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Nl'1,1 Cid- R-.Srjn Strike Off Part I Or Part II Below Whichever Is Not Applicable Za\Nr[Xu [Rc PART

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Nl'1,1 Cid- R-.Srjn Strike Off Part I Or Part II Below Whichever Is Not Applicable Za\Nr[Xu [Rc PART FORM 2A (See Rule 4) NOMINATION PAPER Election to the House of the People Nl'1,1 CId- r-.srJn Strike off Part I or Part II Below whichever is not applicable za\nr[xu [rc PART. I (To be used by candidate set up by recognized political party) I nominate as a candidate for election to the House of the People from the IS-BAPATLA (SC) Parliamentary Constituency. Candidate,snameBABYLATHA.NANDIGAMMHusband,sname SURESH . NANDIGAM His postal address 2-619 Uddandurayunipalem Village, Thulluru Mandal, Guntur District. His name is entered at Sl. No. 36 in Part No 19 of the electoral roll for 86-TADIKONDA (SC) (Assembly constituency comprised within) l3-GUNTUR /' Parliamentary Constittiency. My name is Raj Kumar Chandolu and it is entered in Sl.No.lll in Part No. 228 of the electoral roll for the 105 - Addanki Assembly constituency comprised within 15- Bapatla Parliamentary constituency. Date: Signature of Proposer PART II We nominate as candidate for the House Parliamentary :ituency. Ca 's name Father's / Mether'Y usband's name H|6 postal address Her name is entered at No in Part No of the electo roll for ........( bly constituency comprised within. Parliamentary Consti We that we are electors of the above liamentary constituency names are in the electoral roll for this Parli tary constituency as ind below and we our signatures below the token of ibing to this nomination: Particulars of the proposes and their signatures Name of Elector Roll No. of Component Proposer S. assembly Part No. No. constituency of Sl. No. Full Name Signature Date in that Electoral part Roll I 2 J 4 5 6 7 I NIL NIL NIL NIL NIL NIL 2 NIL NIL NIL NIL NIL NIL J NIL NIL NIL NIL NIL NIL 4 NIL NIL NIL NIL NIL NIL 5 NIL NIL NIL NIL NIL NIL 6 NIL NIL NIL NIL NIL NIL 7 NIL NIL NIL NIL NIL NIL 8 NIL NIL NIL NIL NIL NIL 9 NIL NIL NIL NIL NIL NIL 10 NIL NIL NIL NIL NIL NIL NB : There should be ten electors of the constituency as proposers. PART III I, the candidate mentioned in Pa**I lPartII (Strike out which is not applicable) assent to this nomination and hereby declare - (a) that I am a citizenof Indian and have not acquired the citizenship of any foreign z State / country. '(b) That I have completed 34 years of age; [srRIKE our c(i) or c(ii) BELow WHICHEVER IS Nor APPLICABLE] (c) (i) Perty tn thtt Stato & ;,+qrbe€tto#ed+o-me OR (ii) I am set up at this election by the by the the YUVAJANA SRAMIKA RYTHU ' CONGRESS PARTY(YSRCP), party,which is registered unrecognized politic al partyl that . (Strike out which is not applicable) and that the symbols I have chosen, in order of preference, are: (i) .......(iD .......(iii) JAI that my name and my fa*hefshe+her+ /husband's name have been correctly spelt out above in ENGLISH Lansuaee (name of the language): and (e) that to the best of my knowledge and belief, I am qualified and not also disqualified for being chosen to fill the seat in the House of the People. * I further declare that I am a member of the Madiea (SC) Caste/tribe which is a scheduled caste/tribe of the State of Andhra Pradesh in relation to Thulluru (area) in that State. I also declare that I have not been, and shall not be nominated as candidate at the present general election / bye-elee+iens being held simultaneously, to the House of the People from more than two Parliamentary Constituencies. f-rruGb,.* Date:25-03-2019 Signature of Candidate * Score out this paragraph, if not applicable. ** Score out the words not applicable. NB - A "recognised political party" means a political party recognised by the Election Commission under the Election Symbols (Reservation and Allotment) Order, 1968 in the State concerned. PART IIIA (To be filled by the candidate) I Whether the candidate i) Has been convicted (a) ofany offence(s) under sub-section (1); or (b) for contravention of any law specified in sub-section (2) of section 8 of the Representation of the People Act, 1951 (43 of YES/NO/ 1951); or ii) has been convicted for any offence(s) for which he has been sentenced to imprisonment for two years or more o'Yes", If the answer is the candidate shall furnish the following information: (i) Case/first information report No. / Nos. Not Applicabl0. (iD Police station(s) .. ..... District(s) . Sate (s) Not Applicable (iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been