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Na"X Signature Ofproposer

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Na FORM2A (.eerule 9 NSR P'C 4) I NOMINATIONPAPER st. n to the House of the people rime....l.?-.i..!k1....k ..:..........""" d) venue...&P-...**a+*."/4.. STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOTAPPLICABLE PARTI (To be used by candidate sa up by recogdsed political parry) I a candidate for election to the House of the people .o tbm the ...t................ NA.RA.5.hP..s liamengly "o*tituency. Candidate' narne.. .A.LLi .kh3.E.Sff ... Father,vne6er,s,/h$band,s name..N...h.!+_.i.. ru.LRS.9.r.m.nt tf\u H address . I t .a,.m.Al..':r..8 .r..tDr.s.E.ru.rftT.h0r ..t.h.x.K.A.u_* t,AAm Ks.D. ,Y-.:.5..a.:.r.5_._o.... p..h. !.,.t..h.\.rs.h..r:.ilsL qDf ' His name is entered at S.No.... in Part No......[Y.J....... of the QA!ft*.:.t!.yr(Assembry electoral rol for...f]... comprised within) ... N. h. 3...NS.Sf Constituency. .9 &*r.-.otu.y My name is..Y.E_).L.4..eALti. ff\ LSrJ"a rt is entered at S.No.L5.l...in part No..,5t...ofthe electoral roll for....N.h.g. s P-V..B$.eD....XAssembly constituency comprised withint....C*.fi:.R S ft. ..P tary constituency. Dare.*-....S:I:t 1 nA"x Signature ofproposer I b PART II (To be used by candidate NOT s€t up by recognised political party) We hereby nominate as candidate for election to the House of the People fiom the-.....fl......-... N A R.hS.S.9. 9.(Parliamentary Constioencv Candidate's name. nr.bLL.i.....Afi-:i..e.-5.H...-....-.....'Father's/rnether's/truab'od's f, mme.AJ.A!..L-i..s.r*.a.Art.'Lnn.Tiff#.fir address .l:.Lf.,.rnh.!.1Y..(t.t.Pz..y..e.*.\1.s'I ..t A.rr.x.*.t-.s.Ks.D.E-.ts v..:--.i))1k9-!.....Q.S.-u..4..*:.L-.s.*..{:.}.1.:....\J.S}t- His name is entered at S.No......I.1.9.......in Part No..........\.)4.I1.............of the electoral rolt for ..5..I1.,....P-.8.!=.ft..K.:.t.....'...-.......----...r(Assembly constituency comprised within) .....-..r..L.Ngh..9.S..eV.A-..........Parliamentary constituency' names are We declare that we are electors of the above Parliamentary Constituency and our below and we entered in the electoral roll for that Parliamentary constituency as indicated append our signatures below in token of subscribing to this nomination:- Particulars of the proposers and their signatures Sipature Date Sl.no. Name of Elector RoU No. of Full Name component Proposer Assembly Part No. of S.No. in Constituency Electoral tbat part r Roll 6 7 I 3 4 5 I PALAT<OL t++ 351 1 2 /Q L t++ c, \) oll -t Ko la-+ +1 c 4 T Ar{f+Rs$ P,B 2olf PA Lh l<o L 1A.+ 852_ NRL UE 5 ( L l4+ 6t l-lr rrr/ rlE \i AA, PRA<AD "17 6 1a Eo ,1 oD,t ou^l la:7- :*2- nlE noooTf vANkATAAD 9lpza2 t lo 7 ,bll t4-11- loA- P{:*re 8 1011 Pat-p,/.ot- tL7- 5R oQ-l l&M-, l<k A lq hq € St,A1zA 9 Nrl 16"Vl t 2ht !r^t - t++ 89 1ft.lf t-1q1 1 5 N 10 k A VRSU S'W PN.*Yot- tsl H VE o lzolJ N.B.- There should be ten electors of the constituency as proposers' 2 I PART III I, the candidate mentioned in Part VPart II (Strike out which is not applicable) ass€nt to this nomination and hercby declare- (a) that I am a citizen of India and have not acquired the citizenship ofany foreign Stat€lcountry. (b) that I have completed........-..3.1e............years of age; ISTRIKE OUT c(i) or c(ii) BELOW WHICHEYER IS NOT APPLICABLEI (c) 0) that I am set up at this election by the.. t ..t>LD_.P*e..P N .p_ E NI party, which is a recopised National Party/State Party in this State and that the symbol reserved for the above parly be allotted to me. OR (c) (r, that I am set up at this election by the ... party, which is a registered-unrecopised political partylthat I am contesting this election as an independent candidate. (Strike out which is not applicable) and that the symbols I have chosen, in order ofpreference, are:- (r....At^rto............... (,,)...81*t-i,r-!".e&t,r,... od (d) that my name and my father's/mother's/husband's name have been correctly spelt out above in....E.NA.!-.I..9-hf.. (name of the language); (e) that to the best ofmy knowledge and belief, I am qualfied and not also disqualified fsl being chosen to fill the seat in the House ofthe People. *I further declare that I am a member of the.....-1.-c--h.E.D..Q.LL-D..................**Caste.itribe which is a scheduled **castey'tribe of the State or...4..$..0.H..R.f'.e.S.h.