Government of Puducherry

INDIA NON JUDICIAL Government of Puducherry

e-Stamp

Certificate No. IN-PY02145954690484M Certificate Issued Date 02-Apr-2014 12:06 PM

Account Reference SHCIL (Fl)/ pyshcil01 / PUDUCHERRY/ PY-PU 0 0 0 0 0 0 Unique Doc. Reference SUBIN-PYPYSHCIL0102400913845266M 0 0 0 0 0 0 0 Purchased by R K R ANANTHARAMAN 0 0 0 0 00 0 Description of Document Article 4 Affidavit 0 0 0 0 ° 0 0 0 Property Description AFFIDAVIT 0 0 0 0 0 0 0 0 Consideration Price (Rs.) 0 0 0 0 0 (Zero) 0 0 0 0 0 0 0 0 First Party R K R ANANTHARAMAN o o• 0 0 0 0 0 Second Party ELECTION DEPT 0 0 0 0 0 Stamp Duty Paid By R K R ANANTHARAMAN 0 0 0 0 0 Stamp Duty Amount(Rs.) 20 0 (Twenty only) 0 0

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FORM 26 (See Rule 4A)

Affidavit to be filed by the candidate along with nomination paper ing Officer for election to ...LOK SABHA...... from ... PUDUCHERRY PARLIAMENTARY Constituency ncy)

0000144190

~;;::;:im:r;;:::~r this St<1mp Cenrfrano should ava1lal 1e on the w11DMe renders It invalid. 2 The onus of checking the leg1t1macy 1s on the users of the certificate 3. In case of any discrepancy please inform the Competent Authority PART-A

I ...... R.K.R. ANANTHARAMAN ...... son of... K. RAMATCHANDIRANE ...... aged ...... 41...... years, resident of 18/1 School Street, Nonankuppam, Ariyankuppam post, Puducherry - 605 007 .....(mention full postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under:

(1) I am a candidate set up by ...... PATTALI MAKKAL KATCHI ...... (name of the political party) am contesting as an Independent Candidate(Strike out whichever is not applicable)

(2) My name is enrolled in ...... MANAVELY PUDUCHERRY...... (name of the Constituency and the State, at Serial No...... 191 ...... in Part No..... 10......

(3) My contact telephone number(s) is ...... 9443265171 ...... and my e-mail id (it any) is ... [email protected] ...... and my social Media account(s), if any are ...... [email protected]......

(4) Details of Permanent Account Number(PAN) and status of filing of Income Tax return

SI.No. Name PAN The financial year for Total income shown in which the last Income Tax Income Tax Return (in return has been filed Rupees) 1 R.K.R. ADGPA7503B 2012 2013 Rs:221240/ NIL ANANTHARAMAN 2 Lavanya@ ACOPL6812D 2012 2013 Rs:57830/ NIL Mahalakshmi 3 Aishwariva Nil Nil Nil Nil NIL 4 Sharani Nil Nil Nil Nil NIL 5 Dependent-3 Nil Nil Nil Nil NIL

(5) I am/am not accused of any offence(s) punishable with imprisonment for two years or more in pending case(s) in which a charge(s) has/have been framed by the court(s) of competent jurisdiction.

If the deponent is accused of any such offence(s) he shall furnish the following information:

(i) The following case(s) is/are pending against me in which charges have been framed by the court for an offence punishable with imprisonment for two years or more:

(a) Case/First Information Report No./Nos. together with complete details of NIL concerned Police Station/District/State. (b) Section(s) of the concerned Act(s) and short description of the Not Applicable offence(s) for which char ed. (c) Name of the Court, Case No. and date of order Not Applicable !akin co nizance:

~ c 0 /!//t ·/I , • SI NED BEFORE ME ~~~ (d) Court(s) which framed the char es Not A licable (e) Date(s) on which the charge(s) was/were Not Applicable framed (D Whether all or any of the proceeding(s) have been Not Applicable stayed by any Court(s) of competent ·urisdiction.

