FORM-28 (See Rule 4)

NOMINATION PAPER

ELECTION TO THE LEGISLATIVE ASSEMBLY OF .J.?. . VJ.?. ~ . ~U . f.~. ~~ STATE (Strike off Part I or Part II below whichever is not applicable) Re ize (2c m) phc in wh ite bac 'ull fac

PART-I (To be used by candidate set up by recognised Political Party)

I nominate as a candidate for election to the Legislative Assembly from the

. 1. 7.~ . N.G..1:-:-:~ . ~..!..~ .~ft?Assembly Constituency.

Candidate's Name...... :>.J..A·g · ~ · .'/...It..~ . ~ . £fl . ~.9 ......

Father's I ~er's-1 Hlffibancfs Name...... V . ~ ..~ ..~...... His postal address ...':-:1..~ ..?.."'::.... f.. . ~ ..~. ft..f.. . f!!:. . ~.. '.!;, . !!. . ~ ...... J.~ol L J'TfL<....'=EI ...... g.Y. ..~..~.. ~~..l?~t3: . ~ . ~ .1?..9...SP o J .

His name is entered at S.No ..~J~ . in Part No ...1-... of the electoral roll for

...... J4 .~ . P....Jt :J.. .13..l::f.I}..'I.ft..N...... Assembly Constituency.

/ My name is/ .. .J....1.. 1.'f. .~ . !r. . N..hN..P../tM...... and it is entered at

S.No .J . i-~ . ~ n Part No...i£.. of the electoral! rolls for . i..7:-:-: . N . c. ~~.J71!P..RG. Assembly

Constituency.

Date...~..~ ..1.. 1. ~ .. ~ . ~ . ~ .t.. .. (S lgnature of proposer) 2 - , • P ,RT-Iii (To be used by candidate NOT et up by recognised Political Party) We hereby nominate- as candidat for election to the Legislative Assembly from the ...... t.'. . ~ . f. ... l.Hl)lk .J..(f.f\\};e~y Constitue cy.

Candidate's Name ...... rV.9.. C.b.J...f:..~. ) .. (ft.({. . ~ . g_ .:......

Father's I Mother's I Husband's Narr e...... N. . ~ . f.... ft..~!.. .~J.(; !?.. P..~ r.s:-

His postal address ...... N . ~ . T.. ... ft. . !.. .~..~... <-. .ft. ..~. '::-:. .fi. .~......

His name is entered at S.No...... n Part No ...... of the electora 1I roll for

...... No. ..T...... /t:f.. . f... . ~.. t~A'ss

Particulars of the proposers and t eir signatures. Electoral Roll No. of proposer SI. Part No.of S.No. Full Name Signature Date No. Electoral in that Part Roll (1) (2) (3) (4) (5) (6) 1. 2. 3. (N 0 ( · fr) X f.....-1 L /TfJL G­ . 4. 5. I 6. 7. 8. 9. 10. N.8:- There should be ten electors of the constituency as proposers 3

PART-Ill

I, the candidate mentioned in Part W!s:l U(strike out which is not applicable) assent to this nomination and hereby declare that:­

(a) I am a citizen of India and have not acquired the citizenship of any foreign State:

(b) that I have completed ...... 6.q.... years of age.

(Strike out c(i) or c(ii) below whichever is not applicable) "" ~ Tl {) (N'A- L- Co N(;,Jl.Gs s (c) (i) I am set up at this election by the ..b. . NJ)..l..!V~...... party, which is

recognised National Pa rt y/State-~y in this State and that the symbol reserved for the above party be allotted to me. (OR) (ii) I am set up at this election by the ...... party, which is a registered-unrecognised political party I that I am contesting this election as an independent candidate (strike out which is not applicable) nd that the symbols I have chosen, in order of preference are:­ (i) .... Nat..ll:Jtf.W4>:m$i) .. N.off.R. ~ - ~..Yt!1 . ~~ iii) .. ~t1..f../J . f. g~_ 1.. ~. P.:-. 0 LC­

(d) my name and my father's/m oUaor's/t:iu~ name have been correctly spelt out above in

.....b.,.., .N. .\A"· ..u.s ...... w'. (Ti_ame of the language)

(e) to the best of my knowledge and be 1lief, I am quallified and not also disqualified for being chosen to fill the seat in the Legislative Assembly of this State.

*I further declare that I am a ember of thef/R'JtCrC..Jfll(L5!3}el.t rii be which is a scheduled **caste/tribe of the State of...... 'Y.9..T...... in relation to ...... (area) in that State.

I also declare that I have not been , and shall not be nominated as a candidate at the present ~ e r e\!- 0 l e ~the bye elections being held simultaneousl,y, to the Legislative Assembly of .. 9..o.J).!!..<:J! .t?.~Y .. (State) from more than two Assembly CV·C ies~

Date: .. .. ~.. : .~a. .!. ~.\,,.6 (Signature of Candidate)

*Score out this paragraph, if not applicable.

**Score out the words not applicable .

N.B.:- A "recognised political party" means a political party recognised by the Election Commission of India under the Election Symbols (Reservation and Allotment) Order, 1968 in the Stale concerned . 4

PART Ill A {To be filled by the candidate) Whether the candidate ­ (i) has been convicted ­ (a) of any offence(s) under sub-section (1 ); or (b) for contravention of any law specified in sub-section(2) NO ~/No of section 8 of the Representation of the People Act, 1951 (43 of 1951);or (ii) has been convicted for any other offence(s) for which he has been sentenced to imprisonment for two years or more.

If the answer is "Yes", the candidate shall furnish the following information: ' (i) Case/First Information Report No./Nos ...... hl.t~ ...... ' " . (ii) Police Station(s).... N.t..L ..... District(s) ...... yV.~.L.-...... State(s) ...... f.J..1..L... .

(iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been convicted ...... f.V..i... .k......

(iv) Date(s) of conviction(s) ...... N..\..k ...... (v) Court(s) which convicted the candidate ...... N.!.. ~......

(vi) Punishment(s) imposed [indicate period of . i mpri~onment { s) and I or quantum of fine(s)] · ·· · ····· · ···································· ········· ················N ~ · .t..:...- ·························· ····· ' (vii) Date(s) of release from prison ...... tJ.r...l-.:-...... /./ t L,. (viii) Was/Were any appeal(s)/revision(s) filed against above conviction(s) ...... ¥m/No.

(ix) Date and particulars of the appeal(s)/application(s) for revision filed .... !:!. '. ~ .~ · ········

(x) Name of the court(s) before which the appeal(s)/application(s) for revision filed ...... fV. 1.G ......

(xi) Whether the said appeal(s)/application(s) for revision has/have been disposed of or is/are pending ...... pJt'... .k ......

I (xii) If the said appeal(s)/application(s) for revision has/have been disposed of - N r {___, . N1~ (a) Date(s) of disposal ......

(b) Nature of order(s) passed ...... NtL--? .

