4 D °Ammo 06Dul Qudoos Gtvtemon)

NOMINATION FORM-I (See rule 3) ELELCTION TO THE GENERAL SEATS 52- HYD-X- TANDOALIA YARTL, . Election to the constituency P5 • of , / srNN-4 Provincial Assembly of (Name of the Province) (To be filled in by the proposer) moKI-IT/AR, AHMED (1) (name of the proposer) having National Identity Card No 4130-1--• SS 5 5 606 .registered as an elector at serial number I 59 - in the electoral roll for P•S" 52 14-)1) electoral area inT4f(OOALLA1PeAt i.ehsil/Taluka in TA Al DOA tiA H /AR. • District/Political Agency do hereby propose the name of -I ri QAD whose address is • VILLAGE HAT1 k..torn) mc.)4AmmA9as candidate for election to general seat from AC .52- 14Y0 • E. • rANDOALLAWsktency•• (2) I hereby certify that I have not subscribed to any other nomination paper either as proposer or seconder. Date. 30 - o? - 2-013 Signature of Proposer (To be filled in by the seconder) (1) I TAN VEER 40SsA-IN (name of the seconder) having National Identity Card No 41307-05030 23-7 .registered as an elector at serial number a • in • the electoral roll P C - —S_ for electoral area in TA 1413°41-LA H YAK Tehsil/Taluka in TAND 0 ALLAJVPrk District/Political Agency. do hereby second the nomination • of Ilflb/41) 4-Lt whose address is ViLLA GcµA 31 KHAN N'101-tAftiniA0 • as TAN ti8AL LAW+ Y4127 a candidate for election to general seat from AS ' 6 a" 14 onstituency. (2) I hereby certify that I have not subscribed to .any other nomination paper either as proposer or seconder. d °Ammo Date 30 0 2 20 12 Signature of Seconder Note: Please fill in the Form in capital letters. *Strike off the words not applicable Price : Rs.20/- 06dul Qudoos gtvtemon) Senior Civil Judge Returning Officer NA-223, PS-51 & PS-52 rand° Ailahyar 2 A 4. DECLARATION AND OATH BY THE PERSON NOMINATED . I. I, the above mentioned candidate, hereby declare on oath that,— (i) I have consented to the above nomination and that I fulfill the qualifications specified in Article 62 of the Constitution and I am not subject to any of the dis-qualifications specified in Article 63 of the Constitution or any other law for the time being in force for being elected as a member of the National Assembly/Provincial Assembly. pARL(Ary)6NrARIAN *(ii) I belong to PAK'S-611\i PEOPLES cr.v and a certificate from (Name of political party) that political party showing that I am a party candidate from the above said constituency is attached. OR I do not belong to any political party. I, the above mentioned candidate, solemnly swear that,— I believe in the absolute and unqualified finality of the Prophethood of Muhammad (Peace be upon him), the last of the prophets and that I am not the follower of any one who claims to be 5. a Prophet in any sense of the word or of any description whatsoever after Prophet Muhammad (Peace be upon him), and that I do not recognize such a claimant to be Prophet or a religious (i) reformer, nor do I belong to the Qadiani group or the Lahori group or call myself an Ahmadi. (ii) I will be faithful to the declaration made by the Founder of Pakistan Quaid-e-Azam Muhammad Ali Jinnah, that Pakistan would be a democratic state based on Islamic principles of social justice. I will bear true faith and allegiance to Pakistan and uphold the sovereignty and integrity of Pakistan and that I will strive to preserve the Islamic Ideology which is the basis for the creation of Pakistan. *6. I het 3. I hereby solemnly declare to the best of my knowledge and belief that,— to fil (1) no loan for an amount of two million rupees or more obtained from any bank, financial I her institution, cooperative society or corporate body in my own name or in the name of my mons spouse or any of my dependents, or any business concern mainly owned by me or the aforesaid, stands unpaid for more than one year from the due date, or has got such loan written off; and (ii) I, my spouse or any of my dependents or a business concern mainly owned by me or the aforesaid, is not in default in payment of government dues or utility charges, including • My ed telephone, electricity, gas and water charges of an amount in excess of ten thousand rupees, for over six months, at the time of filing of nomination paper. 8. My pre 9. My Nai Note: *Strike off the words not applicable. **For Muslim candidates only. 10. My Nat 4. I, hereby solemnly affirm that,— (i) The list containing the names of my spouse(s) and dependenth is correct and no name has been left out. (List attached) (ii) Neither I nor my spouse(s) nor any of my dependents mainly owns any company except the ;el in following: qd in NIL. ed as NIL Explanation.