(ii) The following case(s) is/are pending against me in which cognizance has been taken the court (other than the cases mentioned in item(i) above):

(a) Name of the Court, Case 1. Hon'ble Judicial Magistrate court II at Cuddalore. No. and date of order S.T.C. NO. 148/2013, (Cr No 44/2013, Cuddalore NT Police taking cognizance: Station , Tamilnadu.) Date of order taking cognizance was 03 I 6 /2013 2. Cr No 400/2013 .Villupuram Town Police station, U/S 143, 188, of IPC R!W 7(1) (A) of the Criminal Law Amendment Act, Investigation is pending charge sheet not filed/ Cognizance not taken. 3. Cr No.32/2014 U/S 294, 153-A(a)(c),153-B(c), 295 A,505(2)(c),505(2),509 IPC Orleanpet Police Station, Puducherrv. (b) The details of case(s) 1.Case is Pending,4 numbers of prosecution witnesses were where the court has taken examined and case posted for further witnesses on 20/4/2014. cognizance, section(s) of 2. Charge sheet not yet filed by the investigation officer the Act( s) and description Cognizance not taken. of the offence(s) for which 3. Charge sheet not yet filed by the investigation officer cognizance taken. Cognizance not taken. (c) Details of Appeal(s)/ Application(s) for revision -NIL (if any) filed against the above order(s) Note : Details of all pending cases in which cognizance has been taken by the Court, irrespective of the quantum of punishment or framing of charges will have lo be disclosed.(ECl's clarification no.3/4/2012/SDR dated 26.9.2012) (6) I have not been convicted of an offence(s) other than any offence(s) referred to in sub-section (1) or sub-section (2) or covered in sub-section (3), of section 8of the Representation of the People Act, 1951 (43of1951) and sentenced to imprisonment for one year or more. If the deponent is convicted and punished as aforesaid, he shall furnish the following information:

ln the following cases, I have been convicted and sentenced to imprisonment by court of law :

(a) The details of case(s),section (s) of the concerned Act(s) and description of the offence(s) for NIL NIL NIL NIL which convicted. (b) Name of the Court(s), case No (s) and dale(s) of order(s) NIL NIL NIL NIL (c) Punishment imposed NIL NIL NIL NIL (d) Whether any appeal was/has been filed against the conviction order, If so, details and the NIL NIL NIL NIL present status of the appeal: i (7) That I give herein below the details of the assets (movable and immovable etc.} of myself, my spouse and all dependents.

A. Details of movable assets :

Note 1 : Assets in joint name indicating the extent of joint ownership will also have to be given Note 2: In case of deposil/lnvestment, the details including serial Number, Amount, date of deposit, the scheme, name of the Bank/Institution and Branch are to be given Note 3: Value of Bonds/Share Debentures as per current market value in Stock Exchange in respect of listed companies and as per books in case of non listed companies should be given. Note 4: Details including amount is to be given separately in respect of each investment. Note 5: Details including amount is to be given separately in respect of each investment.

SI.No Description Self Spouse Depe Depen Depen ndent dent2 dent3 1 m Cash in hand Rs.75,000/ Rs.50,000/ NIL NIL NIL (ii) Details of deposit in Bank Indian Bank Indian Bank accounts (FDRs), Term Ariyankuppam Ariyankuppam Deposits and all other Puducherry Puducherry types of deposits including SB Ale No :6210577532 Ale No :6210972804 NIL NIL NIL saving accounts) Deposits Amount : Rs:51,000/ Amount: Rs 1000/ with Financial Institutions lndian Bank lndian Bank Non-Banking Financial Ariyan ku ppa m Ariyankuppam Companies and Puducherry Puducherry Cooperative Societies and SB Ale No :717641533 SB Ale No the amount in each such Amount: Rs:600/ :717641464 deposit Amount : Rs:638/ UCO Bank Puducherry Main SB Ale No :00590110023969 Amount: Rs:10200/

