) ) is /are: Nil " anO'r', t".l"i ,"a' account(s) (i) Nil (ii) Nil tiiit Nil of filing oflncome Tax Retum: Number (PAN)* and status (4) Dctails of Permanent Account
in -J6Glli6*e tho*n ln- I PAN financial Year tor Names return lin Rupees) I Sl. No. for which the last come-Tax Financial Years -helncome-tax return the last live (as on Jl st Mureh) has been filed completed 2,21.500/- l 0l E-2u lv ) l. Fddimsetti eNCppsoqsL -Rs, Venkaleswara Rao R.2osPoot 017-2018 ii) fR; Lr&soo, r0l6-2017 (iii) I t0l5-2016 (i!) lNir ,014-201s
lN it 2013-2014 (v)
i) -Eddimsctti -18-2019 -Rsl,l0.950l- 2.. ]HKPP57.15G Padmavathi Rs.3.17,760/- 2017-2018 i) lrn,u.ro', ii) "rS.;:Oi' lrn,r,ro,u i!) Nor APPlicable lro,r-ro', lro,,'ro,o (v) lNor APPlicable
(i) |lol APPlicable l. HUF (lf Candidate ts .lot (ii) t nPPticutt" Not APPlicable ApPlicable Karta/CoParcener) (ii0 Not APPlicable ;tlj h oarsBl (in) APPI'caDre 6f lNor f1) ).- @s=t; [-(s /e4 ?vtu tr4/ Nohry Licence is rnli,j ui, to 11-6-2022 tl-otlppticaUle --56frdans- l rloT .lttott"a PeddimseniKeerthi I;;IPPlicable
ot lPPticaUte t rz:t- -Eiiindant'' z SFTFP Canesh ot,tPPticatte Peddimsetti SatYa Not APPIicabl€
Ioffitlcatte
IiiApPlicable IiffiPtlcaule ePendent-3 " f_-o.cppli"ult"
;APPlicable
No;f,PPlicable
or APPlicable
ffintionPANandincaseofnoPANitShouldbeclearlystated "No PAN alloned" cases (5) Pending criminal "i:ilrii$;irixi;!'i,;,,itril,f*ff,;::i'tr''^"heC'w)ida'lean'll
rt, /,orli,!)ii)!ii'[)i;i;::i."iii;'iiii]i,f:i"ii\i:;,,*'":::"!:,;!{.:;:';"';:!, ' offalte'nati'e t"'oo'" t ,,'"e ,uota ol APPlicrblt 196/201,l c.d s.rri:ottl PS n"m" una l)ralsh!ramam fltnlo. *lrn Cheque Bouncc Case dress of Police Station
i*io-i"it ruag" l-otAPPlicablc ii-tn,laoitionat lnc' t6iffiS-thNameor lhr ( ou ' ..1 t._
W:el -";:JTl]i{;;i,;u ;tx,,!fl ,,, flre.:l-5o6riarlPc N__-otnPPlicatle U.. t:t lt l't G---..tion(.)of*n""tn"d 30 PA l86l Acts/Codes involved Seaion' [give no. of the e.g. Secliofi- "'' etc.) Affi"uute OflPC. sounce -heque 6-riefdescription of
h",ttl"t chu'g"t hu'" been framed (mention
ioilPPli'utt' iiffi"aul" tlir-rePPticoute flfanr*er againtt tet glve above is YES, then the dare on which chargcs \^ere l'ramed
-...... '-..._-n"rt". uny ePPeut I Application [or revrsron the tris'been {ited against oroceedings 1Mc'lit'fl i rs or No)
(6) (i) /
Iii)
--oteppti"att" or.lPPticuSt" o! APPlicable
ttot,tppticatle frotffiicalte anrc oI the Coun ot nPPlicable ot APPlicable (.lir-".tion(.)of Aot/Codes in ol the.Sectk'n volved lgiIe 'rt"' t )li' i"ii",. "'lPc' "r" No--repPl.atte NorlPPti"aUt" iiGnif off"nce fot N-orApplicable rH"fl'
Nolary Lrcenee rb vdi.U up to it,6-ZOZ I :}is, Y\ rl uI1..,