— For the purpose of these declarations, the expression— (i) "loan" shall mean any loan, advance, credit or finance obtained or written off on or after the 31st day of December, 1985, but shall not include the loan the recovery of which has been stayed or suspended by any order of a court or tribunal, including the High Court and the Supreme Court; ncy is (ii) "mainly owned" shall mean holding or controlling a majority interest in a business concern; (iii) "taxes" include all taxes levied by Federal Government, Provincial Government or a Local Government, but shall not include taxes the recovery of which has been stayed or suspended by any order of a court or tribunal; (iv) "government dues and utility charges" shall, inter alia, include rent, charges of rest houses or lodges owned by the Federal Government, Provincial Governments, local governments or corporations, established or controlled by such governments, but shall not include the government dues and utilities charges the recovery of which has been stayed or suspended by eace be any order of a court or tribunal. ns to be 5. I, the above mentioned candidate hereby declare on oath that,— iammad RAP1(14.TANDOAU.ANYAR eligious (i) I have opened Account No. 3953-o. PLS.with ckAnna,AR hmadi. (Name and Branch of scheduled bank) and have deposited therein an amount of Rs.1000000-0qamount in words) ONE fr ILL ION • for the purpose of election expenses. -e-Azam rinciples (ii) I shall make all election expenditures out of the money deposited in the aforesaid account. fereignty (iii) I shall not make any transaction towards the election expenses through an account other than ch is the the above account. I hereby declare on oath that no case of criminal offences was pending against me, six months prior to filing of this nomination. OR financial I hereby declare on oath that following cases of criminal offences were pending against me, six months prior to filing of this nomination: ne of my ne or the Number of case Name of the Court such loan NIL_ me or the including 7. My educational qualification is 3.A • C3eckLOR of AR-r9 ind rupees, 8. My present occupation is ZAM1N 0-A AR• Attested copies 9. My National Identity Card No. is 211307- 9824418- 5 . to be annexed 10. My National Tax Number, if any is 4 119594 - 9 - 41 . ti o S VCTII°11) Rel.kr.\\I'g °W'CeC 11. The statement of assets and liabilities of my own, spouse (s), dependents as on 30th June, is enclosed. • • • I 12. The income tax paid by me during the last three years is given hereunder:- from cons! and move: Total Income other thar **Source of Income Tax Year Total Income Tax Paid June,.? £ 522.000- SALARY (vi. P.Al2.O09-WO. 1 82.3 0 -- 522000- SALAky (41.P.01) 200 - 20(1. 19 070 — 5.22. 000- SALAgY(in.p.A) 20/1 -2012: 18 270-- 1. NET ASSE` FINANCIA Note 1: Attach copies of income tax returns of the years mentioned above. **If more than one sources of income, attach detail. 2. NET ASSE1 13. FINANCIA • How many times traveled abroad during last three years and cost incurred thereon. (Attach copy of the passport and detail of expenditure). 3. INCREASl 14. The agricultural income tax paid by me during the last three years is given below: 4. IMMOVA Tax Year Open plots, Land Holding Agricultural . •Total Agricultural buildings, uncle! . Income •Income Tax Paid Property, etc. (i 2009-2010 2.3co 00- 10000 - present market are presently HI 2010-2011. 2.3 • 2 9 on o - 10000 - (a) Held will 2oti - 2012 2315. 265000- 72.75_ (i) To t^ (ii) A(* k I Note II: Attach copies of agricultural tax returns of the last three years mentioned above. (iii) b) Held out 15. If you have been elected Member of. National Assembly/Provincial Assembly what according to you was the single most important contribution you have made for the benefit of your constituency (i) (attach detail, if any). (ii) 16.. Whether you have paid any sum 5. MOVAB by way of contribution or otherwise to the political party which has awarded you party ticket for this election, and if so how much (attach detail, if any). (a) Busines (i) Nam( 17. Whether you have received any sum from the party which has awarded you ticket, if so how much. (ii) Capi (attach detail, if any). (b) Busine Note III:I Nam hereby solemnly affirm that the information given at serial No.

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