(iii) Details of investment in Bonds, debentures/shares and units in Companies NIL NIL NIL NIL NIL /Mutual funds and others and the amount. (iv) Details of Investment in NSS, Postal saving Insurance Policies and NIL NIL NIL NIL NIL investment in any Financial instruments in Post office or Insurance Company and the amount (v) Personal loans/advance given to any person or NIL NIL NIL NIL NIL entity including firm company, Trust etc, and other receivables from debtors and the amount I

~oTA!(y

o P. SEL~RASSOU :: 0 PUDUCHERRY Q ME' 'S., ltegd.No.7101 ~ ""':~ ~..... (vi) Motor IN NOVA RENAULT SCALA vehicles/Aircrafts/Yach ts/ Make:Toyota lnnova Make:RENAULT ships (Details of make Reg.No.PY 01 BQ 5171 Reg.No.PY 01 BY 9055 NIL NIL NIL registration number etc. Year of Purchase 2012 Year of Purchase 2013 year of purchase and Rs.10,00,000/ Rs.8,50,000/ · amount)

Motor TATA ACE Suzuki Access vehicles/Aircrafts/Yachts/ Make :Tata M Make :Suzuki ships (Details of make Reg.No.PY 01 AV 9237 Reg.No.PY 01 BL 0578 NIL NIL NIL registration number etc. Year of Purchase 2009 Year of Purchase 2011 year of purchase and Rs.1,95,000/ Rs.31,000/ amount)

Motor TATA ACE Tata Ace vehicles/Aircrafts/Yachts/ Make :Tata M Make :Tata ships (Details of make Reg.No.PY 01 AZ 6036 Reg.No: TN 16A 0191 NIL NIL NIL registration number etc. Yearof Purchase 2010 Year of Purchase: 2012 year of purchase and Rs1 ,90,000/ Rs.3,50,000/ amount) Motor ASHOK LAYLAND DOST vehicles/Aircrafts/Yachts/ Make :Ashok Leyland ships (Details of make Reg.No: PY 01 BV 0981 NIL NIL NIL NIL registration number etc. Year of Purchase 2012 year of purchase and Rs.3,75,000/ amount) Motor HONDA AMAZE vehicles/Aircrafts/Yach ts/ Make :HONDA ships (Details of make Reg.No:.PY 01 BY 5171 NIL NIL NIL NIL registration number etc. Year of Purchase 2013 year of purchase and Rs.6,50,000/ amount) Motor EICHER LORRY vehicles/Aircrafts/Yachts/ Make :EICHER ships (Details of make Reg.No :PY01 BU 1065 NIL NIL NIL NIL registration number etc. Year of Purchase 2012 year of purchase and Rs.12,00,000/ amount) Motor vehicles/Aircrafts/Ya chts/ MAHINDRA BOLERO ships (Details of make Make :MAHINDRA NIL NIL NIL registration number etc. Reg.No PY01CA5171 NIL year of purchase and Year of Purchase 2014 amount) Rs. 7,00,000/

Motor TATA MANZA vehicles/Aircrafts/Yachts/ Make :TATA ships (Details of make Reg.No PY01 BC 0452 NIL NIL NIL NIL registration number etc. Year of Purchase: 2010 year of purchase and Rs.4,50,000/ amount)

>( (Vii) Jewellery, bullion and Ornamental Gold Ornamental Gold NIL NIL NIL valuable thing(s) (Give 5 Sovereign 150 Sovereign details of weight and value) Value :Rs.1,00,000/ Value :Rs.30,00,000/ (viii) Any other assets such as NIL NIL NIL NIL NIL value of claims/interest (ix) Gross Total Value Rs 49,96,800/· Rs 42,82,638/· NIL NIL NIL