$.85-t...i" relation to 1) (area) in that State. I also declare that I have not been, and shall not be nominated as a candidate at the present general election/the bye-elections being held simultaneously, to the House of the People from more than two Parliamentary Constituencies. Date S Candidate rScore out the words "assembly constituenq, comprised within" in the case of Jomnu and Kashmif Andanan and Nicobar Islands, Chandigarh, Dadra and Nagar Haveli, Dama and Diu and Iakshadweep. 3 *Score out this paragraph, f not applicable. **Score out the words tnt applicable- N-B'-A "recognised polirical party" means a political party recognised by rhe Elecrion Commission under the Election symbols @eservation and Allotment) ordet t96g in the state concerned- PARTIIIA (To be filled by the candidate) (l) Whether the candidate- (i) has been convicted- (a) of any offence(s) under sub_section ( I ); or (b) for contravention of any law specified in sub-section (2), of section 8 of people the Representation of rhe Act, l95l (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 shalr fumish the folrowing information: (i) case/firstinformationreportNo,/Nos...n-.r.9.lI.ltp.p.Lt.cR.D!-A--d-\.A) (i, Police station(s)............0*.y\ (iii) Section(s) of the concemed Ac(s) and brief description of the offence(s) for which he has been convicted ,\r (,, Date(s) of convicrion(s) .......1^.* (v) Court(s) which convicted the candidate ,.S. (v, Punishmen(s) imposed [indicate period of imprisonment(s) andlor guantum of fine(s)l (vii) Date(s) of release from prison........... (viii) WaVwere any appea(s/revision(s) filed again<t above conviction(s) Y*tN/ 4 (ix) Date and particulars of appea(s)/application(s) for revision fi1ed.....t):.4....... (*) Name ofthe court(s) before which the appeal(s/application(s) for revision filed. .. (xi) whether the said appea(s/application(s) for revision has/have been disposed of or iVare pending....N.$ (xiD lfthe said appeal(s/application(s) for revision has/have been disposed of- (a) Dat{s) of dsposal........... hr..N......... (b) Nature of orde(s) passed. .. .. f9 ,s (2) whether the candidate is holding any office of profit rmder the covernment of India or State Govemment?......... (ks/No)'/ -If Yes, details of the office held ,t-a' (3) Whether the candidate has been declared insolvent by any Court?.......... €fun,Io) -If Yes, has he been discharged from insotvency. N.h. (4) Whether the,/ gndidate is under allegiance or adherence to any foreign country?......... (&MNo)- -IfYes, give details........... .... N (5) Whether the candidate has been disqualified under section 8A of the said Act by an order of the President? CtrsNdf -IfYes, the period for which disqualified. s (6) Whether the candidate was dismissed for comrption or for disloyalty while holdin&office under the Govemment of India or the Government of any State? .........g€df.Ioj" -If Yes, the date of such dismissal (7) whether the candidate has any subsisting contrac(s) with the Govemment either in individual capaclty or by trust or partnership in which the candidate has a share for supply of any goods to that Govemment or for execution of works undertaken by that Govemment?.............. qAsRVoy/ -IfYes, with which Govemment and details ofsubsisting contrac(s) ,N+ 5 (8) whether the candidate is a managing agent, or mrnager or secretary of any company or corporation (other than a cooperative society) in the capital of which the cenhal Govemment or State Govemment has not less than twanty-five percent share?............ (Yes/no) -If Yes,withwhich ,..l A (9) Whether the by the Commission under section l0A of the said Act. -If yes, the date of disqualification. Ns- prace: J-v. a.(.s s ?rPu A^ Signaturew of Candidate oate:..*5:3::k\) 6 I t t I I D t,1tn f.x re t V es ord 15 d 5' slr*r vtvl ANDHRA pRADESH 'i"'la=r- D at-=ssl>- l.ie+I - i;A-"4€=FJdf,"-*t{s>' 3';Lo*c& i I FORM 26 I It (See rule 4A) :\ I I I a i qnJ AFFIDAVIT TO BE FITED BY THE CANDIDATE ATONG WITH NOMINATION PAPEFETFORE THE RETURNING OFFICER FOR ETECTION TO LOK SABHA FROM NARASAPURAM CONSTITUENCY Ng.s _A I PART I tlAtll RAJESH Son of NARASIMHA MURTHy(Late), aged 36 years, resident of D.No.1-28, Main Rold, Venkatapuram, Palakol Mandal, West Godavari District a candidate at the above election dlhere by solemnly affirm and state on oath as under:- t s[P.
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