.s.rrlunoJ_u8loJoJ ul settllrqetl pus puD'peorqp uorrnllsul slesse llEJo slrpt.p Jo ,{poq .trq)o ,{uE pur.lueq ,a,..roj oi iru.r,.rnul'rJ.r,roaap rreJo srrerep 'sepntrur ,,qess' aroqsJJo,, uo,.s;rdi" ,*lI;;;H;;".Jar"'a eql rog uorteuBldxg "qr 'slesse aJoqsJJoJo drqsleu^ro Jo ur lserelul aql apnlcu! plnoqs slrelec .9 :aloN
qrBeJo tJadsar ut,{loleJ,des ue^ta eq ot sr rr".., ,.r0",:x1Tr1:::H ., :aloN i!.ql JoJ JteplpueJ .ql uo tuepu;dep .tE oq^\ -.. . Or, ," .rn"J:;;Ur,l;:;, ou ir^Bq oq\'\'53eurEt! Jo poolq {q JJqpI/,\ "*"rr, (uEpueJsnodsJoJlsp,purraqtloi.ylatqdnEp.{s)uos.srualedsupJur,rulpuidJo,.r:rloNeleplpueJ eq ol palel.J uostad Jiqto
prls rl-rrou Jo .sE, ur s{ooq:ed se pue serued** Ll3:Y-r!.."ur.dueqJxe Or",,al:lj:.'j rcors ur anl,l let.p'r rualJnr rad se sa,ntueq.6,,rqlr!puo[]o rn1"r1 g ,",orrl rre qruprg pue uonntnsutAuEg .au.qrs .trsod.p .^ -.1r1j.1.:: :, sqt Jo rLueN eq) Jo alep'lunotuv 'JeqlunN aurpnlJu! slletep IEues aqi )ueui;nr16ooarp- jo rl .Z :aloN "rr" aq ol e^eq oslp III.^A drqsrau^{o lurorJo ruelxe eql Burlerrpur a,rru ,u,oq u, ,1"1,j , ,",o*
{ur .11es,(ur1o (.c1a alqe^ou.rr pue arqe.\our) slrss',rrJo srrer.;:X:T:[TJ,,:#:,i,Ti'fl,r, ,r, .ruerdns erq,uoH Jo rsusrrd'roc u! uo,,r*.,*,, ,*Ll,0!zj,,d';f:r"il :rri,.r;#J:,li:tllffjJ.r? .prrrnberJt .saf,B, peppB aq ,{But treqs leuolllppv } pauo!,u.,u aq o, esEr .tua1 ,*,, *, *!ffi]l!:[ifi*ll3:,1ii,Jj^i:,,H,*i3:,1J.,"# ., rlrBa lsursto sournlor tuareJJ!p rrpun rse.r qrue.rol .sreDrt ,{pleiudaluri,l nq o1 .1;"1"q .7 O-IOB ur ,ilqr8at pus,ttrE.tr prrntur rq ptnoqs stretao .I
N r Nott v)t,dd vroN r1,n,c1-a" q,o,1,,ll$:i;;'!,::{J!:, :,gi;i, (9) puE (E) sqde'l8eted ur ue^rB iliilily 1n,',,,,a,-i'p,.a'i1"',ffiiil';:i,i;;"^:;'1,1'l:i:*:":";i:,X;#::H:i,Tr,::,,:i",:ili
leldde.Jo snlels luesaJd pue sltEtap r^rt ,tqPrtddV toN alqErtddV loN -!3I1aSE (?) ol ron"sueJl lq) (ON ,to Sgf uouuahl repJo uorlcr^uoc lsutpAD paJrl etqesIddV roN atq"r!tddV roN olqBirrddv loN ua.q seq leeddv ,{uE reqleq/i\ (tu Dep SL No. I)escription Self Sgrse HUf Dependent- Dependent end I -2 cnt- (i) Cash in hand 3 Rs. I ,50,000/- Not Not Not Applicable Applicable Applicable App lica 1i) Details of depoiit- in-Efr NIL ble \IL Nor T N.r accounts (FDRS, Term De. Nur lN; Applicable - Applicabte posir\ and allother lvDes or lApprrcabte lApp dcpo:irs including saving Irrca lble aocounls), Deposits with Financial Inslitutions. Non-banking Financial lompanres and Cooperarive iocrelres and the amount in )ach such deposit
(iii) ot -,wEGeii- loeuils NIL INIL Bonds. debentures/ share lNor Nor lNor lAppricabte Applicable lnd units rrr comoanrer lApptrcabrelApp-lNA Mutual ttnds and orher I llica and the amount I lur.