Place: £vS>u ~~fl-~~ V,..

Date: ,_.. \ \ · 1.---0 ib (Signature of the candidate) 5

PART IV (To be filled by the Returning Officer)

Serial No. of Nomination paper ... ~ ......

This nomination was delivered to me at my office at .. 7:-:.' . ~ . 1:-:-.. ~ .).. (hour) on £?).} . ~!./. .. ~~... (date) by the *candidate/proposer ...... \r•... N~T~·~f.. ... (name).

Date .. 9.~ . J . ~ . ~JJ.O f '1 Retum~icer - ~ ti'etURNING------OFFICER. -cum· * Score out the words not applicable vn DlR~CtOR OF INDUSTRIES &COMMERCE PUOUCHERRY

PARTV DECISION OF RETURNING OFFICER ACCEPTING OR REJECTING THE NOMINATION PAPER

I have examined this nomination paper in accordance with section 36 of the

Representation of the People Act, 1951 and decide as follows:-

Date...... Returning Officer

...... Perforation ......

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 ......

The nomination paper of ...... a candidate for election from the ...... Assembly Constituency was delivered to me at my office at ...... (hour) on ...... (date) by the *candidate/proposer.

All nomination papers will be taken up for scrutiny at ...... (hour) on ...... (date) at...... (place).

Date...... Returning Officer

*Score out the words not applicable INDIA NON JUDICIAL

e-Stamp

Certificate No. IN-PY142612429562810 Certificate Issued Date 27-0ct-2016 05:05 PM Account Reference JMPACC (SH)/ pyshimp17/ SARAM/ PY-PU Unique Doc. Reference SUBIN-PYPYSHIMP17218145284010380 Purchased by V NA RAY ANASAMY Description of Document Article 4 Affidavit Property Description NOMINATION FOR NELLITHOPE ASSEMBLY CONSTITUENCY Consideration Price (Rs.) 0 (Zero) First Party V NARAY ANASAMY Second Party RETURNING OFFICER Stamp Duty Paid By V NARAYANASAMY Stamp Duty Amount(Rs.) 100 (One Hundred only)

FORM-26 (See Rule 4A)

Affidavit to be filled by the candidate along with nomination paper before the Returning Officer for Election to the Puducherry Legislative Assembly from the .J!l~ltti·~tpe Assembly Constituency ~OT4'9µ 0005160368 r PART-A

l, NARAYANASAMY**son /daughter l'Nife of VELU, aged 69 yea rs, resident of No.5, Ellaiamman Koil St., 605 001, Puducherry U.T. (men tion full posta l address),a candidate a t the above election, do hereby solemnly affirm a nd state on oa th as under :­

1. l am a ca ndidate set up by (Name of the political party) /**am eontesting as an Independent Candidate. (**Stril

2. My name is enrolled in 14-RAJ BHAVAN-PUDUCHERRY (Na m e of the Constituency and the Sta te), a t Seria l No. 119, in Part No.l ,

3. My contact telephone number(s) #;/are 9443233909, 0413-2339099 and my e-mail ID (if a ny) is [email protected] and my Social Media account(s), if any 1:15/are Twitter ID: VNarayanasami and Facebook ID: pondy.vnarayanasamy.

4. Deta ils of Perma ne nt Account Number (PAN) a nd status of filing oflncome Ta x Return:- The fina ncial year for Tota l income s hovvn Sl. which the last Income in incom e Tax N a mes PAN No. Tax return h as been return filed (in Rs.) 1 NARAYANASAMY AKUPS9377C 2015-16 19,89,150/­

2 Spouse NIL NIL NIL ~3 Depe ndent- I NIL NIL NIL 4 Depe ndent-2 NIL NIL NIL 1' 5 Dependent-3 l NIL NIL NIL I

5. I -ftffi I am not accused of any offe nce(s) punis hable with imprisonmen t for two years or more in a pending case(s) in which a charge(s) has I have bee n fram ed by the court(s) of competent jurisdiction. lf the deponent is accused of any such offenee(s) he shall furnjsh the fo llowing infonnation:­

(i) The following case(s) is I a re pending a gainst me in whieh cha r ges h ave been fra med by the court for a n offence punisha ble with imprisonme nt for two years or more:-

M Case I First lnforma ti o~ Report No~/ Nos. together with eomplete details Not Applicable of coneerned Police Station I District I State t----­ - - - (b) Section(s) of the concerned Aet(s) and short description of the offence(s) Not Applicable for w hi eh charged (c) Name of the Court, Case No. and date of order taking cognizance Not Applicable (d) Court(s) which framed the charge(s) Not Aoolicable (e) Date(s) on whieh the eharge(s) was/ were framed Not Aoolicable (f) Whether all or any of the proeeeding(s) have been stayed by any Court(s) Not Applicable of eompetent jurisdiction (ii) The following ease(s) is I are pe nding against me in which cognizance has been ta ken by _!_he Court (9ther than the f ase_§ mentioned in_i te.,...1_n-'( ~i )_a____bo ve_,,_:-______--. (a) Name of the Court, Case No. and date of order Judicial Magist rate-IV, I taking cognizanee Puducherry. (Old No.33/2015 & 34/2015inJM-I) I Renumbered as STC 258/16 and STC 290/16.

- - - Date 13.1.2015. (b) The deta ils of case(s) where the Court has ta ken eognizance, section(s) of the Act(s) a nd description u/s 188 I.P.C., r/w 34 I.P.C. of the offence(s) for which co ·nizanee ta ken (c) Details of appeal(s) I applieation(s) for revision (if The above two cases in [SI.No. (a)] a ny) filed against the above order(s) are pending. He nce the question of a eal/revision does not arise. De ils of all pending case,; in whieh cognizance has been ta ken by tlll' Court, irre:;pectivc of the quantum of pu 'shment or framing ofcharges will have to be disclosed. (ECI's clarification No. 3/4/2012/S DR dated 2()-~)-201 2 ) 6. I have been I have not been convicted of an offence(s) [other than any offonce(s) referred to in sub-section (1) or sub-section (~) or covered in sub-section(3), of section 8 of the Representation of the People \ct, 1951 (43 of 1951)] and sentenced to imprisonment for one year or more.

If the deponent is convicted and punished as aforesaid, he shall furnish the following information:

ln the following cases, I have been convicted and sentenced to imprisonment by a court of law:­ (a) The details of case(s), section(s) of the concerned Act(s) and Not Applicable _descri ti_Q I_!_of the offence(s) for which convicted _ (b) Name of the Court(s), Case No.(s)., and date(s) of order(s) Not A licable (c) Punishment im osed (d) Whether any appeal was I has been filed against the conviction Not Applicable order. lfso, details and the resent status of the a eal

7. That I give herein below the details of the assets(movable and immovable etc.,) of myself, my spouse (*late Mrs. Kalaiselvi) and all dependents: A. Details of movable assets: Note 1 : Assets in joint name indicating the extent of joint ownership will ahm have to be given. Note 2 : ln case of deposit I investment, the detaiL induding serial number, amount, date of deposit, the scheme, name of the Bank I Institution and Branch are to be given. Note 3: Value of Bonds I Share Debentures as per current market value in Stock Exchange in re::;pect of listed companies and as per books in case of non-listed companies should be given. Note 4 : Dependent here has the same meaning as assigned in Explanation (v) under section 75A of the Representation of the People Act, 1951. Note 5: Details including amount is to be given separately in respect of each investment.

