eeordrSaSS'errnsrstvr flX qfil > -fArJL$*"- s.r. t.)4KlD tls t' "$1 * t"'t^-L.o'r'-^r Y-'"'r Ilffi"#fif-., Lc--{>r^'-r-r{

6 FORM 26 F BEFORE THE RETURNING OFFICER FOR ELECTION TO LEGISLATIVE ASSEMBLY OF ANDHRA PRADESH FROM 114 OF MADHIRA ASSEMBLY CONSTITUENCY H AFFIDAVIT

E I, LINGALA KAMAL RAJU, S/o. Gnanalah,Age: 37 yea-rs,Occu: Social service, R/o, Madhira (V&M), District, presently residing at Bodepudi Bhavan f, (Cpt (M) Division Office), Madhira of , ,candidate to the above election, do hereby solemnly affirm and state on oath as follows:- il " 1. That I am the listed accused of offences punishable with imprisonment for two years or more in a pending case(s) in which a charge (s) has/ have been framed by ' the court(s) of competent jurisdiction.

Case in Cr. {FIR)No. 33/2007 P,S. , Khammam District, A.P. State. ., Section of Law L43, 34I, 447,353 R/w. L49 IPC and Sec. 7 (1) of Criminal 'l'-J," Law Amendment Act, 1932. Shof-l.description of offences ... l Assembly, 2) Wrongful restraining of person, 3) r oCrfminal trespass, 4) Assault use of criminal force against public servant while . <,t * .

anaf,av !fr'''

/

./! il. i) Case in Cr. (FIR) No.6412007 ' / 'in) P.S.Madhira Rural , Khammam District, A.P. State. iii) Section of Law 143, L47, L88, 447 R/w. 149 IPC and Sec. 4 & 5 of Urban Land Grabbing Act.

1) Alleged member in unlawful Assembly, 2) Wrongful restraining of person, 3) Disobediance of orders to an order lawfully promulgated by the public servant, if such disobedience caused obstruction annoyance or injuries to the person lawfully employed", 4) Criminal trespassing 5) Sec. 4 & 5 of Urban Land Grabbing about public property.

Stage of the cases : Both cases are pending charges not framed. No competent court was staYed the above cases

2. I have not been convicted of any offence (other than any offences) referred to in sub-section (1) or sub-section (21,or covered in sub-section (3) of section 8 of the Representation'oithe PeoplesAct, iOSt 1+Sof 1951) and serttencedto imprisonment for.one year or more.

Khammam, Date: 24-O3-2OO9 NENT Verification : I, the above named deponent verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief; no part of it is false and nothing material has been concealed there from. Verified at Khamlnam on this t'ne 24th day of March, 2OO9.

.,f ' ""lt u-; I ANNEXURE - I

BEFORE THE RETURNING OFFICER FOR ELECTION TO I,ECTSLATIVEASSEMBLY . OF ANDHRA PRADESH FROM 114 MADHIRA ASSEMBLY CONSTITUENCY

AFFIDAVIT

I, LINGALA KAMAL RAJU, S/o. Gnanaiah, Age:37 years, Occu: Social service, R/o. Madhira (V&M), Khammam District, presently residing at Bodepudi Bhavan (CPI (M) Division Office), Madhira of Khammam District, candidate to the above election, do hereby solemnly affirm and state on oath as follows:-

1. That the following case is pending against me in which cognizarrce has been taken by the court.

i) Section of the Act and description of the No cognizance taken offence for which cognizance taken

ii)The court which has taken cognizartce No cognizance taken

iii) Case No. Cr. No. 33l2OO7 and, Cr. No. 64l2OOT

iv) Date of order of the court taking Not taken cognizance cognizance

v) Details of appeal(s)/applications (s) for Nil revision, etc., if any, filed against above order taking cognizance

Khammam, Date: 24-O3-2OO9

Verification : I, the above named deponent veriSr and declare that the contents of this affidavit are true and correct to the best of my lcrowled{e and belief; no part of it is false and nothing material has been concealed there from. Verified at Khammam on this the 24tt'day of March, 2OO9. '| rsd6'srr*rvtvr ANDHRAPRADESH -r--- Y 204 12 F-.ttiil4-.s . t, (h1 F='^-'^^-^.4-Lys^Jc",'-^ 4-- /4-l t"t'-*p II ,\7 C1'-' Ed. Ffi $' Ta. sl--4.*Lp^ Ld'"=-^ "l 1tt*m Vmdw, ,hennlr." c,:b