(iv) ot Joeuil' in'esrE*r-- I NtL NIL NSS, postrt Savins Nor lNor lN;! lin tn- Applicabte - lsumnce policies and invesr- lApptrcabte lApptrcabte lmenr in any Financial in- struments in posr ofllce o. ble lnsurance Company and theJ amount i
(") lrersonat loans/ \II, ,\ll_ gi!en lo Jadvance any person --lH**]x: lor enho including firm. 1xil,,.",,. l*, company, Trust etc. and other receirablcs from debtors and] iAeericabre i il;, the amounl I / .ATTESTED /1,@ r*'[crot-b\11 ,.P. \-2e12 l',.6.2t1! (tl Motor Vehichsr'- NIL Nll, I Not Not ll-lero AircraftYYachrs/Ships (De_ Noi Applicable tarls of Ma[e. regjstrarion l,lpplicable lx.',.,. App number AP O5CY lica 49212014 ble etc. year of purchase and amouno I ofRs. 80,000/-
(vii) Jewellery. bullion gms aa7- au otgold 568 crams Not I9.1grams 22 Grams Nol raluable rhing(s) (gi!e de_ which is vatued at Gold is Applicable cold which Gold lails ofweight and !alue) Rs. 1.20,000/- 'vhich which is lica Rs. 17,04.000t Rs. valLred at ble 5,82,000/- Rs. (viii) Any other 66,000/- a-iii- f, as NIL \L Not value Not Noi Not of claims Applicable interesl Applicabte Applicable Iica (i\) Gross-lbtal Valuc ble Rs. 17.04.000/- Not Rs. tu. Nol Applicable s,82,000/- t.46,000/- App lica ble
tJ. Detirils of Immovable Assets; Note: L Propenies injoint ownershiD indiM .-irr arso h-ave'[o be I:i, i ni:*Lii:H[,i:,,*Hf.i.Ji*f,td#tr#Tir ndica'|ed
s t\io. l)escripai0o Spouse HUF Deperder!l DepcrdeDt,2 D€peodrnt.l S. Pydi Pat, S. Ptdi Pata Nol S. Lard village, Pydi Pata S. Pydi Pata Not Appljcabte villaCe, Applicab Village, Locarionls) Rowthulapudi Village, Rowlhrlnpudi Rowthulapudi Sur!ey Mandat, Rowthulapudi Easl Maodal. Easr Mrodal, numbe(s) Godavari East Mandal. fasl Codarari Godarari Districq Godavari District, District, S,Nos. Dislricl, 199,205, S.Nos. 199,205 S.N0s.207,20S 201 S,Nos.l99,20S
TECTF ) ^; li I^.[L"r(o.,'\5\g ?w&- Area (tolal Ac. 8.76 cenrs lAc 5.58 c;;E lNot Ac. measuremenl- in 1.90 Centi ac. :.to Cents rrppricaUte leppticat fNot lre
No Not No inherited Not Applicabte Applicab le (Yes or No) Date of purchasal 1-A-20t)4 1-8-2001 Nol -U--100,1 case ofself- acquired 7-8-2004 Not Applicabie propeny Applicab le cosr ort-anaiin case Rs.5,26,0007 Ks_ J.J5.000/- Nor purchase) al rhe time"t Rs.1.33.000r Rs. I,68.000/- Applicab le Any inveslment; \IL NIL Not Nor the land by way of Applicabte Not Applicable Nol Applicable Af'plicab le epproximatc cuiiif ls.55,80,000/- r(e. t9.00,0001- Rs.28,00,00i1/ Not Applicabte
(iD Non-Asricu NIL NIL Not Nor Itural Applicable Not Applicabte Not Applicabte brxl Appli(ab Localion(s) le Sunel numbe(s)
Area (total N II- h"l l- measurement Not lNor Attticabre Not Applicabl; Not Applicabte in Appticab q.fl.) i NIL NrL -lNor Nor inhcrited - Applicable Not Applicable propert_v (Yes lAeethab Date of purchas- NIL in-- NIL Not Nor case Appl,cabte Not Applicabte Not Applicable ofself-acquired Applicab propeny le
Cost of l-andl r'n case- NIL NIL Not ofpurchasc) Not Applicabte al the Applicab tinte of purchase le
Anl irnetrrrc.Dr ol] NIL NIL Not Not thc land epplicabte Nor Applicable Nor Appticable b\ \\,n\ ol Applicab I ,"AT] !onstrrction llc. 'ESTEp -Jlcli-' B\.q Approximare NIL Nll. Not Nol Applicable Not Applicable Not Applicablc curent market Applicab l€
(iii) Commercial NIL Nll_ Nor Not Applicable Not Applicable Buildinps (in- Applicab l-ludirrg apartments) le -Locaiion(s) -Survev Area (total NIL NII- Not Not Applicable Nor Applicable Nol Applicablc Measuremen! in Applicab sq. ff.) le NIL Buillup Area NIt, Not Not Applicable Not Applicable Not Applicable (lolal Applicab measurement in le Whelher NIL Nll. Not Nor Applicable Not Applicab,e Nol Applicable inherited Applicab pmperty (Yes le Dare ofpurchase m NIL N1l. Nol Not Applicable Not Applicable Not Applicable case ofself'acquired Applicab properr]- le
Cost of property (in NIL Nlt_ Nol Not Applicable Nor Applicable Not Applicablc )ase ofpurchase) at the Applicab :ime ofpurchase le
Ary investment on N _ NJL Not Nor Applicable Nol Applicable Nor Applicable he land by way of Applicab levelopment, le |onstmclioI elc_ \ppro\imalc NlL NIL Not Not Applicablc Not Applicable Not Applicable Applicab le
Residentiql N . NII, Not \ol Applicable Nol Applicable Not Applicable Buildinss (in- Applicab cludiDg apartments) 1e -l-(rcation(s) -SuNey Dumbe(s)
N _ N II- Not Not Applicable Not Applicable Nol Applicable Measurement in Applicab sq. ft.) le Brilt up Area NIL Nol lNrL Not Applicabte Nol Applicable Nol Applicable (rotal Applicab mgasurement in le sq. ft.)