convicted. Not Applicable . (iv) Date(s) of conviction(s) Not Applicable (v) Court(s) which convicted the candidate Not Applicable (vi) Punishment(s) imposed [indicate period of imprisonment(s) and/or quantum of fine (s)lNot Applicable (vii) Date(s) of release from prison Not Applicable (viii) Was /were any appeal(s) / revision(s) filed against above conviction(s) NO (Yes/No). (ix) Date and particulars of appeal(s) / application(s) for revision filed Not Applicable (x) Name of the court(s) before which the appeal(s) / application(s) for revision filed Not Applicable (xi) Whether the said appeal(s) / application(s) for revision has / have been disposed of or is/ are pending Not Applicable , (xii) If the said appeal (s)/ application(s) for revision has / have disposed of - a) Date(s) of disposal Not Appticalle b) Nature of order(s) passed Not Applicable (2) Whether the candidate is holding any offi4ce of profit under the Govemment of India or State Govemment? NO (Yes/f.{o) If yes, details of the office held - Not Appticable (3) Whether the candidate has been declared insolvent by any court ? NO 1y"*4t1o, If yes, has he been discharged from insolvency - Not Applicable (4) Whether the candidate is under allegiance or adherence to any foreign country? NO 1Y"*4t1o, If yes, give details - Not Applicable (5) Whether the candidate has been disqualified under section 8A of the said Act by n order of the President? NO 1Y"*151o, If yes, the period for which disqualified - Not Applicable (6) Whether the candidate was dismissed for comrption or for disloyalty while holding office under the Government of India or the Government of any State? NO 1y"*4to, If Yes, the date of such dismissal - Not Appticable (7) Whether the candidate has any subsisting contract(s) with the Government either in individual capacity or by trust or partnership in which the candidate has a share for supply of any goods to the Government or for execution of works undertaken by that Government ? NO (YesA{o) / (8) Whether the candidate is a managing agent, or manager or Secretary of any company or Corporation (other than a cooperative society) in the capital of which the Central Government or State Government has not less than twenty-five percent share? NO (YesAro) (9) Whether the candidate has been disqualified by the Commission under section 10A of the said Act NO 1Y".4t1o, If yes, the date of disqualification - Not Applicable Place: Ongole fr [a*k b#^* Date25-03-2019 Signature ofCandidate a PART IV (To be filled by the Returning Officer) paper Seriat No. orNomination . 2. AIHP *e. \.*tl..f This nomination was delivered to me at my office at.?:5..fh.f <n"*l on I ,(Name). Date .*14t, Returning Officer *Score out the word not applicable PART V Decision of Returning Ollicer 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) Rs.,,,,I 0G qsiEqqi ]NDIil tlf cD 51 8501 t.s---? La,L) (sEE RULE 4A) E F IAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO THE HOUSE or rnr PEoPLE FRoM Is-BApATLA (scl pARLIAMENTARy coNSTrruENCy fl ra.nr,q. I{BABY LATHA NANDIGAM Wife of SURESH NANDIGAM, aged 34 years, resident c i Door No.2-6l8, UDDANDARAYLTNIPALEM VILLAGE, THULLURU Mandal, Guntur tistrict, 522503, Andhra Pradesh , candidate at the above election do hereby solemnly affirm a,rd state on oath as under:- H (') I am a candidate setup by YUVAJANA SRAMIKA RyrHU CONGRESS PARTY(YSRCP) (**name of thepolitical party)l idate (strike out whicheuV( is not applicable) f.{ {b-{L*ti'* (2) My name is enrolled in 86 TADIKONDA (SC) ASSEMBLY CONSTITUENCY of ANDHRA PRADEH STATE (Name of the Constituency and the State), at Serial No36 in Pan No.19 ( UDDANDARAYUNIPALEM VILLAGE). (3) My contact telephone number(s) 8125227799 is/are.and my e-mail id - [email protected] (if any) is and my social media account(s) NO (if anylislare (D ..........NrL (ii) NrL........... (iii) ..........NrL (4) Details of Permanent Account Number (PAI9 and status of filing of Income tax return: Total income SI.N The financial year for Shown in Income Tax Return (in Rupees) o. Names PAN which the last Income- for the last. Five Financial Years tax return has been hled completed (as on 3 I't March) I Self (i) NIL (iD BABY LATHA. BRWPNs3I2G NIL NIL NANDIGAM (iii) NIL (iv) NIL (v) NIL 2 Spouse (D 2017 -2018 - Rs.3,40,270-00 (ii) 2016-2017 SURESH - Rs.4,00,160-00 BABU.NANDI BARPN8O23L 2017-2018 (iiD 2015-2016- Rs.3,05,610-00 GAM (iv) NIL (v) NIL .) HUF (rf (D NIL candidate is NIL NIL (iD Kartha/Coparcen NIL or) (iiD NIL NIL (iv) NIL (v) NIL 4 Dependent -l (D NIL NANDIGAM.
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