SpousL' SI. De pe n Dl'JX'll De pen Description Self (*late Mrs. No (font- 1 Kalaiselvi) dl'nt-2 dent-3 (i) Cash in hand NIL NIL NIL NIL Rs. 1,00,000/- (ii) Details of deposit m Bank SBI-Parliament Street, NIL NIL NIL NIL accounts (FDRs). Term New Delhi. Deposits and all other types Ale No.10023830511, of deposit8 including Saving Amount: Rs. 4,33,911/- Account::;, Deposits with Financial lm;titutions, Non- ICICI Bank, Pondicherry. Banking Financial Ale No.623301116664, Companies and Co-operative Amount: Rs. NIL Societies and the amount m each such deposit. Syndicate Bank, Pondicherry. Ale No.96012200002604 Amount Rs. 10,323/-

UCO Bank, Pondicherry. Ale No.00590100009776, Amount Rs. 40,752/-

SBI, Pondicherry, 1) Ne No.20171885307, mount Rs. 3,34,252 ,2) Ne No. l~ ' ~14J.._l1'i b Amount Rs.15,00,000 (Election Account) 4

Spouse SI. Dept' n Dl'pcn De pen De:ocription Sl'lf (*late Mrs. No dent-I dent-2 dl'nt-3 Kalaiselvi)

(iii) Details of Investment 111

I Bonds, debentures I shares ! I and units in Companies I NIL NIL NIL I NIL NIL Mutual funds and others and the amount (iv) BIMABACHAT Details of investment in NSS, Postal Saving, Insurance Policy No.735933093 Policies and investment in D.0.C.-16.12.2010 NIL NIL NIL NIL any Financial Instruments in Premium: ! Post Office or Insurance Rs. 5,58,488/­ Company and the amount D.O.M.-16.12.2019 (v) Personal loans I advance given to any person or entity including firm, company, NIL NIL NIL NIL NIL trust etc., and other i receivables from debtors and I the amount (vi) Ford Eco sport Maruti Swift :Niotor vehicles I Aircrafts I I Car Car DL 2C AF ! Yachts I Ships, (details of I make, registration number Reg. No: DL 10 OF 5931 8488 Value: NIL NIL NIL etc., year of purchase and 31.07.2014 Rs.4,25,000/­ 1 amount) Rs. 9,18,845/- Year-2004 (vii) Jewellery, bullion and Gold Ornaments valuable thing(s). (Give Wt.:200 Gms. NIL NIL NIL NIL I details of weight and value) Value:Rs.5,72,400/- (viii) Any other assets such as i value of claims I interest NIL NIL I NIL NIL NIL

(ix) Gross total value Rs. 44,68,971 Rs.4,25,000/- NIL NIL NIL

~ :\H :;c t>< 1n the name of (la te) Mr8. h a l a 1 ~c lv1 1H ~'Bl Lu be part1l1oned anwng the legal he 11'H .

B. Details of immovable assets: Note I: Prnpertico in joint ownership indicating the ext 'nt of joint ownl'rnhip will also lrnw lo be indieatL'd. Note 2: Each land or building or apartment ,,;hould be mcntionl'd :;e paratcly in this format.

Spousu SI. DupL' n DL'Jl<.m Depen Description Sl'lf (*late Mrs. No dent-I de nt-2 dcnt-3 Kalaiselvi) (i) Agricultural land: 1. Poorana.nkuppam Revenue Village, Kombakkam Puducherry. Location(s) Revenue Village, NIL NIL NIL 2. Puducherry. Revenue Village, Puducherry R.S. No.15/2 1. R.S. No.107/3, 108//8, 11011 Survey number(s) Ward L, Block 1 NIL NIL 2. R.S. No.33/5, 33/9, 33/10 NIL T.S. No:15/2 Area l. 0.83. 75 Hectares 25 Kuzhi (Total measurement NIL NIL NIL 2. 0.50.50 Hectares in acres) Whether inherited Yes No I NIL NIL NIL

Nil 27.7.1995 NIL NIL NIL

Nil Rs.36,500/- NIL NIL NIL 5

Spouse SI. ! Depen De pen Dl·pen De;;cript.ion SL'if (*late Mrs. No ! de nt-1 d l• nt-~ dent-3 Kalaiselvi) Any investment on I the land by way of i Yes (Dilapidated- Nil NIL NIL NIL development, shed) construction, etc. Approximate 1. Rs. 52,00,000/­ current market Rs. 55,00,000/- NIL NIL NIL 2. Rs. 2,25,00,000/- value (ii) Non-Agricultural land: Pooranankuppam, Location(s) Plot at Gurgaon NIL NIL NIL Puducherry Sector 40, Survey number(s) R.S. No.101151, 101152 NIL NIL NIL I Plot No.928 Area (Total measurement 3,615 Sq. Ft. 160 Sq. Mt. NIL NIL NIL in sq.ft.) Whether inherited

property? I Yes No NIL NIL NIL (Yes or No) Date of purchase, in case of self- Nil 12.11.1994 NIL NIL NIL I acquired property Cost of land (in case Nil Rs. 7,50,000/- of purchase) at the NIL I NIL NIL time of purchase Any investment on the land by way ofI : Nil Nil NIL NIL NIL ' development, 1 ! construction, etc. Approximate I current market Rs. 15,00,000/­ Rs.50,00,000/- NIL NIL I NIL value l I (iii) Commercial buildings (including apartments):

Location(s) NIL NIL NIL NIL NIL Survey number(s) NIL NIL NIL NIL NIL Area I ' (Total measurement NIL NIL NIL NIL NIL I in sq.ft.) Built-up area (Total measurement NIL NIL NIL NIL NIL in sq .ft.) Whether inherited property? NIL NIL NIL NIL NIL (Yes or No) Date of purchase, in case of self- NIL NIL NIL NIL NIL acquired property Cost of property (in case of purchase) at NIL NIL NIL NIL NIL l_ the time of purchase Any investment on the land by way of NIL NIL NIL NIL NIL development, I construction, etc. Approximate - current market NIL NIL NIL NIL NIL .-... .a.R 1 ~ue ~o~~ ~\)lt\t-.\. +: l't\.~·V!c\\a~~\ }lr ~ ~ · V v\lO ~O · "?>S l ~ p: 0. ~elf" · ".>-LJ Ot-­ ~v J": OF pu'O 6