iSTED
Whether \tl NIL Not Nor Applicabh plicablc inherited Applicab lll'l\ ]E:)\l?\ r\ftPnrp",ty 1Y.5 .r.i, . le \ trL* ( F l-i.:- ,. .. ''. Date ofpurchase m NII, NIL Not Not Appticable Not Applicable Not Applicable case ofself-acquired Applicab property le
Cost of prop€rty (in N ll- NII- Not Not Applicable Not Applicable Not Applicable case of purchase) at the Applicab time of purchase le
Any investnent on NII, NIL Not Not Appticable Nor Applicable Not Applicable the land by way of Applicab development, le constnrction etc. Approximate Nlt- NIL Not Not Applicable Not Applicable Not Applicable current market Applicab value le (, Ohers (such as NII, NIL Not Nor Applicable Not Applicable interest in Applicab DroDerty) le ("i) Totalofcurrent Rs.87.60,000r Rs.55.80,0001 Nor Rs.39.00,000! Rs. 28.00.000 - market value of Applicab (i)to(v)abole le
(8) I give herein below the details oftiabilities/dues to public financial institutions and govemment:- [Note: please give separate details ofname ofbank, institution, entity or individual and amount before each item]
Dcpe Depcnden \\G Descriplion Ht f r-3 tl t-2
NIL NIL Not Not Nor Nor Applic Appli Appli Applicable (i) Brnldfinancial able cable iostitution(s)
Name ofihe Bank or fi nancial insritution, Amount oulstanding, Nature of Loan
NIL NIL Not Not Not Not Lorn or dues to any Applic Appli Appli Applicablc Orher irdit iduals/€nrit) able cable cable other lhan rrentioncd
Nxrne{\). Anrcunt outsland-
Any other liabilit) NIL NIL Nol Not Not Not Applic Appli Appli Applicable AlTESTED able ,rL t-r l'-{er'' L\rl ? K*"/,&/ Nol Nor I Not Nll- ApPli Applicable NIL Applic I na oot of c lable I liabiliti€3
\-,\
eoirnment du"s' Duc; r" dtPanrncttt' ;;i,s with govemment accom- NO modation
l'T:*;:[]L!*;d',fl **#i:[i,'# 0" rhe Governmenr accommodation' "'n''lio,xfl'Jl,;. "r N* "11\dL ..
"" HJ:#:i:::5ffi:f"lLT:r*T':'""" it', elccrricrrycharges: lil liilillli'liliJL"*-'-'-'o'' I:lT j;i:'." '*'m$;i'ilnrs:"',:1:l'l;llx" thereafterl' .- . , -^- .r," .d"ncies concemed ,:.*rfrlnq*"ltryr*l"*-P'-'' _l
b-uesto dePartment derling \\ ith govemment rranspon (including and air-crafts '-or ot APPlicablc epPti"uute i-otepPtl"art" friorne tax d'res I ApPlicable irlpPti"utt" iifiorePPticaute4rr
<, -*;,ffi*[*[.di,h;* -cdfi. 4) I Iiffiticaute l--otnppticable ol APplicable oher dues -ny 01 APPlicable l6i-orrPPti"att" IffiPti"out" IorepPlicable ot APPlicable ether anY other liabrlilies-t ar€ rn. disouts. iI so. mentron lhe amount in!olved- uniit'" urtr'o'lrY *rot" which il is Pending
or occup{tioni (9t Details of profession Selli : Buslness 6, SPotrse: House Wife r9AI Detailsof :ourcelsloiincome: lar Self: Buslness wtle^- rh! Sp.,use: House Applicable ll any'r). ofdependents.or s!P!"-' --- Not (c) Sources of income' " *u[r*r*#*$"+fi'[i.o*Tffi ,,', e ) d ar e o r ic h c a n di '| :i i e i n $ h $:i [ ::]:il:Xai.ffiq s 'i,In details ot contracts il'Jflr,1".ff,i soouse or dePendcnts i; .''' *i.f Jji::'jil;H:'1",1'n'l'' """u"' ;"ffittl:"'iJ*:lff ::?tJi:yi$,"i:i[$;]fi?::J'liJl;"]:'i'fff'$T:i'ii"'::f;' colrrpletcd ) fl ATTESTED Mnnl#ffi-rlah NOTANY rrt trv {.lcvt ol A.P. -.H $g}I'lilii,,'i"1' 11,'," ) PARI'.II I Name of rhetiid-iiiies- Peddimseni VenkateGEi
u.No. 2-J5, Ramalayam Street, Coddatipalem, Karapa Mandal. East Godava pradesh I District, Andhra Kalinada,endhrapraaesl- nd Siate
.: ,t rrrc potiricat pan) l\drnc \ hich,er;tlre Jana JaSrurhr Parry (olhcrqi!e r\ ,lnoependenr,l lcdnJrddre rire 5. total nurnuer orpendinliiiE JiG ior+rpprcai{e e _ nOS
num@r 0lh,,t/r,fu 'orar or cases tn which
7 PAN of Year for which tasl Total income shiwn- incom€ Tax rerurn fite.t
a) Candidate ANGPP8O98L 2018-2019,?317-2Il8, Rs. 6,28.000r Peddimsetti 2016-2017 Venkateswam Rao
b) Spouse CHKPP5715G tt) t 6-zu t9. 2u t /-2018, Rs.8.28.460t Peddimsetti 2016-20t7 Padmavathi