H BEFORE THE RETURNING OFFICER FOR ELECTION TO LEGISLATIVE ASSEMBLY OF ANDHRA PRADESH FROM 115 OF WYRA ASSEMBLY CONSTITUENCY H I, LINGALA KAMAL RAJU, S/o. Gnanaiah, Age: 37 years, Occu: Social service, R/o. Madhira (V&M), Khammam District, presenfly residing at Bodepudi Bhavan *n (CPI (M) Division Office), Madhira of Khammam District, candidate to the above * election, do hereby solemnly afnrm and state on oath as follows:- H That I give herein below the details of the assets (movable, immovable, Bank E balance, etc) of myself and my spouse and my dependents. r

A. DETAILS OF MOVABLE ASSETS

$ (R"".ts in joint name indicating the extent of joint ownership will also have to be given)

sl. Description Self Spouse Dependent Dependent Dependent No. Name L. No.1 No.2 No.3 Vasantha Abhuday Abhignya Rani (Govt. Teacher) 1. Cash 1000 10000 2. Deposits in Rs. 543/- Rs. 10000 Bank & in Andhra in SBH Financial Bank Wyra Madhira Alc.11325 A/c. Institutions and 62003605650 non Banking financial companies 3. Bonds, Debentures & shares in companies 4. Other financial Each Rs. 100000 instruments, Rs.50OOO of LIC policy NSS, Postal two savings, LIC polices in policies, etc LIC 5. Motor vehicles (details of make, etc) 6. Jewelery (give 4 Grms 80 grams detals of weight worth of worth and value) Rs.5,000 around Rs.rooooo 7. Other assets, such as values of claims/ interest

Note: Value of Bonds/ shares/ debentures as per the latest market value in Stock Exchange in respect of listed companies and as per books in the case of non listed companies should be given.

Dependent here means a person substantially dependents on the income of the candidate.

(Note: Properties joint in name indicating the extent ofjoint ownership will also have to be indicated)

si. Description Self Spouse Dependent Dependent Dependent No. Name L. No.1 No.2 No.3 Vasantha Abhuday Abhignya Gnanaiah Rani (Govt. (son) (daughter) (father) Teacher) 1. Agriculture land Ac.1.01Gts locations - in Sy.No. Sy.No.-Extent 227, (total Ac.O.23Gts measurement)- in Sy. 231 Current market Ac.O.15Gts value in 5y.232 Ac.0.32 Gts in Sy.239

,n\ ''4

total extent of Ac.2.32Gt situated at Musalanadugu { (V)wyra (M), Khmmam Dt 2. Non agriculture 240 Sq.yds 120 Sq.yds land locations - plot No250 5y.492/A, Sy.No.-Extent Sy.88/A, at Velugu- (total BB/A2 at Matla, KMM Somavaram, Urban, measurement)- Wyra, KMM KMM Dt. Current market Dt. value

3. Buildings (comm. & resid) locations - Sy.No./D.No- Fxtent (total measurement)- Current rnarket value 4. House - Apartment, etc locations - Sy.No.-Extent (total measurement)- Current narket value 5. Others (such as lntefest ln orooertvl

I

3. I give herein below the details of my liabilities/ overdue to public financial institutions and Government dues:- (Note: Please give separate details for each item).

5i, a.narage ;t,,'r.,{.rB.L t:i.,'?f Advoce: Y -t.No: lt-3-ii i -, -- ,.r,i.r,-y,r, K H A ivli,l i;t".-5i.1? iift t Description Name & Address of Amount outstanding Bank/Financial institutes/ De Loans from Banks ii) Loans fro iii) Govt. due a) Dues to Dept. d;alfig *ith Govt"

blDues to Oept. aeatG[with suootv of water.

ot1)^luestooe@ electricitv. !).Qu9s to Dept.aeattng with Telephones. e) Dues to Dept. dealing with Covf including ::a.lsport Aircrafts & rreI1COpters Other dues if an1.. Name & Address oJ

institutes/ Dept. i) Income tax@ (Also indicate the assessment vear upto which income tax return filed. Given also permanent account ii; Whetfr@ assessment year upto which Wealth tax return filed. iii) Sales tarffi

iv) Property tax

My educational qualifications are as under:_

M.A. from Osmania University, .