SI. Spouse De pe n Dep L• n De pen Dc,.;cription Self No (*late M1·s. l{alaiselvi) de nt-1 dent-2 de nt-3

(iv) Residential buildings (including apartments):

1. House No.5, I 1. House No.5, i Ellaiamman Koil St., Ellaiamman Koil St., Puducherry-1. Location(s) Puducherry-605 001. NIL NIL NIL 2. Shanthi Nagar Extn., 2. Flat at Vikas Puri, Ilango Nagar, Delhi. I Puducherry 1. Door No.5, Ward-D, Block-16, ! 1. Door No.5, Ward -D, T.S. No.201 Block-16, Survey I 2. Ward-G, Block No.17, T.S. No.201 NIL NIL NIL number(s) :I T.S. No.135, I R.S. No.96/21 2. No.38, Sector-C

1. 1,496 Sq. Ft.(Totnl Extent) Area 1. 1,496 Sq. Ft. (Total l·:xtc nt) Joint ownership (Tota l Joint ownership I Self-Share: 748 Sq. Ft. NIL I NIL NIL measurement Spouse Share: 748 Sq.Ft in sq.ft.) 2. 1,560 Sq. Ft. 2. 160 Sq. Mt.

Built-up area I I (Tota l 1. 2,700 Sq. Ft. 1. 2,700 Sq. Ft. ! NIL NIL NIL measurement 2. 5,000 Sq. Ft. 2. 1,320 Sq. Ft. in sq.ft.) Whether inherited No No NIL NIL NIL property? (Yes or No) Date of purchase, 1n case of self­ 1. 6.3.1981 1. 6.3.1981 NIL NIL NIL acquired 2. 16.7.1979 2. 27.4.1995 property 1. Rs.50,000/­ 1. Rs.50,000/- Cost of land (in (Total Rs.1,00,000) (Total Rs.1,00,000) case of purchase) Joint Ownership - Joint Ownership ­ NIL NIL NIL at the time of Self Share Spouse Share purchase Rs.50,000/­ Rs.50,000/­ 2. Rs. 9,000/­ 2. Rs.13,50,000/- Any investment on the land by ! 1. Yes 1. Yes i w ay of NIL NIL NIL 2. Yes 2. Nil (Flat) development, construction, etc. Approximate 1. Rs. 1,00,00,000/­ 1. Rs. l,00,00,000/­ current ma rket NIL NIL NIL 2. Rs. 1,70,00,000/­ 2. Rs. 1,50,00,000/- value Others (such as (v) interest in Nil Nil NIL NIL NIL propertv) I Total of current (vi) market value of Rs. 5,62,00,000/­ Rs.3,55,00,000/- NIL NIL NIL I (i) to (v) a bove 7 8. I give herein below the details of liabilities I dues to public financial institutions and government:-

N ote : l'Ieatie 141ve ~e p a r a tc c 1.:1 ta1 Isof na me o ru ank·. 1m;t1tut1un. entilv or indivic ual a nc amount be fore each ite m. Spou::;c De p e n Depend D e pen SI. No Description Self ("" la tt• Mm. cle nt-1 t' Ilt-~ dc n t-3 Ka la i::;e lvi) (i) Loans or dues to Bank I Financial institution(s):-

Name of the Bank or UCO Bank, NIL NIL NIL NIL Financial institution Puducherry Amount outstanding Rs. 27,66,228/- NIL NIL NIL NIL

Nature of loan Mortgage Loan NIL NIL NIL NIL Loans or dues to any other individuals I entity other than mentioned above:-

Name (s) NIL NIL NIL NIL NIL

Amount outstanding NIL NIL NIL NIL NIL

Nature of loan NIL NIL NIL NIL NIL

Any other liability NIL NIL NIL NIL NIL

Grand total of liabilities NIL NIL NIL NIL NIL

(ii) Government dues: Dues to departments dealing with NIL NIL NIL NIL NIL Government accommodation Dues to departments dealing with supply of NIL NIL NIL NIL NIL water Dues to departments dealing with supply of NIL NIL NIL NIL NIL electricity Dues to departments dealing with supply of NIL NIL NIL NIL NIL telephones I mobiles Dues to depa rtments dealing with government transport (including aircraft NIL NIL NIL NIL NIL and helicopters) Income tax dues NIL NIL NIL NIL NIL

Wealth tax dues NIL NIL NIL NIL NIL

Service tax dues NIL NIL NIL NIL NIL

Municipal/Property tax dues NIL NIL NIL NIL NIL

Sales tax dues NIL NIL NIL NIL NIL

Any other dues NIL NIL NIL NIL NIL

(iii) Gra nd total of all Government dues NIL NIL NIL NIL NIL Whether any other liabilities are in dispute? lf so, mention the amount I (iv) NIL NIL NIL NIL NIL involved and the a uthority before which it is pending . . * : \ 88e t. ~ in the name of (late) Mr ~ . h. a lu1 ~e lv1 1,; ~ 1 et to be pa rt1lmned among t he legal hl'll".·.

9. Details of profession or occupation­ (a) Self : Advocate (Suspended practice in Advocate Profession, because of holding as Chief Minister)

(b) Spouse :Not Applicable

10. My educa tional qualification is as under:

1965 B.A. 1969 .B.L. 1973 M.L. Annamalai University, Chidambaram 2008 V· 8 PART-B 11.ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART-A: 1. Name of the candidate Shri V. NARAYANASAMY 2. Full postal address N o.5, EllaiamrnanKoil St., Pondicherry, Puducherry 3. Number & name of the constituency and State No.17- Nellithope Assembly Constituency, Puducherry 4. Name of the Political Party which set up the INDIAN NATIONAL CONGRESS candidate (otherwise write "Independent") *5(i) Total number of pending cases where charges have been framed by the Court for offences NIL punishable with imprisonment for two years or · more *(ii) Total number of pending cases where the Court(s) have taken cognizance [other than the 2 (Two) cases mentioned in item (i) above] 6. Total number of cases in which convicted and sentenced to imprisonment for one year or more [except for offences referred to in sub-sections NIL (1), (2) or (3) of section 8 of the Representation of the People Act, 1951 l Year for which PAN of last income tax Total income shown return filed 7. (a) Candidate AKUPS9377C 2015-16 Rs.19,89,150/­ (b) Spouse NIL NIL NIL

(c) Dependents NIL NIL NIL 8. Details of assets and liabilities in : Spouse Depend De pen Depen Description Self (*late !\.'Ir:;. Kalaiselvi) ent-1 cl ent-2 cl ent-:3 ' Movable assets (Total A. Rs. 44,68,971/­ Rs.4,25,000/- NIL NIL NIL value)

B. Immovable assets

(i) Purchase price of self­ Rs.59,000/­ Rs.21,86,500/- NIL NIL NIL acquired immovable property (ii) Development/construction I

cost of immovable property I Rs.1,54,00,000/­ Rs.54,00,000/- NIL NIL NIL II ! after purchase (if applicable) l