B. Details of Immovable assets :

Note 1 : Properties in joint ownership indication the extent of joint ownership will also have to be indicated. Note 2 : Each land or building or apartment should be mentioned separately in this format

SI.No Description Self Spouse De pen Depen Depen dent1 dent2 dent3 (i) Aaricultural Land: Location (s) Manavely Manavely NIL NIL NIL Survey number(s) RS.No.12/5 RS.No 12/5 NIL NIL NIL Area (Total measurement 7A .75 CA 16A.50 CA in acres) NIL NIL NIL Whether inherited No No NIL NIL NIL property(yes or No) Date of purchase, in case 22/07/2011 18/10/2010 NIL NIL NIL of self acquired prooertv Cost of land (in case of Rs.5,82,000/ Rs: 7, 13,000/ purchase) at the time of NIL NIL NIL purchase. Any investment on the land by way of NIL NIL NIL NIL NIL development, construction etc. Approximate current market value Rs.6,25,000/ Rs.9,00,000/ NIL NIL NIL ii) Non Aaricultural Land: Location (s) .Villianur Ariyankuppam Commune Commune NIL NIL NIL

Survey number(s) RS No 283/2 RS No 14/8 NIL NIL NIL Area (Total measurement 1200 sq.ft 1000 sq.ft in sq.ft) NIL NIL NIL Whether inherited No No property(yes or No) NIL NIL NIL Date of purchase, in case 7/12/2011 20/07/2012 NIL NIL NIL of self acquired property Cost of land (in case of purchase) at the time of Rs.1,92,000/ Rs. 7,00,000/ NIL NIL NIL purchase. Any investment on the land by way of NIL NIL NIL NIL NIL development, construction etc. Approximate current market "~'"" Rs.3,00,000/ Rs.9,00,00/ NIL NIL NIL 0--..._rr ~ ,_~ I ~~ - ·~r I 'I y o P. SEL~SSOU -< 0 PUDUCHERlY 0- "1~ ~/' L. Regd. No. 7101 ~ ~~ ~ S ~DB FORE ME, t~EN't· O ~ Location (s) Mannadipet Ariyankuppam commune Commune NIL NIL NIL

Survey number(s) RS No 2817 t S No 76/18 RS No 27/2A NIL NIL NIL RS No 27/28 RS No 29/11 RS No 30/1

Area {Total measurement 13, 120 sq.ft 1800 sq.ft NIL NIL NIL in sq.ft) Whether inherited No No NIL NIL NIL propertv(ves or No) Date of purchase, in case of self acquired property 28/05/2013 13/03/2009 NIL NIL NIL

Cost of land (in case of purchase) at the time of Rs.13, 15,000/ Rs.1,44,000/ NIL NIL NIL purchase. Any investment on the land by way of NIL Nil NIL NIL NIL development, construction etc. Approximate current market value Rs.15,00,000/ Rs:3,00,000/- NIL NIL NIL

Location (s) Mannadipet Villianur Commune Commune NIL NIL NIL

Survey number(s) RS No 26/12 . RS No 118/14 RS No 27/2A RS No 27/28 NIL NIL NIL RS No 29/11 RS No 30/1 RS No 30/2

Area (Total measurement 10,800 Sq. ft 1750 sq.ft in so .ftl NIL NIL NIL Whether inherited property(yes or No) No No NIL NIL NIL

Date of purchase, in case of self acquired property 28/05/2013 18/07/2012 NIL NIL NIL

Cost of land (in case of purchase) at the time of Rs.10,80,000/ Rs. 70,000/ NIL NIL NIL purchase. Any investment on the land by way of Nil Nil NIL NIL NIL development, construction etc. Approximate current market value Rs:11,00,000/- Rs:1,00,000/ NIL NIL NIL

I Location (s} Mannadipet Ariyankuppam Commune Commune NIL NIL NIL

Survey number(s} RS No 27/2A RS No 147/2 RS No 27/28 RS No 29/11 NIL NIL NIL RS No 30/1 RS No 30/2