Khammam. Date: 24-O3-2OOT ,";:|ffi*,1_'j^,.1:,:pi. T-ed deponentverify and declar.fr.,',V::tJtlents .:r of l$;gi:;,#;:::. j:1 _.,:1'.::,,:,1" * i ;i_; _#-; a# "'[T :,lfi ff ?.ff ;i on this t]ne O4-tu,-l^-, ^rrtr^---1- #ilil on this the 24ta day of March, 2OOg. tLT'i!'i"L%'#L'#

K- \-. LltfNed1 5'q Y.C.Printers & Binders'@: 228666 0L?'utrnA offlceor theTahsrrqar I -^. I U D.Dis.trto. f f ?b I I lffii I ANNEXUR,E r: ttf FORMOF CASTECERTTFICATE

Thisis certifythat claim of Sri*6t.llsdnr !---=.--1 Sorr/ Daughterof €.- ofVillage / Town Date Mandal ih the on thestate has been"Verified as perthe precedure laid down anO neisfre betongs to the - Ca'ste/TriUe / Gommuntywhich is recognised as a ScheduledCaste / SceeduledTribe i fiabld,brdclass under.

...". The Constirution (Scheduled Caste) Ordet I 950 .....TheConstirution.(Scheduled Tribe) Order 1950

G.O.Ms. 1973 Education Dated 29-9-1970 as amehdedfrom time to time ( Amendedby ) theschedule Caste and schedule tribes lists ( Modificationorders 1856the scheduled caste and scheduled tribes order ( AmendmentAct. 1976.

2. Sri/ Smt/ Kumari and his/ her familyordinarily reside in village/ District/ Division of theState A'p

of ------.>

Plaee

Seal: lForm'A'

Communicationwith Regardto Authorised PersonsTo Intimate Namesof Candidatesset up By RecognisedNATIONAL oR STATE Political Party or REGISTEREDUNRECOGNISED Politicat Party

(SeePara 13(c),(d) and (e) of the Election Symbols (Reservationand Allotment) Order, 1963) To,

State/UnionTerritory 'Ihe 2. Returni+gOfficer for the .....111*c[\,r]r+. C9.q). ....constituency g{olrt* 4&5*'4m Subject: General/b Elections," t-o?i @ Territory) - Allotment of Symbols- Authorisaticinof personsto intimatdnamesof candidates

Sir,

In pursuanceof paragraph13 (c), (d) and (e) of the Election symbols (Reservation and Allotment) Order, 1968,I hereby communicate that the firllowing person(s) has/have beenauthorisedbytheParty,whichisaNationalparty/@ /registered unrecognised to intimate the names of the candidates proposedto be set up by the Party at the elections cited above:

Name of the person Name of the offrce held in District(s/areas,Constituen authorisedto sendnotice the Partv cylConstituenciesin respect of which he has been authorised

I 2 J l. B'v. QAG't+sVu t-u S<-oJbr'g P-k; A'"oltY#. Cf .}CIt SCG"'-tC* 2. Uai""

J, 4. The specimensignatures of the above mentioned person(s) so authorised are given'- below:

1. SpecimenSignatures ofshri A. V, R #&r+ffi V U L \] o ,,> KK4L--*J* ,,u,,

2. Specimensignatures of Shri

(i) (iii)

a J. Specimensignatures of Shri

(i) (iiit

Yours faithfully 4//^il GeneralSecretary Parryofhdia (tda$ist) Place: Ner^l Dl-flj Date: > 4 -o3-zool

N.B.