(iii) Approximate current market i 11 NIL NIL NIL price of- (a) Self acquired assets (Total Rs.2,70,00,000/­ Rs.3,55,00,000/- NIL NIL NIL value)

I (b) Inherited assets (Total Rs.2,92,00,000/- NIL NIL NIL NIL value) I 9. Liabilities­ (i) Government dues (Total) Nil Nil NIL NIL NIL Loans from Bank, Financial UCO Bank (ii) Institutions and others Nil NIL NIL NIL Rs.27,66,228/- (Total) 9

Spouse Depend Depen De pen Description Self ("late Mrs. I\alaiselvi) ent-1 dent-2 cle nt-3 10. Liabilities that are under dispute:

(i) Government dues (Total) NIL NIL NIL NIL NIL Loans from Bank, Financial (ii) Institutions and others NIL NIL NIL NIL NIL

(Total) 11 11. Highest educational qualification: (Give details ofhighest School!Un iue,.sity ed11catio11 mentioning the full form ofthe certificate/ diploma/deg,.ee course, name ofthe School!College/ Un ive,.sity and the yeai· in which the course was complete

B.L. Madras Law College, Chennai 1973

M.L. Annamalai University, Chidambaram 2008

*Note: Details of' all µending cases in which cognizance has been. taken by the Court, irrespective ol the quantu. 111 ul punishment or /i'Olning ol charges will have to be disclosed. (ECJ's clarilication No. 314 I 20121 SDR dated 26-9-201 2)

VERIFICATION I, the deponent, above named, do hereby verify and decla re tha t 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 materia l has been concealed therefrom. I further decl a n~ that:­ \l (a} T~ rej s no case ofconviction or pending case a gainst me other than those mentioned in items 5 a 1~f P a rt-A a nd B above; "iub) I, my spouse, or my dependents do not have a ny asset or liability, ot her than those mentioned in items 7 and 8 ofPart-A and items 8, 9 and 10 of Pa rt-B above.

Verified at Puducherry this the ...... l:.\.~..-:- .. ..'day of OCTOBER, 2016

SIGNED- BEFORE ME \)·~ DEPONENT ~~) / \\.'°. ''~Y1r~'-c N. K. PERUMAL,B-A. . B.l., Notary Public 630, Bharathy Street, PUDUCHERRY - 605 001

Note J:Affidavit should be filed latest by 3.00 p.m. on the last day of filing nomination. Note 2:Affidavit should be sworn befo re an Oath Commissioner or Magistrate of the First Class or befo re a Notary Public. Note 3: All columns should be filled up and no column should be left blank. lf there is no info rmation to furnish in respect of any item, either "NlL" or ''NOTE APPLICABLE" as the ease may be, should be mentioned. Note 4: The Affidavit should be either typed or written legibly and neatly. INDIA NON JUDICIAL

e-Stamp

Certificate No. IN-PY142840280929080 Certificate Issued Date 31-0ct-2016 10:35 AM Account Reference 1.MPACC (SH)/ pyshimp17/ PUDUCHERRY/ PY-PU 0 0 Unique Doc. Reference SUBIN-PYPYSHIMP17218496070637090 0 0 Purchased by V NARAYANASAMY 0 Description of Document Article 4 Affidavit Property Description NOMINATION FOR NELLITHOPE ASSEMBLY CONSTITUENCY Consideration Price (Rs.) 0 0 (Zero) 0 • 0 0 0 0 First Party V NARA Y ANASAMY a 0 • 0 Second Party RETURNING OFFICER 0 0 0 Stamp Duty Paid By V NARAYANASAMY 0 0 Stamp Duty Amount(Rs.) 20 (Twenty only)

- •• ------• •• ------••••··•••••• - •• - •• --- .Please write or type below this line- - •...• - •..•• - •.....- ...- . - ...•••- - . - • - - •• -•-

ADDITIONAL AFFIDAVIT TO BE SUBMITTED BY ,..'J',~~~IDATES ,,.,..--fJlllfll.e\\No.509/11/2004-.JS.I dated 3.2.2016)

us of checking the 1eg1timecy i~ on the users of the certificate. '"'5===::frl""ccia sG of ari y d!~crc p ancy please inform the Competent Authorlty. Election to Puducherry Legislative Assembly (Name of the House), from

17- Nellithope Assembly Constituency.

I,NARAYANASAMY, (Name of candidate), son/d.attghtm /wife of VELU, aged69years, resident of No.5, EllaiammanKoil St., Pondicherry, a candidate at the above election, do solemnly affirm and state on oath as under:­

(i) I have not been allotte any govt, accommodation at any time during the period of last 1 ears prior to the date of notification of the current election. OR

(ii) I have been allotted govt. accommodation at Government Guest House, New Delhi and Chennai (mention the address of the accommodation) during the period of last 10 years prior to the date of notification of the current election, and there are no arrears of any dues to be paid towards rent for the accommodation or any arrears to the agencies providing electricity, water and telephone at the said accommodation as on 30th September 2016(the date

should be the last day of the 3rd month prior to the month in which the election is announced) (iii) "No Dues Certificates" from the agencies concerned are attached hereto.

VERIFICATION

I, the deponent above named, do hereby verify and declare that the above statements are correct to the best of my knowledge, and no part of it, is false. Verified at Puducherry this the ...... "~..\ .'~ day of October 2016 \)v DEPONENT

SIGNED BEf ORE ME ~~\O\\~•

N.K.PERUMAL,B.A.. B.L. Notary Public 630, Bharathy Street, PUOUCHERRY • 605 001 PlJ DUCHERRY MUNCJPALfTY REVE NUE SECTION - l

No. 1948/PM./ROJ/A.4/2016-17 Dated ~ 13 , J 0 - 2..-0 /-b

To

Thiru. NAP~YANASAMY , S/ o. Velu, No. 5.. Ellaimman Koil Sreet.. Puducherty.

Sir,

Sub: PM - ROI- lssue o f No Arrear Certifica te for the candidate o f Puducherry Legislative Assembly Election - 2016-R eg .

Ref: Your Let ter dated. 03.10.2016

With refer ence to your fetter cited above on the subject mentioned above it is c2rtified that Thiru. NARAYANASAMY, S/o. Velu, has no any arrear of tax / p ci yment to this Puducherry upto the fi na ncial year of 2016-17.

This certificate is issued to produce before the Election Commission of India for the Nellithope constituency in conn ~ ct io n with t he Puducherrv Legislative

Assembl Election - 2016.

Note:- Certificate Fees Rs. 100/­

Receipt No. ~

Date , ) _3 l Q ' \.\l OULGARET MUNICIPALITY PUDUCHERRY-5

F.No.12-2/Rev/O.M/2016 Jawahar Nagar, dt. 3 _ le~ l

NO DUE CERTIFICATE

This is to certify that that Thiru/Tmt./Selvi Y. N.CA.."('O\.~l'Y\.J\..3a~ S/o./W/o/D/o \/.e__\\.\. residing at '4-~ · 5; ~.....9...~ ~ ~t\ &'r9Ur , ~~'<'1j _ \ has no due payable to . this Municipality as on date.