c) HUI: Not Applicable Not Applicabte c)Dependents )eddimseniKeel.lhi Not Applicabt€ Not Applicable
Dep€ndants-2 DFYPPI"I22L Not Applicable Peddimse[iSatya Canesh 8 o LraD rnes (inctudirg ofTshore assersy in Ruoees Description Self Spouse Dependen!-t Dep€ndenl-ll Depende nr-lll Rs.2.70,000./- (s. r 7,04.000t Rs.5,82,000/- Rs.1,46,0001 Not Applicabl ts
I Purchase Pri;a;? Ks. ).26,000/- Rs.3.35,000/- Rs. l,ll,000a seif-acquired im- Rs. 1,68,000! Nol Applicabl
II Development/ con- Not Applicable Not Applicable Not Applicabte Not Nor immovable property Applacable Applicabl aRer purchase (if u?..tut applicable) )LrBll I ? t. Approximare Current market price - a) self-acquired Rs. 87.60,000/- Rs.55,80,0001 Rr.39.00,000/- Rs.28.00,000r (Toral assers value) Nor (b) inherited assets Not Af,plicable Not Applicable Not Not Applicable Applica (Toral Value) Applicabl€ ble 9. Liabiliti€s
(i) NIL NIL Nol Not Applicable Not ( Ioral) Applicable Applica
(ii) Loans from Bank, NII- N 1I, Noi Not Applicablc Not Financiallnslitu- Applicable Applica tions and others ble (Total)
t0. Liabilities thal are under dispule
(i) NIL NIL Not Not Applicable Not (rolal) Applicable ble (ii) Loans from BanI. NIL NII- Not Not Applicablc Not Financial Instilu- Applicable ble (Toral)
(II) Highest educational qualification: B.A. Discontinue, Andhra University (Give d€lails ofhighesl School/ Universiry cducation menrioning rhe ful form ofthe cenificare/diptoma_l degree course, name ofthe School/College/Universiry and rheyear ;n which the course was completeij.) r ATTESTED
., .. fuoointnr.i , I,rr.nf A.p. Ret Ob.ruc.l . ;{r.l,il t2'6'2012 Iotary Licence is vel;C up io r i'v'i022 .*11.":,ri-venkateswara^Raf#:t*Tf,I*tt, veeranra, ased 46 years. his posrat ^,*^^] , 2-37, peta, 1gd,ress ls-P.No. B.C. coddatipalem, Z. Bhavaram io.,,'X"rup" Mandal, Codavari Districr, Andhra pradesh. East rhe deponenr. ut*. nr..O. Jo he"r"Jl rerifi and declarc lhal thc c.nrents of rhis affidavir are rruc and corr""r to rt u.r-r oi,,y t n;;i;;;;;d beticIand no pan or it is falseand nothing materiar has been concealed there" from. (a),lhere I funher ie?are that:- is no case of conr iction or pending case against me oifr* l-fr"rifr""" ,n*tioned in items 5 and 6 ol P;rn A and B abo\ c: ft, l. my spousc. or my dependenls do nor hare any assel or liabiliN. other than those m flem\ / )l pan g. and ol A and irems a and I0 ofpan B abore. Vefllied al Kakinada. rhis 25ri day ofMarch.20lq (
Note: I. Allidavit shouta Note: 2, Allidavirrhould be.swom before an Oarh Commissionei'o. V"gir"r."," ,f," firsr Class or before a Notary Public. ", Note: J. All column should be filled rro and no column to be left blank. Ifthere is no information to tirmish in respecr ofany irem, either ,,Nil,, o.;;N"i"ppiL"'if" , th"" u", ,huuld b. mentioned. ". "u.e -ay Nolc: 4. I hc Affidavir should be eilher ryped or wrinen lesibly and nearlr Note: 5. Each page ofthe Aflidavit shourd .ig,"o uv t" ,r. i.pi*ri arna"rit shourd bear on each.page the stamp of the Notary ""i,i" orbarr, c"o,,ni"'.r.*. .. ir"gistrate before whom Aflidavit is swom. the
i'"", 'I ,"'"i itr: 'X;Wjfi,):l f;1'TESTED \qsndr pr [u=rgrl,-!l,g'
: .;i;i.P. . -:.:-$-?r12 i-t!i.,. _ .: ,i .:.lt.i i:;? $. CHITTT!.4. - ,.i a.B.L tr!)il.y Appoint.d oy Govt.ot A.p Rcf-G.O. r.tlo.3B5ii0Eidr.i2.6-201 2 l,."rwed vkL G5 ota',ylr71ilnOi 7 DUg7.20t8 | :ary LicGnca is Valid Upto tr.06.2022 Sf{r+r ruo: z, rl Ddk: 2C.o3. 2Al g Ti" : 13; et p*
FORM 2A (SED RULE 4] NOMINATION PAPER
Election to the house ofthe people n0ft w rnd wi- !.er\
STRIKE OFI.' PART I OR PART II BELOW WHICTIEVER IS NOT APPI,ICABLE
PART I
(To be used by candidate set up by recognized political pany) I nominate as a candidate for election to the House of the people lrom thc Kakinada Parliamentary Constituency.
