I ytsr eg otd r$ d,5' en;sr ANDHRA rRADEsH 23 MARz[ll9' 6inffi' sl. No.-€F-L3., Dare : 23-03-20 1 9, Rs. I 00/- KINTHADA MADHAY Sold to: NfAHARTSETTY MADHAYI, wo.N. Narasimha Rao, Vijayaawada. t'"*oo'.:I1fi#||:, For Whom: Self. a. N^ 6^-r._oat,2ol7 I t09. I FORM 26 (See rul"r dA) s I I TH_E RETURNING OFFICER *i?Y FOR ELECTION TO THE HOUSE OF THE EA,|JYLH (NAME OF' THE HOUSE) ,, - -,O.O*O'O **A"N' CONSTITUENCY (NAME OF THE CONSTITUENCYI-"*O* Ie **senldaugh+e#wife of w laxasuUna RAO, Aged M, 47 years,vears residentresi.ent ofnf Door,'n^- No.N^ 1l-5-29.rr Er^ Rangannavarin^--- treet. Viiavawada -520001 (mention full :;ostal address), . candidate at the above election, do hereby solernnly affrrm and state on oath as under: (1; I AM A CANdidAtE SEt UP bY INDIAN NATIONAL CONGRESS PARTY (** name of the political * party)/** strike out whichever is not applicable) y..., N, N^/,hrr',tr- \? -rl Q; o ,ln ! rl 2 Y (2)MynameisenrolledinTg-VIJAYAWADA.WES.I.ASSEVIT- at Serial No 773 in ANDHRA PRADESH (name of the constituency and the State), Part No. 174. my e-mail id (if any) -- NIL' (3) My contact telephone number (s) is /are 9848128623 and and my social media accounts (if any) are NIL (D " " "Nil' (ii) ......Nil. (iii) ......Nil. of filing of Income Tax (4) Details of Permanent Account Number (PAN) and status return: T'otal irrcome Shown in S1.No. Names PAN The financial year for Irncome: Tax Return (in which the lupees;) for the last Five last Income- rinanc ial years comPleted (as tax return has rn 3l't March) been filed r I Self (1) 2018-1e (i) Rs. 6,04,546/- I (2) 2017-18 (ii) Rs.5,69,501/- (iii) I NaranarisettY ADXPNOO96M (3) 2016-17 Rs.5,16,9251 I Madhavi (4) 20rs-r6 Itv) Rs.4,95,852/- (s) 2014-ls (v) Rs. 3,98,540/- (1) 2018-1e (i) Rs.7,02,155/- 2 Spouse I Rs. 6,28,144l- (2) 2017-18 | CD Naraharisetty (3) 2016-17 (iii' Pts.6,47,2201' ADXPNOO53G | Narasimha Rao (4) 201s-16 (iv) Rs.5,91,0331 (s) 2014-1s (v) Rs.4,18,595/- NOT (i) NIL J HUF 0f NA Candidate is APPLICABLE (ii) NIL Kartal (iii) NIL Coparcener) (iv) NIL (v) NIL (i) NIL 4 Dependent I NOT APPLICABLE (ii) NIL NaraharisettY BGYPN6638J (iii) NIL Vinitha (iv) NIL 4 h.- (v) NIL d ',/" N $J)tur,- {o \ W 2 KOT}/ Ir1 l, 1\ NOT (i) NIL 5 Dependent 2 APPLICABLE (ii) NIL (iii) NIL NaraharisettY BGLPN2393F Supraja (iv) NIL (v) NIL NOT (i) NIL 6 Dependent 3 APPLICABLE (ii) NIL NIL NaraharisettY BGLPN2395D (iii) Vishnu PriYa (iv) NIL (v) NIL it should be clearly stated'No PAN allotted" (5) Pending Criminal Cases : against / i. I declare that there is no pending criminal case ^" ' pending against the candidate (Tick this alternative if there is no criminal case (ii) below) and write NoT APPLICABLE against alternative OR me: NOT APPLICABLE ii. The fellswing Griminol eeses are Pending against then tick this (If there are pending criminal cases against the candidate, give details of all pending cases alternative and score off alternative (i) above, and in the Table below) Table (a) FIR No. With name NIL and address of Police NIL NIL Station concerned (b) Case No. with Name NIL NIL NIL of the Court (c) Section(s) of concerned Acts/Codes involved (give No. of NIL NIL NIL the Section, a.E t Section...... of IPC' (d) Brief descriPtion of NIL NIL NIL offence (e) Whether charges framed have been NO (mention YES or NO) NO NO r \ -/N.m".J-AaP." ll'l*-ld ' lur \\ 6I\{ e 3 ltg FA 4 (f) If answer against (e) above is YES, then NIL give the date on NIL NIL which charges were framed. any APPeaV (e) Whether I Application for I Revision has been NO NO filed against the NO proceedings (Mention YES or NO) (6) Cases of Conviction Criminal offence' / i. I declare that I have not been convicted for any and write NOT (Tick this alternative if the candidate has not been convicted APPLICABLE against alternative (ii) below) OR below : NOT APPLICABLE ii. I have been convicted for offences mentioned and score off (If the candidate has been convicted, then tick this alternative alternative (i) above, and give details in the Table below) Table NOT NOT NOT (a) Case No. APPLICABLE APPLICABLE APPLICABLE APPLICABLE *o NA (b) Name of the Court NOT "_ (c) Sections of Acts/Courts involved (give no, of the NOT NOT NOT APPLICABLE Section, e.g. APPLICABLE APPLICABLE Section........of IPC' etc.) (d) Brief descriPtion of NOT NOT NOT APPLICABLE Offence forwhich APPLICABLE APPLICABLE convicted (e) Dates of orders of NO NO NO conviction NUI NOT NOT APPLICABLE /*n HK-"nt imPosed APPLICABLE APPLICABLE './ N .fqdAl^dJJ^' tr ffi or ,lY9ffi t1 j 'i 5 (e) Whether any has been filed against conviction NO NO NO order (Mention YES or NO) (h) If answer to (g) above is NOT NOT APPLICABLE YES, give details and NOT APPLICABLE APPLICABLE present status of aPPeal about all (6A) I have given full and up-to-date information to my political Party as given in pending Criminal cases against me and about all cases of conviction I paragraphs (5) and (6). EW 6(i). above. should clearly write NOT [candidates to whom this item is not applicable APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), abovel Note: 1. Details should be entered clearly and legible in BoLD letters. 