1' This must be deliveredto the ReturningOffrcer unCrt. Chief ElectoralOfficer not Iaterthan 3 p.m. on the lastdate for makingnominations. 2. Form must be signedin ink by the offrce bearer(s)mentioned above. No facsimile signatureor signatureby meansof rubberstamp, itc., of any offrce bearershall be accepted. 3. No form transmittedby fax shallbe accepted. I Insertedby NotificationNo. 56lVTlJudl-III,dated ts.tl.Igg:. ' FORMB NOTICEAS TO NAME OF CANDIDATE SET UP BY THEPOLMCAL PARTY

fseeporogrrophslilb)'(c]md(eJqdl3Aofthd^ElectiulSymbols fl?eserwflon qtd NlotmqttJ Order 19681

of the ConstituencY)in

Slr, (Reservorionond Allotment)- Inpursuonce of porogrophsr 3 (b),(c) ond (e)o# r 3,Aof the,Efffion svrnbors 6hD^d"}a Q{s'0a<','-It) order,l e6B,I herebygtve nolice on o"nor bi.furncnurnl.$:.'fo{ ip"ng (2) (4) is the opproved thot the personwhose porlculors ore furnlshedIn columns to betow condidote of the porty obove nomed, ond (5) lsthe subst'rMecondldcrte (ii) the personwrp6e porlculors ore mentioned ln columns tq7) bebw on scrutiny porty,wrrowlllstepln on the opprcn@ condHote's nomlnqtion belng re|ected condidqte, "tnor on hiswithdrcnMng t,,om trre contest, lf ttre zubafittrteeondldote- is sfilio contesling ottheensuinggenero|/byee|ect|onfrorn|hlsconslituency: Fatheld Postal Nameof the Nareoftp Fathe/s/ Postal l'lameof the subdih*e Mdressof approvecl Mother's/ addressof candidatewho will tvbthe/d ConstituencY substibte Candidate Husband's approted stepinon the Husband's l.lameof candidate approrydcandidate's Nameof Candidate .substitute appmved nominationbeing' candidate rsiededon scntinY candidate or on his'withdrawing fromthe contest if substiMecandidate is stilla contestingcandidate

U:"qa}.a C-Plcil KoI^h D\\ASon Dvitiuv) Ki'*"I dlst*., dth'c! Rtu N\oail t

1 lnser@ W Nottftqtlon No' ftP7 lJtfit-lll, dr:/ed I 5'12'1 997 I

l3 'B' *2. Ihe notice in Form gMeneorlier in fovourof Shrilsmt/Sushrl.,. ,,..,,,,.osporty's opprovedcondirJote/Shr/Smt/Su$d ...osPorty's subst'ttute condidote is herebyrescinded. r3. It iscerlified thot eoch of the condidoteswhose nome ls.mentionedobove is o member of this polificolporty ond hisnome isduly borneon tlre rollsof members of thisporty'

YoursfoithfulM fVl?Hk--L (Nomeond $gfrotureof the f::-\ch Aufhorlseclperson of the PortY) \ :i tut ii v Q#6tfAvu Cn\ ?u, ;i itt (Seolofthe Porty) 9"gdry rb;;;oi A

*Scoreotf.fnoacppf;oOb

il.8. l, Ihb nr16 be de*reed b fhe nena;*rgOmcer rpt ktlerftst 3 p.rn. an fhe bst doF for nt€ffitg nqnhoflorg Fom rnu$bedgrpd h mbyheo@becrertslntenllOned6oP. rv.r*foc$mlledgnofureoI SlgnoturebVmeqrs of rubberstqrnp.,etc., of orryofficebeorer$to$ be qccepted. 3, Noform tronsmltted bYfox shollbe occepted' 4, poro2 of the Fonhmust be scoredoff, lf notoppllcoble, or mustbe properlyfllled, if opplicoble'

t4 $1do 1$;trao dcr gSBg $$'rF.iP (ry6d o'a5ot1odctzg (J) $06;6o) (o'$ a'$$bq5SoJCIS $sq cadE$dcOSsb 6o0ro6')

*(do rr$ts6 epors...(ftO5;,.*.K.r#-.gS8p abi bd a$$ boireg)d eo'sl dg S+oo6os.rep{$Br qr66 S$ oQ$$oo$ $So3eC1'$r5}C1 ...... er$;!$0,a$$o o.5o'{bo,t$ aarSofio SOfl6odr$C, +166dd$ $6garIuer501,$pS56So s$6erS0 d$S tl0cr $Srmo SQilJXD'565S{ Qr655ompog dQ;r1$0.