Candidate's Name Not Applicable, father's name: Noa applicable, his postal Address is {9g ApD!!!4Uh .ll is name is entered at S.No. Not Applicable in Part No. Not Applicable ofthe electoral roll ,i)r Ngljppulghlgconstituency. M1 name is Not Applicable and ir is entered at S.No. Not Applicable in pan No. Not Applicable ofthe clectoral roll for the Not Applicable Parliamentsry constituency.
I)ate. l5-j-1019 Signatnre of the Proposcr. ' pant u (To be used by candidate NOT set up by recognized political party) We hereby nominate as candidate for election to the house of the people frofi rhe 6- KAKINADA Parliamenlary Constituency. Candidate's Name peddimsetti Venkqteswara pedUimsetti RafO,vcoddatipalem, Veeranna, aged 46 years. his postal address is D.No.2-35. Ramalayam Streel. Karapa MaoJal, East Godavari District, Andhra Pradesh. His name is entered at serial No. 505 in part No. 202 ot the electoral roll for 38- KAKINADA RURAL ( Assemble Constituency Comprised within) 6-KAKINADA Parliamentar) Constiruency.
parliamentary we declare thal we are electors ofthe above constifuency amd our names arc enlered in thc electoral roll-for that Parliamentary constiluency as indicated below and we append our signaturcs belorr in ro[,cn ofsubscribing ro this nomination:- Particulars of the proposers nnd their signatures Elector Roll s. Name ofComponent FullNanc Siliraturc f)atc No. Assembly Constituency no. ol'
I)art S.
No. of No. Elec- in
,7 I 3 J J 6 t. Kakinada Rural Mandal 201 779 PEDDIMSETTI 25-3-2019 SATYA GANI.]SH ? 5. g-o"{'r'A (akinada Rural 2/ Mandal t07 928 SRINIVAS JANA 25-l 20 r9
Kakinada 3. Rural Mandal 203 381 PEDDIMSETTI 25-l 2019 KEERTHI lu-a* (akinada v Rural N,landal 1t .110 VI]TRABAB JANA 25-3,20r9 s rr"---t-l"^ Kakinada Rural l\4andal 108 ll28 RADHA KRISHNA , 15,3-2019 CHODAVARAPU e!-^, 6. Kakinada Rural Mandal 50 817 KISI{ORE KADALI ur",- 25-3-20r9 '1. Kakinada Rural Mandal JA ti5 VENKATA 25-t-20 t9 RAMANA CEDDADA C,u.A*-** - 8. Fakinada Rural Mandal 36 t3l VAMSEE KRISTTNA 25-3-20t9 KAKARAPAI,I-I b-*v'- 9. Krkinada Rural l\ranLlal {0 169 SRINIVASA RAO l5-l-2019 KADALI lz6o?o>d t- 10. .tiakinada I{ural MaDdrl l0l io6 PAONAYATF- 25-3-10r9 PEDDIN'ISE'I'TY ?,P^4.nY
N.B. - Therc should be ten electors ofthe constituency as proposers. ' **r-
[,thecandidalementionedinPartUPartll(Stikeoutwhichisnotapplicable)assenttothis nomination and herEby declare tlrc citizerrship ofa[y foreign State / cotm!-y' G) Thd I am a citizen oflndia ard have not acquircd years ofagel (b) That I have completed '16 [SIRIKEOUT@ORcCt BELOWWHICHEVERISNOTAPPUCABII] party' which is a recognized National Party / (c) (i) that I am set up at this election by the Not lpplicable party be allotted to me' '-' Siiii pl,niv'in this State and that the symboi reserved for the above (OR) party' which is a registered (c) (ii) that I am set up at this election by the JANA JAGRUTIII an"i19:ry|*t candidate (Strike out ;".*;; political partv/that t urn this election T "ont"*ing in order ol prelerence' are:- *t i"tt i. not uppti"aUlej and that the symbols I have chosen'
(iii) (i) MIKE ( ii) MIKL MIKE name have been correctly spelt out (d) That mY name and my Father's/Mother's/Husband's (name ofthe language); and above in -P4g!!g[
to qualified and not also disqualified for being chosen (c) Thal to the best ofmy knowledge and belief, I am State' fill the seal in the Legislative Parliamentary of this
*lfurtherdeclarethatlamamemberoftheNotADDlicableltCaste/tribewhichisa scheduledl*caste/tribeofthestateofNotADDlicrbleinrelationtoNgjA!p!!!40!9(alea)inthat
State.