2. Details to be given separately for each case under different columns against each item. to be 3. Details should be given in reverse chronological order, i.e., the latest case mentioned first and backwards in the order of dates for the other cases. 4, Additional sheet may be added if required' 5. Candidate is responsible for supplying all information in compliance of Hon'ble supreme court's judgment in w.P(c) No.536 0f 2011. etc.) of (7) That I give herein below the details of the assets (movable and immovable myself, my spouse and all dependents: A. Details of movable assets: also have to Note: l. Assets in joint name indicating the extent of joint ownership will be given. Number, Amount, Note: 2. In case of deposit/investment, the details including serial Branch are to be date of deposit, the schemeo Name of the Bank/Institution and ,./ N'Co-J'0ta-J *7€ t/rq per current market value in stock Note:3. value of Bonds/Share Debentures as as per books in case of non-listed exchange in respect of listed companies and companies should be given' +to t .Dependent, daughter(s)-1-r^../^\ of^r the candidateaoat or spouse anc Note: 4. means parents, son(s), whether by blood or marriage' who any other person related to the candidate are dependent on the candidate for have no separate means of income and who their livelihood. separately in respect of each Note: 5. Details including amount is to be given investment. in or ownership of offshore assets Note: 6. Details should include the interest assets" includes' Explanation: For the purpose of this Form, the expression "offshore Banks and any other body or details of all deposits or investments in Foreign liabilities in foreign countries' institution abroad, and details of all assets and N. N. N. Bank 1) Saving Bank Gtails of deposit l) Saving Vinitha Supraja Vishnu No bearing in Bank accounts Accourrt bearing Account Priya (FDRs, Term 36302200000874 No 7382610860 with Syndicate Syndicate S.B.A/c. S.B.A/c. S.B.A/c. Deposits and all with No. No. No. Bank, Akividu Bank, Akividu other types of 06061010 06061010 06061010 Branch, West West 004318t. deposits including Branch, 0043163, 0043172, Godavari District Andhra Godavari .,Jisffict Andhra Andhra saving accounts), Balance as on Bank, Bank, Bank, with Balance as on Main Deposits 2210312019 is Main Main 2210312019 is branch, Financial Rs. 10'716/- branch, branch, /- Vijayawa Non- Rs. 2'654 Vijayawa I viluya*u Institutions, da da da Banking 2) Saving Bank Balance 2) Saving Bank Balance Balance as bearing No Financial Account as on Account bearing as on on Companies and 520101260069905 22103120 No 5211261476-9 221031201 221031201 with CorPoration 19 is Cooperative with State Bank of 9is 9is Bank, RR APPa Rao Rs. societies and the Civil Courts Rs. Rs. Street Branch, India, 5,000/- amount in each 4,E00/- l2,3E5l- Vijayawada. Branch, deposit such Balance as on Vijayawada 2010312019 is Balance as on Rs.1,000/- 2210312019 is Rs. 3,000 /- 'EZ=-<Q) N crt*-J-k*r; [/**:sxrmls \sFrg 7 ) Savings Bank account bearing No. 0606lorooo25o33 with Andhra Bank, Main Branch, Vijayawada Jointly held with spouse NaraharisettY Madhavi Balance as on 2210312019 is Rs. 547 /- 4) Saving Bank Account bearing No 520101260068322 with CorPoration Bank, RR APPa Rao Street Branch, Vijayawada. Balance as on 2010312019 is Rs.1'000/- Details of investment in Bonds, debentures/ shares and units in companies/ Mutual funds and others and the amount Details of investment in NSS, Postal Saving, Insurance policies and investment in anY NIL Financial instruments in Post office or Insurance Company and the ,/ N m*/Aor* ' lt| 8 Personal loans/ advance given to any person or entity including firm, companY, Trust etc., and other receivables from debtors and the amount Motor Vehicles/ AMBASIDAR QUALIS -2.4 DFS Aircrafts/Yachts/ Bearing Reg.No.