This Certificate is issued to the said individual on his / her request for the purpose of contesting the Bye Election to the Nellithope Legislative Assembly Constituency.

c.,3 1a lb. OFFICER REVEN OFFICER OUtGARET MUNICIPALITY PUDUCHERRY • 18$ 005. To ~~'-~ Thiru /Tmt. / Selvi. V - ~~~~ 2r'~--- Receipt No. 0\08~

Certificate Fee ~ . \oo&--

Date 3_...to .....-&A?U OFF/CJ:.' OF 1HE B-tHOUR COMUNE PANCH4Y.AT

No.31 i2016!BCP!Rev./Rl . the 6.10.20'16

CER11FlC4TE

C'erti:tied that Tluru. V. Narayanasamy. S/o. VeJu residing at o. o-. Etlaiamrnari Koil Street Puducherry-605 001 has no laxes due to this Commune Panchayat as on 06.10.2016

This certificate is issued to the individual on his reque t to contest as a candidate in the ensuing Assembly Election 2016~ Puducberry. ..

(G. SA~~IRAR1 . AN) co:rvuvnss ONER

To

Tiuru. V. Narayanasamy, S.'o. Velu No.OS, Ellaianunan KoiJ Street Puducherrv-605 001 . COMMUNE PANCHAYAT OFFICE ARIYANKUPPAM -PUDUCHERRY-7.

No. 20-2/2016-201 7I ACP/Rev Date:~ 3-l D ~41-b

CERTIFICATE

This is to certify that Thiru. V. Narayanasamy1 S/o. Velu residing at No. 5, Eff aiamman Koil Street, Puducherry has no due to this Commune Panchayat as on date.

This certificate is issued to the individual on his request to fiie nomination in the Puducheny Legislative Assembly Election 201 '6.

Rt. No. 84~-b Date : ~

To

Thiru. V. Narayanasamy, S/o. Velu No. 5, Ellaiamman Koil Street, Puducherry. No.F. ,l/:3 / VCP /20 1 6-17 / Re~ /NA C OFFICE OF THE COMMUNE PANCHAYA'f - :oOo:­ V'llLrnur, D ate ;- 's • \.O• 9--0L-b

NO ARREAR S C E R T I FICAT~

T his is w ce r ify U o Thiru / :i::..+i-t . V- NS..~ . 4Y4N8Sl.t.t¥1 . '.'f ,

S / o . . V~ L. .IJ ...... residing at.. !WJ .·, ~· e.t.1 .G\.hOM"~ . .1~l . .~~~

..~~~YYJ ··· · ·· · · ··· ··· ··

..a s :'\o D ues / Arrears to be pai d to this Co1 . u1:. c Panch H, <- d '- ~ ,.; on <1:1 1<'

Election 2016.

( D . A R U~l' / ~ 'C O IMISSIONER Ce rtificmc l'ec Rs .:. ~'S"J .

Recei p L \Ju .. ~ . 9:-. :8&a>.J .. .

Dme S-. :. \0 _. \.b . OFFICE · SSIONER NETTAPA PANCHAYAT

F.No. Dated : I 1/1 c/ Ib

This is to certify that Thiru/'Hftt.....V~ .. N . A . R. . Pr . Y,A-. NA-~f.} .r:0. ~ .. son / Wife of...... V.B.k-.V.. .. ·...... ·~·. ..residing at

N .o~ . s:, ... C. .~, .Ar.o. m.Rt.'-'L ...KC)l .k . .STu .~~f1 .•.• .P.uD.v..~ G: R RY .. -· .. ..b . c~ .. .. D.o.l...... _.,,, ...... has no arrear due to this Commune Panchayat as on date.

This Certificate is issued for the purpose of participating the Legislative Assembly By Elections in Puducherry State for the Year 2016.

Rt. No. 09\\1 ~ ~r,~ {A.MANOHAR) Dated: I '1· \G• \b Rs. 25 /- COMMISSIONER (f) 04 l'.3-2640 t61 MANNADIPET COMHVNE PANCHAYAT THIRUBUVANAI· PUDUCHERRY- 605 107·

No. /MCP/20 /- Dated, the

No. - 44-4_/MCP}Revenue}2016 Dated: 17.10.2016

NO DUES CERTIF1CATE

This Is to certify that Thlru.V.NARAYANASAMY4 residinq at No.S, Ellaiamman Koil Street. Puducherry has "NO DUES11 in this Commune Panchavat as on date. This Certificate is issued based on his request to contest In the Puducherry Leql5'ative Assembly Election 2016.• Puducherry.

(P.sEETHARAMAN) COMMISSIONER To Thiru. v. Naravanasamv No . 5, ENaiammcm koil street, Puducherry - 605 001

Kr- ::i.s , _ B; t\ ~ a ~ &7 7 g­

;::>qr..c,p\ l~ , 7 ,-t't> # ~ t--b OFFICE OF THE EXECUTIVE OFFICER (TEMPLES) KARAIKAL

N0:537/EO(T)/KKL/2016 DATE: 14-10-2016

TO WHOME SO EVER IT MAY CONCERN

This is to certify that Thiru.V.Narayanasamy residing at No,5, Ellaiamman Koil

Street, Puducherry has NO DUES as on date to the Temples under the jurisdiction of the undersigned. ~~)o

EXECUTIVE~ OFFICER (TEMPLES) 1 1 1 1 T• h• i~_::, ·•i~ ::, .,_. .,. """~ •r t1·fy t 11~t a , Thi.nu\/_ . ·_ TAR'.-"Y.~ rl.l"' ~ ..!\ - _,- . •· v''l__ ---.1'1-1'""r1 v. - , ._

( -, ·<=- c:,T 11S"- 1i . >1 - 0 p rl 1~11 <=- rry , ;o, - -. , _ "1~ ' F- ·~:: - · ~ -' ..... J Hr_ __ .._) _. "-':.. I...n• _ ,,• • - raga•1", Gu r·1·m:o.r\il v u ..... ; _ ...... :..1 . -- ... - ~ - - ""u''"nc' 1..... - .. ~ _ _ ....,,, ...... ,._ , _,..,, _...,.

en ~ 6. l 0 2015 ~\l.P'\.;:, ~\a\\0 ? lace: Pu j -:he1:y . PUBLIC RELA NS ASS~STANT GOVT. GUEST HOUSE 0?tL: 16.: 0.2Cl6 INDIRA NA.GAR PUDUCHERRY No. 35/GTH (U)/2016 GOVERNMENT TOURIST HOME UPPALAM, PUDUCHERRY. ***

NO DUE CERTIFICATE

This is to certify that Thiru. V. Narayanasamy, No.5. Ellaiamman Koil Street, Puducherry -1 has "No Dues" in Government Tourist Home, Uppalam, Puducherry as on 29.09.2016.