nominated as a candidate at the present general I also declare that I have not been, and shall notbe Pradesh to the l-egislative Parliarnentary OfAndhra electior/the bye-elections being held simultaneously' (State) from more than two Parliamentary Constituencies'
Date.-. 25-3-201 9 ,glk#
rscore out this pamgrapb ifnot applicable'
**Score out the words not applicable. b-) th.e,Election Commission "recognized political party" means a political party recognized N.B.-A concemed' g["i". (Rlservalion and illotme;t) Order' 1968 in the Stalc -a". rfr" Syi,bols J PART IIIA
(To be filled by the candidate)
Whether the cardidate
(i) has been convicted -No (a) of any offence(s) under sub-section (l); or - Not Applicable
(b) for contmvention ofany law sprecified in suEsection (2),
ofsection 8 ofthe Representation ofthe peoplc Act, l95l
(43 of l95l); or _ Nor Appticabte
(ii) has been convicted for any other offenc{s) for which he
has been sentenced to impdsonment for two yea$ or more. - Not Applicable
Ifthe amwer is "Yes", the candidate shall fumish the following information:
(i) Case/fiNt information repon No./Nos : Not Applicable
(iD Police station(s) Not Applicable Dishict(s) Not Applicable Stale(s) Not Appliceble
(iii) Section(s) ofthe concemed Act(s) and brief descdption ofthe offence(s) for which he has been convicted - Not Applicable (iv) Date(s) ofconviction(s) - Not Applicable
(v) Cou((s) which convicted rhe candidate- Not Applicable
(vi) Punishment(s) imposed Iindicate period of imprisonment(s) and/or quanrum of
fi ne(s)l- Not Applicable
(vii) Date(s) of release liom prison - Not Applicable
(viii) WaVwere any appeal(s)/revision(s) filed against above conviction(s)-No
(ix) Date and particula$ ofappeal(s)/application(s) for revision hled - Not Applicable
(x) Name of the cout(s) before which the appeal(s)/ Application (s) for revision ftled - Not Applicable
(xi) Whether the said appeal(s)/application(s) fbr revision has/have been disposed ofor is/are pending- Not Applicable
(xii) tfthe said appeal(syapplication(s) for revision has,tave been disposed of- (a) Date(s) ofdisposal - Not Applicrble
@) Nature oforde(s) passed- Not Applicable
(2) Whether the candidate is holding any ofiice ofprofit under the Governnent of India or State Govenunent?- No
-If Yes, details ofthe office held - Not Applicable (3) 7 Whether the candidate has been declared insolvent by any Court?- No
lf Yes. has he been discharged ftom irsolvency. - Not Applicrble (4) Whether the candidate is under allegiance or adherence to any foreign country? - No
-lf Yes, give details Not Applicable
O whether the candidate has been disqualified under section 8A ofthe said Act by an order of the President? - No
-lf Yes, the period for udich disqualified - Not Applicable
(O whether the candidate was dismissed for corruption or for disloyalty while holding office
under the Govemment of lndia or the Govemment ofany State? - No
-lf Yes, the date ofsuch dismissal- Not Applicrble
O 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 ofany goods to that Covemment or for execution ofwo*s wtdenaken by thal Govemment?- No -
tf Yes, with which Government and details of subsisting contract (s) Not Applicable
(8) whether the candidate is a managing agent, or marager or Secrctary ofany company or
Corporation (other than a cooperative society) in the capital ofwhich the Central Govemment or State
Governnent has not less than twenty-five percent share? -No
lf Yes, with which Govemment and the details thercof- Noa Applicable
(9) Whether the candidate has been disqualified by the Commission under section l0A ofthe
said Act- No
Jfyes. the date ofdisqualification Not Applicable Place: Kakinada Date:25-3-2019 .[,,$"4. 1
PART IV
(to be fill€d by rhe Retuming Officer) Serial No. of nomination pup"r.....?1...... on was delivercd to me at my oflice at..13.t f1.1...... 1t our.1 or...2f :-3).?lJ.6ut"1oy the * Oate/proposer.(Nameofproposer...... ) Date
*Strike out the word not applicable. Assistant q Un{cer 0 - Kaki ilameitary CcnsiiiiteicY
PARTV
Decision ofReturning Omcer Accepting or Rejecting the Nominstion paper I have exanlined this nomination paper in accordance with section 36 ofthe Representation o.the peopre Act, I951(41 of 195l) ard decide as fbllows:_
Dalc
Renrming Ollicer
(?erforation) FORM A
Communication with regard to Authorized Persons to intimate names of the candidates setup by recognized National or State political party or Registered un-recognized politicalparty.
