GERNALELECTIONM $Ry7 N

SOMBIR SANGWAN Number ana nimEif Name of State / UnionTdri Nature of etection @Gise GERNALELECTIONM mention whether General Election of State Assembly/Lok Date of dectaraEoi oFEiltt Name analaares] ofJtre If candidate is set up byi-- political party, please mention the name of the Whether the party is a Date:15-11-20L9 Place: CHARKHI DADRI ,.rn $ry7 Signature of the Candidate Name 9o-n A; n PART III: ABSTRACT OF SO ISED BY CANDIDATE S. No. Particulars Amount fin Rupees) L 2 3 I Amount of own fund used for the election campaign 2s62421- fEnclose as per Schedule -7') II Lump sum amount received from the party(ies) in NIL cash or cheque etc. fEnclose as per Schedule-9) III Lump sum amount received from any person 33se00/- /company / firm / associations / body fEnclose as per Schedule-9) Total 592t42/- ' -Jrrbt\Signature of the Candidate Name -surnr)R. CI,ONN Before the District Election Officer ffii@ Haryana Affidavit of Shri Satpal Sangwan S/o Shri Mange Ram I sombir sangwan son of shri Rishal singh aged 42 years, r/o vPo charkhi rehsil & Distt. charkhi Dadri (Haryana) do hereby solemnly and sincerely state and declare as under: _ That I was a contesting candidate at the general election to the General Election Legislative Assembly Haryana 2019 from 55-Badhra constituency, the result of which was 24 L0.20L9. declared on That l/my election agent kept a separate and correct account of all expenditure incurred authorised by me my election agent / / in connection with the above election between """" fthe date on which I was nominatedJ and the date of declaration of the result thereof, both days inclusive. That the said account was maintained in the Register furnished by the Returning officer for the purpose and the said Register itself is annexed hereto with the supporting vouchers/bills mentioned in the said account. That the account of my election expenditure as annexed hereto includes all items of election expenditure incurred or authorised by me or by my election agent, the political party sponsored which me' other associations body of persons / and other individuals supporting me, in connection with the election, and nothing has been concealed or withheld/suppressed therefrom (other than the expense on travel of leaders' covered by Explanations 1 and 2 under section TT (L) of the Representation of the peopre Act, r.951J. That the Abstract statement of Election Expenses annexed as Annexure II to the said account also includes all expenditure incurred or authoris.q political me, my election agent, the party which sponiored me, other associations !, individuals / body of persons and other supporting me, in connection with the election. That the statements. u foregoing lt paragraphs. [1) to (5) are true to the best knowledge and belief, llthat nothin[ of my ir ririu an"a n'ottririg"nrt.rirr has been concealed. 1{;b,o- Solemnly affirmed/sworn by sombir at 15th this day of Novemb er ZlLgbefore me, (signature and seal of the Attesting authority, i.e. Magistrate of the first class or oath Commission or Notary public). ACKNOWLEDGEMENT FORM lo THE RETURNING OFFICE& <7^- D-^-rl; Sir, I acknowledge receipt your of letter No ............. dated ...... along with its enclosures containing among other documents, a Register bearing serial No,......,,.... for maintaining of my accounts of election expenses. I have noted the requirements of law for maintenance of account of election expenses and lodging of true copy of that account with the District Election 0fficer / Returning officer. yours faithfully, (Signffire of Candidate with date) * Strike off whichever is inapplicable. ACKNOWLEDGEMENT (To be filled up by Office) The account of the election expensss in respect or....fh;.9.-0..4::f .... (Constituency) result of which was declared on .+*i.l.fLl,l..l..1oate; has been filed by him /on his behalf on tDate) and has.been received by me today the ..1a........ (Date) of .. N.9.U............... guron*l . -.,2... :.. t n.. -... fv"rrl. oistrict Chq-l.i & taa n DirtriyEl%-" officer ($p9' 0ffice Seal Xe6*orQ *e .r-qtd ftqfi rrtqT FEftfi schedule-1- gat,vr.urf..riture r oful CandidateLallqloate sion etc. Political party) [i.e.: o S.No. rtdLure ..- I or Expendlture Total Amount I L.lqurce of Expenrliture in Rupees I Amt. incurred/ Amt. Amt Auth. By incurred/ by incurred by Candidate/ Pol. Party ot}ters qgent 7 2 -with nrmo 3 Vehidcc f^ 4 5 L .vr Lr qrrDUur LtIlB, vlslEors 6 NIL NIL NIL 2 Erecung Stage, pandal & NIL NIL NIL Furnifure, Fixtures. nolec prr NIL NIL 3 Darrtcaoes etc. NIL NIL NIL NIL 4 Flowers/ garlands 960 NIL NIL 960 LIi 5 r.u rrrE, Luuq spgaKgrs, NIL NIL Microphone, amplifi ers, NIL NIL comparers etc. 6 Posters, hand Uitts+arnptrtEi NIL NIL Banners, Cut-outs, hoardines NIL NIL 7 Beverages like EaTater, cold NIL NiI drinh juice etc. NIL NIL 8 t r y -Doaros dlsplay, 'r6rLdl -boards, NIL NIL Projector display, tickers NIL NIL 3D display 9 Expenses on celebrities, NIL NIL payment to musicians, other NIL NIL artists remuneration etc II 10 .rururlldLruu trems uKe sertal NIL NIL lights, boards etc. NIL NIL 11 Expenses on I transport,.