2ooq iro$636oat%$"loXf Sgas ($Ioc$o)er$ A*-3o (pd6o) ef $IogoddSP 600) g!5roo O/ gS'&.....g;s.q.O,.m..oi.,..-.9..0..F.*.....,...... i...... ndr ;r da'6. sdgc{ QY655ongssg Sa6.

.-{,-,sgqa}r{rl .1 (e$spsg$o65ol R.o (116, ft'e, $"F.)

*sEo*c o.cc sS dc$o6. d$DCg:- €{ SSyp bfgs) erdgQo$eofl;:odS, cPGi eeovd a;r&d$o cso6doltO. To The ReturningOfficer, ! 14-Madhi ra(SC) Assem bty Constituency SpecialDep&ty Collector, KinnerasaniProject/Indhira Sagar project, (Polavaram)Project, Unit-I, . Sir,

My nameshould be appeared/writtenin ballotpaper as mentionedbelow:

TELUGU: ( S"rc-lst aQ . e90 n.le)

ENGLTSH: K}tY) ftl*-t'4efr1' L-lN qq tO

(SignatU rdrOf/ the Coritestin g Cand idate)

Name of the Candidate:: L , lLf.mcuoL 45t-l

Party affiliation :: C P t (n l ORIGINAL/DUPLICATE (Originalto be keptwith riominritionpaper and Duplicateto be handedover to candidate)

CHECK LIST OF DOCUMENTS IN CONNECTION WITH FILING OFNOMINATION

NAME OF THE CONSTITUENCY : 114-Madhira(SC) Assembly Constituency

NAME OF THE CANDIDATE : KAMAL.A RA\iTUL\NffiIA DArEAND rIME oF FILING NoMTNATIoN pApERzt-gtKtr.@ tf&,. L Se p^tv, SL.NO.OF NOMINATIONPAPER : c1--

Sl.No Documents Whetherfi led-(writeyes/no) 1 Affidavit in Eform-26 YE9 2 Affidavit as per the Commission'sorder dated 27-3',-2003 \3s , Certifiedextract of electoralroll (whencandidate J is an electorofa differenceconstituencv). Form-A andB (applicablein the caseof 4 candidatesset up by political parties) Yss Copy of casteCertificate (if the candidateclaims 5 to belongto SC/ST) eGs, 6 Oath/affi rmation (whether taken) \Gs.

The followine documentswhich have not been filed should be filed-as indicated below:

Received.

(Signature of candidate) RO / ARO (Signature)

Conti. I 1*FORM-zB

(sEE RULE4) NOMINATIONPAPER

Electionto the LegisrativeAssembry of .A.ru.u..u.Ra....pR.h.D.Es.H state. STR/KE OFF PARTI OR PARTII BELOW WHICHEVERIS NOT APPLICABLE PARTI

Date...2*5.. ;.8...=... 2-o.o.3

I

Part No for We declare thatwe are electorsof\ the electoralroll for this n...rrOf,i signaturesbelow in token "irJ'n..r,Li 1" Substitutedby NotificationNo. SO OOSfEl,\ 9:8.1996. PARTICULARSOF THEPROPOSERS AND THEIRS/GNATURES FliiiN

N.B.:There should be ten electors of constituencyas proposers' . PARTIIi nominatiot l, thecandidate mentioned in Partl/Pa*t['(Strike out which is not applicable)assent to this and herebydeclare- (a)that I havecompleted.. 3 7 C:thiVt1.'.S.+-rr.gr)yearsof age; [srR/KE OUr b0 OR b(ii)BELOW WHICHEVER /S NOTAPPLTCABLE] whichis (b) (i) thatI am setup at thiselection by the...... C..r.P.:...\,..(fr). .party, recognizedNaiional Party/State Party in this Stateand that the symbolreserved for the abovePartY be allottedto me. (ii) thatI am setr\at thiselection by the...... party,which is a registered unrecogniseap\ica! party/thatI am contestingthis election as an independent candidate (Strikeout which is notappticable) andthat the symbol\ havechosen, in orderof preference,are:-

(c) thatmy nameand my father's/mother's/husband'sname have been correctly spelt out above in. ..Err{.G,L\. 5..\{,... (name of the Iang uage) for being (d) thatto the bestof my knowledgeand belief,I am qualifiedand not alsodisqualified chosento fillthe seatin the LegislativeAssembly of thisstate. *l furtherdeclare that I am a memberof ***caJeltribe which is a scheduled of the Stateof...... A,.p...