This certificate is issued to him for the purpose of Puducherry Legislative Assembly Election, Puducherry. ? 11: ,~ ~I rv', - = r (L.EZHUM-'ALAi ( r 8 MANAGER GOVERNMENT TOURIST HOME UPPALAM,PUDUCHERRY

Place: Puducherry.

Date: 29.09.2016.

Copy submitted to: The Director of Tourism, Puducherry. P D 'CJ-IERR't TOl ~ RI DE\ ELOP E Tl C R R 1 I PTDC ' LI 111~ I o3-lo-)h

/TA;.!:, ,\,? to C_ QM~ a-hat- ~ 6 O'V\ ~ J-M_WQ__ ~ ~ d~ ~ ~o°* h..oltb

rvo . S, ~ O/VV) ~ (<__.a ~ ~&:.I.A._~) p~ ~~~ ,_ bD5o~ f,

MANAGER _WATER, SPORTS CHUNNAMBAR

'lo·/ It-\i f2-Li . V · N R{LA y RN,?l ~ A l'V!)/,,

f'J 0 ,s;-,,, f:;~ OJM YYJ O/VJ KD ~ Sl/ r~L~V\/ - boS 00 I.

It I l - , GOVERNMENT OF PUDUCHERRY

TOURISM DEPARTMENT

No. 768/Tour/KKL/Election/16-17 Karaikal , dt. 07.10.16

NO DUES CERTIFICATE

It is certified that Thiru. V.Narayanasamy, S/o. Velu has no dues to be paid to this Dept. in respect of Room Rent. This certificate is issued for the purpose of by Election to the Puducherry . Legislative

Assembly , 2016 on his request.

(P,MUTHU)

NODAL OFFICER. No. 68-12/RAMJC4/2016 / '5:/- b GOVERNMENTOFPUDUCHERRY OFFICE OF THE REGIONAL ADMINISTRATOR *** Mahe, Dt: 07-10-2016

To

~ru. V. Narayanasamy, No. 5, Ellaiamrnan Koil Street, Puducherry - 605001.

Sir,

Sub:- O/o the RA Mahe - No Due Certificate - Reg.

Ref:- Lr. No. Nil dated 06-10-2016

*** With reference to the above, I am to inform you that, NO DUES are pending for recovery towards the occupation of Govt. Guest House/Tourist Home, Mahe.

Yo~~:r

(S. MANICKADEEPAN) REGIONAL ADMINISTRATOR MAHE PlTDUCHERRY TOURISM DEVELO MEN1' CORPORAT'ION LIMITED PTDC (A Government of Pu \1cherry Undertaking) Puducherry ,date: 30.09.2016

NO DUE CERTIFICATE

This is to certify that as on date there is no due at seagulls

Beach in the name of Thiru.V.Narayanasamy, No.5, Ellaiamman Koil

Street, Puducherry-605 001.

J.(\fl./\/\f\,/ ~ (M. SEZHIAN) MANAGER SEAGULLS BEACH

To Thiru. V.Narayanasamy, No.5, Ellaiamman Koil Street, Puducherry-605 001.

CIN : U55 109PY2005SGC0018 57 Regd.1Admn.Off !o.40, Gotf~rt:Al\lAktf,:il'#Q~..., &~liJ\N ag r, Puc!ucherry-605 0 1. South India Phone · Admn. Off : '1J l-0413-23 353'7"C2 IT3~'.f'"To"urnffl''M fonnation · 9 -0413-2339497, 2226744 Fax : 91 -04 13-23%444 e-mail : [email protected] Gt ._ RNMENT OF PUDUCHERRY OFFICE OF THE RESIDENT COMMISSIONER PUDUCHERRY HOUSE, NEW DELHI roroOC\6<:\6

No.ARC/PH-ND/2016-17/ SI5 Date: 07.10.2016

To

Shri V. Narayanasamy Hon'ble Chief Minister Government of Puducherry No.5, Ellaiaman Kail Street Puducherry 605 001

Sub No Due Certificate- Reg . Ref: Letter dated 01 .10.2016.

Sir, With reference to your letter dated 07.10.2016, it is informed that no dues are outstanding against you to be settled in respect of this Guest House, as per our records.

Yours faithfully, ~ (K. K. SINGH) Addi. Resident Commissioner 11R?1. ~ f.'rrrr1 ~a/ Bharat Sahchar Nigam Limited (l'fRrr ei?.ct>li inT "3i\~)/ (A Government oflndia Enterprise) !JJ )l)1 BS#lli\li ~ · t5t Cf51t!1 fc:;<{\>1 > ~tl 605 001. f.;ii111~ ' ' ~.I! · Office of the General Manager, Puducherry - 605 001.

·AO (TRA) PY NO Dues I 2015-16/ .R.1 Dated @Pondicherry the 07-10-2016

CERTIFICATE

TO WHOM SO EVER IT MAY BE CONCEI_lN This· is to certify that there is no due in the name of

Sri. V. Narayanasamy residing at 5, Ellamman Koil Street, Puducherry605001.This is issued for the purpose of contesting Legislative Assembly Election.

( ~~\~h-- Pondicherry. ACCOUNTS OFFICER [TR), 07-10-16 010 GM, BSNL, I ~ ! ~~, . t>UDUCffi:RRY - 605 001

,. · '­ No.2684 /PW/PHD/JA.O/REV/2016 GOVERNMENT OF PUDUCHERRY PUBLIC WORKS DEPARTME T PUBLIC HEALTH DI ISIO -000-

NO DUE CERTIFICATE

E!la1amman Koil Street Puctucherry rias no uJes of ~r:a er ax upto 3rd

Quarter 2016 (L e. fro 11 July to September ~O 6) in re ..pe ~ of Po'i..:y

.-Jo.46T' Code No.23i102 vida rece:o 1 '.o . O~ 473'5 d::~:::c 20:101201 f\ or • ,.., _ ' 01 "'~ . : ·-

co ..es. i ~e .\sse,..r:b!y E'.ect!or. 2016.

M· a .~. JUNIOR ACCOU TS OFFICER (REV.\ PUBll, HEAl TH DIVISION P.W.D., PUOUCHERRY.

'-../' 1 .,: V "~~ra -1a n a·-a ny; . "' I ' No : EUaiamman KnH Str-=~t P1 1du·-·hern1 I '\o.• ... • • i ;. l\Jo. ~;{ ~ 6 /PW/EE/BRC/DB/DBII/2016 GOVERNMENT OF PUDUCHERRY PUBLIC WORKS DEPARTMENT BUILDINGS & ROADS (CENTRAL) DIVISION PUDUCHERRY -ooo-

Puducherry, the 07.10.2016

NO DUE CERTIFICATE

This is to certify that Thiru V. Narayanasamy residing at No.5,

Ellaiamman Koil Street, Puducherry-605 001 has no dues in respect of

Government Accommodation.