- NIL NIL Helicopter/ aircraft / vehicles/ NIL NIL boats etc. charges [for sel[, celebrity or any other campaigner other than Star Campaigner) 12 Powercon@ NIL NIL cnarges NIL NIL 13 Rent for venue NIL NIL NIL NIL L4 Guards & security charges NIL NIL NIL NIL 15 Boarding & Iodging expenses of NIL NIL self, celebrity, party functionary NIL NIL or any other campaigner including Star Campaisner L6 lers expenses NIL NIL NIL NIL 960 Nil NIL 960 al -->^ 4.t-- Schedule-z- ef( wlm tne sta Campai gnerfs) candidate [i.e.: other than thoie fni as apportio nedto= rl""""l'^." ,r updBallqaj S. No Date and ffi Amountort@ Venue Campaigner(s) Remarks, if I & Name of meeting rally, procession Pr.ty eti. with any I the-Star Campaignergsl apportionea to the candidate (As other than for general party propaganda) in Rupees 1 2 3 5 Sou..u ofIni6ilE-- Amount by Amount by Amount candidate / Political by Agent Party 0thers Total Nil NiI Nil Schedule-q I O"oilr of u* outs, gates & :::H'J:9,"1::f,t3llH,'-'Jft:.1Y"--*:,"::':"'.:l=;Tid; qeq,rvl board dispray,3D display etc. for -r Es rrr JLrrEuute- s. No Narure-f I 6l ZJ I Expinses Total Sources I of Expenffi Remarks, Amount in if Amt. By any Rupees Amt. By Amt. By candidate/ asen Pol. ParW 7 2 others 3 4 5 6 7 L Stickers Pamplate etc. 83226 83226 NIL 2 Lu Hreprauon NIL N NIL 3 Hoardings NIL l\tL NIL r o[€u 83226 83226 NIL )cnequle- 4 : and ellectronic media including SMS or internet or social caUte network Uu[- media, new item! fV Radio channels 7 7 etc., including the paid news so decided by MCMC or voluntarily admitted Uy ttre canaiaat, e. The ,details should on I include the expenditure incurred all guch news appearing in privalelv owned np, orc /TI/ /-^l elot t v/lqu io channels S. No Netr nf NI T+ etc. trame anc address Total Sources ofExpenditure medium address of of agenry, reporter Amount in (electroni media provider Amt. By Amt. By Amt. By ,stringer, company Rupees Col. c print) candidate/ Pol. / fprint or any person to (3) + others [a) agent and /electronic whom charges/ Party duration /SMS / voice/ commission etc. cable TV, social paid /payable, if media I etc.) anv I L 2 3 4 5 6 7 2 Danik Social I Media Danik Services & 18000 18000 Services News Media & News Netword Media Network ur,ill 18000 I 18000 0 0 ->o\b1'\-- Schedule -4A Details of e*p sMS or internet or social media, new itemi / Tv /Radio channels etc., including ihe paid news so decided by MCMC or voluntarily admitted by the candidate. The details should include ir,. .*punaiture incurred on.all such news appearing.in newspapers / Tv / radio channels etc. owned by the candidate or by the politi$l party sponsoring the candidaie. l\ame ano 'l'otal Sources of nditure medium address of address of Amount in Amt. By Amt. By Amt By (electronic media agency, reporter, Rupees candidate Pol. others / print) provider stringer, Col. [3) + / agent Party and (print company or any (4) duration /electronic person to whom /SMS / voicef charges / cable TV, commission etc. social media paid /payable, if etc.J any 1 t2 t3 4 s 16 7 I 1 ISTVEnL lSTVEnt. ST\/ E"t 11800 I rraoo NIL NIL Total -]-11800 11800 NIL NIL Schedule -S Detailsofexpenditureoncampaignvehiclec)' 5. Registratio n. Hiring Charges of ve ricle No. of Total Sources of Expenditure No No. of Vehicle Days for amL Rate for Fuel Driver's Amt. Amt. Amt. & Type of which incurred/ Hiring of charges charges By By Pol. By Vehicle used auth.ln vehicle / (lfnot (lf not candid Party others maintena covered covered Rupees ate/ nce under agent hirinsl L 2 3a 3b 3c 4 5 6 7 I t HR6LB-2444 1000 11 Days 11000 2 HR61A-2325 1000 11 Days 11000 3 HR19L-0135 1000 11 Days 11000 4 HR19L-4451 1000 11 Days 11000 5 HR19M-9315 1000 11 Days 1 1000 6 HR66A-2449 1000 B Days 8000 7 HRL6L-672L 1000 B Days 8000 B HR478.5468 1000 8 Days 8000 9 HR198-2521 1000 B Days 8000 10 HR88-3750 1000 6 Days 6000 11 HR6IC-2721 500 8 Days 4000 t2 HRB4-0456 500 8 Days 4000 t3 HR84-6306 500 8 Days 4000 14 HR6IB-2444 2000 558 5 Days 72790 15 HR6tA-2325 2000 558 5 Days L2790 16 HR19L-0135 2000 558 5 Days 72790 L7 HR19L-4451 2000 558 7 Days L7906 1B HR19M-9315 2000 558 B Days 20464 19 HR66A-2449 2000 558 5 Days 12790 20 HRL6L-6727 2000 558 5 Days L2790 {?"h4f -9 2L HR478.5468 2000 qR-?q?1 5 Days L2790 22 HR1 2000 558 5 Days L2790 23 nKUU-s750 2000 558 5 Days L2790 24 HR67A-7450 2000 558 3 Days 7674 25 HR6LC-2721 1000 558 7790 26 HR84-0456 1000 558 5 Days 7790 27 HR84-6306 1000 558 5 Davs 7790 26 HR61D-903 1000 558 3 Days 4674 27 HR55AA- 1000 558 3 Days 4674 9676 DRIVER 558 10 NOS.

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