I also declarethat I have not been,and shail ***nnominated not be, as a candidateat the present general',eIection rthe-bve-eleetiens being held simultaneousry,to the LegislativeAssembly of

Date.... 2.5 .:...i..:....L.9.91 *Score ndldate ouf iirisparagraph, if not applicable. **Score out the Words not applicable. N'B': A "recognizedpolitical party" means a political party recognizedby ,the€lection cornmission underthe Flectionsymbols (Reservation andAllotment) orjer, 196gin the Stateconcerned.

PARTIII A (Tobe fiiledby the candidate) Whetherthe Candidate - (i) hr::;been convicted _ !r, of anyoffence(s) under sub_section (1); or (b) For contraventionof any taw speciRelOin Sub-Section (Z), / , of Section b of tfi; F/No. Representationof the peopleAct, I 1951 Ai " of 1951);or (ii) ha: beenconvicted for any other offence(s) for which he.i;as been sentenced to imprisonmentiol.t*o ye"rs or tlore. ' lf ine ,,yes', i:lnsweris , thetcandidateshall furnish the foltcwing information: (i) Case/Firstinformation report No./Nos (iil Policestation (s) ...... -*-*----'-'-'--"------= - -- District(s) state(s)...... Section(s)of the coniernedAct(s) and brief descriptionof the offence(s)for w'hich he has beenconvicted Date(s)of conviction(s) Court(s)which convicted the candidate Punishment(s) imposed l'.rdicate period of rmprtsonment(s)and/or quantum of find(s)l Date(s)of releasefrom prison - Was/wereany appeal(s)/revision(s)filed against YeyN6*- aboveconviction(s) l ,_ Dateand partieulars bf appeal(s)/application(s) for revisionfiled of.the |"T: court(s)before which the appeal(s) /application(s) for revision filed *l furtherdeclare that I am a member ***caje/tdb€ t#.::15..,,.S)...... Caste/tsbewhich is a scheduled of thestate "f of...... A,.p... .inreration 1e -ar[--1s1ea) inthat state. I also declarethat I have not been,and ****nominated shail not be, as a candidateat the present n"nfl?,oerection.]Tjr*bdry beingherd simurtaneousry,to the LegisrativeAssembly of

Date.... 25 .:--.8..:....Lp.9.t *Score of andidate oui ii:is **Score \/ ,rrurr"On, if not applicabte. out theWords not appticable. 'recognized N'B': A politicalparty" means political a party recognizedby ,the€lection commjssion underthe Electionsymbols (Reservation andAllotment) order, 1g6gin the stateconcerned.

PARTIII A (Tobe fiiledby the candidate) Whethe'rhe Candidate - (i) h;::-been convicted _ \", of anyoffence(s) under sub-section (1); or (b.r For contraventionof any taw specifidOin Sub-Section (2), / of Section b of th; E/No. Representationof the peopleAct, 1gS1(4i " of 1951);or (ii) ha beenconvicted for any other offence(s) for which he :,asbeen sentenced to imprisonmentior twoyurra orrnore. ' ,,yes,' lf :^eflnswer is , thecandidate shall furnish the fo;.:wing information: (i) Case/Firstinformation report No.iNos (iil Policestation (s) .....,...... District(s) State(s) Section(s)of the concernedAct(s) and brief descriptionof the offence(s)for whichhe has beenconvicted Date(s)of conviction(s) Court(s)which convicted the candidate Punishment(s) impgsed l'.rdicate period of rmpnsonment(s)and{or quantum of find(s)l Date(s)of releasefrom prison Was/werea.ny appea'l(s)/revision(s) filed against YetNd-- aboveconviction(s) I \* pate and particularsbf appeat(s)/apptication(s) for revisionfiled of.the |"T: court(s)before which the appeal(s) /application(s) for revision filed qpp,lidatidn' Whetherthe said appeal(s)-/ 1s;.'islarefor revision"haslhave been disposddof or .Yta pending lf the said appeal(s)/application(s)for revision haslhavebeen disPosed of a Date(s)of disPosal b Natureof orde(s) Passed' '.