To 1. The ChiefElectoral Officer, Andhra Pradesh (State/Union Territoryl. 2. The Returning Officer for the Constituency. Subject: General Elections to Assembly/Parliamentar.v from Andhra Pradesh (State/Union Territory) - Allotment ofsymbols - Authorization of persons to intimate names ofcandidates
Sir, In pursuance ofparagraph 13 (c), (d) and (e) ofthe Election Symbols (Reservation and Allotment) Order. 1968, I hereby communicate that the following person (s) has/have been authorized by the party, which is National Party/State Party in the State ofAndhla PIadgSh /Registered Un-recognized Party to intimate the names ofthe candidates proposed to be set up by the party at the election cited above
Sl.No. Name of person authorized Name ofoffice held District(s)/area (s) to send notice in the constituency/ party Constituencies in respect of which he has been authorized. 1 2 3 1. Smt. Kothapalli Geetha President Entire State ofAndhra Pradesh
2. The specimen signatures ofthe above mentioned person (s) so authorized are given below:
Iii)
Yours faithfully, + JIqv\ P. Abhinay Tej, GeneralSecretary Jana lagruti Party
PIace: Visakhapatnam Date: 19d March, 2019 (Seal ofthe Pafty) FORM B
NOTICE AS TO NAMES OF CANDTDATES SET UP BY THE POLITICAL PARTY '1o The Retuming officer, KAKINADA Parliamentary Constituency Andhra Pradesh.
Sub: General election to PARLIAMENT li"om KAKINADA (Name of the constiluenc)rin Andhra Pradesh - Setting up ofcandidate.
Sir.
ln pursuance ofnotification dt.18.3.2019 t hereby give notice on behalfofJana Jagruti pany;
(i) That the person whose particulars are fr.rmished in columns (2) and (4) below is the approved candidale ofthe party above named, and (iD The person whose particulars arc mentioned in columns (5) and (7) below is the substitute cardidate of the party *ho will step-in onthe approved candidate's nomination being rejected on scrutiny or on his withdrawing from the contest. If the substitute candidate is till a candidate, al the ensuing election liom this Parliamentary/Assembly constituency.
Name ofthe Nane ofthe Falher\/H usband's Postal address of Name oflhe substilute Father Postal approved name ofthe approved candidat€ candidate who will 's/Hus addre cardidate approved candidate step in lhe approved band's ss of Constiluencv candidates nomination substi being rejected on ofthe scruliny or his subsrir candi wilhdrawing fiom lhe date candid
I .l j 6 1 CODDATIPALf,M. PIDDIMSETTI DNO.&6 Z BAVARAM POST. V[,NKATESTI'A VEIRANNA NO NO NO I.(AKI\.,ADA ILA RAO KARAPA MANDALAM. E.C.DtST 533 ,162 u fi,,k,L
l lhe notice in FoIm B given earlier in f'avaour r shri/smt?.Vu*lJsLw approved AatFo candidates and Shri/Smt Noh party's substitute candidate is hereby rescinded; It is certified 2. that each ofthc candidates whose name is mentioned above is a member ofthe political pany and his name is duly bome onthe rolls ofmembers ofthis pany.
Yours faithfully
PLACE: VISAKHAPATNAM KOTHAPALLI GET]THA DATE: 20-03-2019 PRESIDENT JANA .IAGRtiTI PARTY Seal of the partv PART - VI
Receipt for Nomination Paper and Notice of Scrutiny (To be handed over to the person presenting the nomination paper)
Serial No, of Nomination paper : 2l
The nomination paper of candidate for election from the 6-Kakinada Parliamenta ry Constituency was
Cr t t'l'O delivered to me at my Omce at l3- lt1 (hour) on ? 3-2c lf{Oate) UV the Candidate / Proposer. All nomination papers will be taken up for scrutiny at 11.OO A.M on 26,03.2019 at Court Hall, Collector's Office. Kakinada.
Place: Kakinada
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Issue Oate 22/03/2A19 custfmer A/c No. 00931040001aa3r9UU'J TU4UUUIUAJI9 Nam l! MR vENKATES*Aoo ooo oaoo,Jnara, D No 2 r5, MrrALAyAr utcon,[ coooot,oertu l KAnepa rvANDAL,arv, rasr coo{vlnI, etoHRA pRADEs I KAKIMDA ANDHRApRAot sx tr,,(:ra si:asz Customer IO 3587 Nomination : Nomination not avaitabte