This certificate is issued on the request of the individual in order to contest in the Assembly Election 2016.

NGINEER (Central) Division

To

Thiru V. Narayanasamy, No.S, Ellaiamman Kail Street, Puducherry-605 001. o.0700105/ED/Rev.l/S.l/U3/2016 GOVERNMENT OF PUDUCHERRY ELECTR ICITY DEPARTMENT -oOo-

Puducherry, the / - 1o ~ -

CERTIFICATE

This is to certify that Thiru. V Narayanasamy, No.5, Ellaimman koil street, Puducherry, has cfeared the C. C. Charges upto August 2016 in respect of Policy Nos.02-07-01-0105/A2,02-07..0 -01058/A2, 02-07-01-0105CJA2 and 02-07-01-0105D/A2 existing in the name of

Th. . Ir' !. r_Narayanasamy, No. 5, E!laimmankoil Street1 Puducherry. The e 3re no dues pend"ng to be settled in respect of the abo e mentioned policies upto .6.ugust 201: 1vh1ch is for tre purpose of puducherry Legislative Assembly Electiori, Puducherry. ~\o JUNIOR ACCO~~S OFFICER t REVENUE-~)

To

Thiru. V. f\Jarayanasarny)

No 5, Ellaimmankoil street,

Puducherry. o.070105/ED/Rev.l/S.l/U3/2016 GOVERNMENT OF PUDUCHERRY ELECTRICITY DEPARTMENT -oOo-

P ducherry, the 01 - r o - 2. o lb

CERTIFICATE

Th:s is to certify that Thiru. V. Narayanasamy, No.5, Ellaimman ..o:I street; Puducherry, has cleared the C.C charges upto claim of Septe:i 1ber 2016 in respect of Po icy Nos.02-07-01-0105/A2,02-07­ Ll1-0 5B/A2, 02..07 - -0105C/A2 a d 02-07-01-0105D/A2 existing

L th narr.i? o Thiru. V .. arayana_amy, . J..... 5, Ellaiamman koil Street

PL:!1..1_' .e 1 y. There are no dues e din to be settled in respect of tl;e 3bove mentioned policies for the claim upto Sept._mber 2016 ," hich is f r the pur .ose of pudu"'herr\ Legislati e Assembly Election,

P1 au herry. ~\~ JU JOR ACCOUI TS OFFICER · (REVEN E-1)

T I

Thi. u. '/. 1 Jarayanasamy,

o .~.... , C:I_, ,a1amman. k·01 . , st.ree ,

P ... ducherry. 6 5001 ~1uf\;q ~ PARLIAMENT OF INDIA ~ ~~ fifT:4ctlcl~ RAJYA SABHA SECRETARIAT ~~,~~ . Parliament HouselAnnexe, ~ ~ - 11 00 01 New Delhi-110001 ~ http //rajyasabhahindi.nic.in Webs ite : http://rajyasabha.nic.m ;-irn E-mail : ~ Fax : ~ Telephone :

NO.RS. 49/2016-17 MSA Dated the 23rd September, 2016

NO DUES CERTIFICATE

This is to certify that as per records of this Secretariat and the information furni shed by the allied agencies, nothing is due against Shri V . Narayanasamy, Ex. Member Rajya Sabha as on date. Shri V. Narayanasamy retired from the Raj ya Sabha on 06.10.2009.

.., (S.C. DIX T) JOINT DIRECTOR Tel.: 23034540 SECRETARIAT

(MSA BRANCH)

Telegrams :LOK SAB HA, NEW DELHI PARLIAMENT HOUSE A NEXE, FAX:2301 0756/23017167 ~JEW DELHI - ·110 001

No.: 150543/15-LS/MSA/LSS/2016-20"17 Dated : 23/09/2016

TO WHOM SO EVER IT MAY CONCERN * * * * *

This 1s to certify that "No Dues" are outstanding against V. Narayanasamy, MP (15 Lok Sabha), I. C.No. 15054 3 as per the information received from the various Branches of Lok Sabha Secretariat and other allied agencies like MTNUBSNL, NDMC and Directorate of Estates as on 2310912016 . ~~"1~ Executive Officer Lok Sabha Secretariat New Delhi GOVERNME NT OF PUD UCHERRY OFFIC E OF THE REGIONAL ADMINISTRATOR (TOURISM UNIT) * * * No.137/RAY/A1/Tourism/2016 {u\~~ Yanam, dated 07-10-2016

NO DUES CE RTIFICAT E

This is to certify that Thiru V.Narayanasamy, Hon'ble Chief

Minister, No.5, Ellaiamman Koil Street, Puducherry is not having any

dues to the Government Guest House running by Tourism Department at Yanam.

This certificate has been iss ued to the applicant with reference to his application dated 06.10.2016 in order to enclose the same along with his nomination papers for ensuing bye elections.

£.---. '""-=-...__....""'--'..._-:,-=:t(c9­ (D. SU BRAMAN I ESWARAO) REGIONAL ADMINISTRATOR YANAM

To Thiru V.Narayanasamy, Hon'ble Chief Minister, No.5, Ellaiamman Koil Street, Puducherry. GOVERNMENT OF OFFICE PUDUCHERRY ***

No.3734/TOP/A/NOC/2016 Puducherry, the 06.10.2016

NO ARREARS CERTIFICATE

Certified that Thiru. V. Narayanasamy S/o Velu residing at No.5, Ellaiamman Koil Street, Puducherry has No ARREARS of Land tax in respect of this Puducherry Taluk limit.

~. 6b . t,.O. u, (J. DAYALAN .) TAHSILDAR Place: Puducherry DAY 1 E T 4$ LOAR Date: 06.10.2016 oc:'FICE PUDUCHERRY NIOlORIAL CERTIFICATE

Be it known and made manifest (unto all people), that on 31st day of October two thousand and Sixteen at Pondicherry. I, N.K. PERUMAL, Notary appointed by the Government of

Pondicherry to practice in Pondicherry State of Pondicherry duly authoriz c:~ d admitted and sworn subject to the provisions of the Notaries Rule 8(5) do hereby certify that; Deponent personally appeared before me is known to be the perso descl""ibed in the Indemnity Bond as Mr. V. NARAYANASA.MY. Deponent and he deposed in my presence and signed his after knowing the contents of this Indemnity Bond, having been read over and

E~ xp lained to the deponent who seemed perfectly in understand it or acknowledged that he signed the same at freewill. This instrument is intended to take effect within Pondicherry. NOTORIAl REGISTE:R BOOK: - VOLUME·V, PAGE No.16, SERIAL No.88, IN TESTIMONY WHEREOF I have hereunto set my hand and seal of office at Pondicherry on :31st day of October 2016.

#Y N.K.PERUMAL,B.A. B.L. Notilry Public . 530, Bharathy Street PUOUCHERRY - 605 001