Place ..--f.-{rA--D--\)\RA----,------o*: z.s-=.-3-=--2.o-e.E-.----..-.-.--.------:

PARTIV

(Tobe filledby the ReturningOfficer)

. Thisnomination was seriarNo. of nominationpaper...... O ....., deliveredtogle at myoffice at.....fu:Le..R1$.....(trour) on..9..*.$.:'4.-@afe) by the r'/ candidate/p+epo'ser .LS.<.3.-.e.1.. RetD?r[nseftnbfzs\r\, Date 1 *Scoreouf the word not applicable.

PARTV Decisionof ReturningOfficer Accepting or Rejectingthe NominationPaper I haveexamined this nomination paper in accordancewith section 36 of theRepresentation of thePeople Act, 1951 and decide as follows:

['\ cf o ReturningOfficer \ Perforation)...... \ .l ,: l

I l. I FORM26 (SEERULE 44)

Affidavit to be furnished by the candidate before the Returning Officer for election to AgJ'Eni..B.L)'..(hameof the House) from.tl4.hAs$tRAConstituencylname of the constituency)

l,l(.Am.A.LA.RATU..Lrnr.6sl.oson/da$qhter+Arifeqf ..G.N.a.NA.r.a.L.l..., aged about 37.years, resident of .ll.'sl.e.'.).)-:.53r.F.r*uu.r.r.acandidate at the abbveelection, do herebysolemnly affirm/state on oath '"ol';t/aeaet ?] accusedof any offence(s)punishabte with imprisonment)o,t*o yearsor morein a pendingcase(s) in which a charge(s)has/have been framed by the court(s)of competent jurisdiction.

lf the depo.nenfis accusedof any suahaffence(s) he shaltfurnish the foltowinginformation: (i) CaseiFirstinformation reports No./ Nos.....A.Si.A*r i.H....iS.....e-\..c.1o,.9s-e... rrribL cll,. (ii) Policestation(s) ... District(s)...... F..q.-vbi..c.rrlar9 - State(s) (iii) . Section(s)of the concernedAct(s) and short description of the offence(s)for whichthe candidatehas been charged..... (iv) whichframed the charge(s) (v) Date(s)on whichthe charge(s)...... (vi) Whetherall or any of the proceeding(s)have been stayed by any court(s)of competent jurisdiction

not beenconvicted of an offence(s)[other than any offences) referredto in sub-section(1) sub-section(2),, or coveredin sub-section(3),of section I of theRepresentation of the PeopleAct, 19 (43of 1951)land sentenced to imprisonmentfor oneyear or more.

lf the deponentis and punishedas aforesaid,he shallfurnish the foilowinginformation: (i) Case/Firsti qn reportgNo./Nos..... (ii) Count(s)which (iii) Policestation(s) ...... ) District(s) .State(s). (iv) Section(s)of the concerl (s)and short description of the offence(s)for whichthe candidatehas beencha (vi) Date(s)on whichthe sen was/werepronounced (vii) Whetherthe sentence(s) stayedby any court(e) of competentjurisdiction

ptace ....l3..A.D..\\.1.R. A...... Date ..,.. L. 5...=3..-_..2_e,e fl ' , : ':i ,",,; , ti.'.. .;1.;)., : ,,:rr ,',j:.'l vERtFtcATtoN --i ' ; ) . -,,,..:..;:.,'i t ri,t i .1. r.; :,',. l:,.;i.,i....,; -. ,r.i:j,.r,r,,, l, the,above,nameddeponenl do herebvverfy"qFd.dediare that the contents of thisaffidavft'*q?B true. . andcorrect to the best of mv r