Area (Total measurement in sq.ft} 10,673 Sq.ft 3475 Sq.ft NIL NIL NIL

Whether inherited property(yes or No} NO .No NIL NIL NIL

Date of purchase, in case of self acquired property 28/05/2013 07/12/2011 NIL NIL NIL

Cost of land (in case of purchase} at the time of Rs.10,70,000/ Rs.1,40,000/ NIL NIL NIL purchase. Any investment on the land by way of Nil NIL NIL NIL NIL development, construction etc. Approximate current market value Rs.12,00,000/ Rs:2,00,000/ NIL NIL NIL

Location (s} NIL Manavelv Commune NIL NIL NIL Survey number(s} NIL RS No 70/1/B NIL NIL NIL Area (Total measurement NIL in sq.ft} 2781 sq.ft NIL NIL NIL

Whether inherited NIL property(yes or No) No NIL NIL NIL Date of purchase, in case NIL of self acouired property 03.09.2012 NIL NIL NIL Cost of land (in case of NIL purchase} at the time of Rs: 20,86,000/ NIL NIL NIL purchase. Any investment on the land by way of NIL NIL NIL NIL NIL development, construction etc. Approximate current NIL Rs.25,00,000/ NIL NIL NIL market value

SIGNE~ inEFORE ME ~~ Location (s) NIL Thavalakuppam Revenue Village NIL NIL NIL

Survey number(s) NIL RS No 121/13 NIL NIL NIL

Area (Total measurement NIL in sq.ft) BA NIL NIL NIL Whether inherited property(yes or No) NIL No NIL NIL NIL

Date of purchase, in case NIL of self acquired property 29.01.2014 NIL NIL NIL Cost of land (in case of NIL purchase) at the time of Rs.6,50,000/ NIL NIL NIL purchase.

Any investment on the NIL NIL NIL NIL land by way of NII development, construction etc. Approximate current NIL Rs.6,50,000/ NIL NIL NIL market value iii) Commercial Buildings (Including apartments):· Location (s) Manavely Revenue NIL NIL NIL NIL Vi\laqe Survey number(s) RS.No 14/3, 14/10 NIL NIL NIL NIL Area (Total measurement 7200 sq,ft NIL NIL NIL NIL in sq.ft) Whether inherited No NIL NIL NIL NIL propertvlves or Nol Date of purchase, in case 31/01/2000 NIL NIL NIL NIL of self acquired property Cost of land (in case of Rs : 71,000/ NIL NIL NIL NIL purchase) at the time of purchase. Any investment on the Rs: 10,00,000/ NIL NIL NIL NIL land by way of development, construction etc. Approximate current Rs: 12,00,000/ NIL NIL NIL NIL market value iv) Residential Buildings llncludina aoartmentsl:· Location (s) Mudaliarpet Ariyankuppam NIL NIL NIL commune Survey number(s) R. S. No:44/6 pt R. S. No : 38/66 NIL NIL NIL Area (Total measurement NIL NIL NIL in sq.ft) 600 sq.ft 1131.5 Sa.ft Whether inherited NIL NIL NIL property(yes or No) No No Date of purchase, in case NIL NIL NIL of self acquired property 20 /06/ 2013 08/10/2003 ~o'TA~y y x ..I \' ·I .t. I ) 0 P.SEL~SSOU I 0 PUDUCttERlY Cl- 6i5J /f j L. Reg~.No. 7101 ~ SIGNED BEFORE ME ~~ ~ -~A1F.N·'°... ? ~~---- ~~ Cost of land (in case of NIL NIL NIL purchase) at the time of Rs: 9,00,000/ Rs : 70,0001 purchase. Any investment on the NIL NIL NIL land by way of Rs : 10,00,000/ Rs : 10,00,000/ development, construction etc. Approximate current NIL NIL NIL market value Rs : 19,00,000/ Rs : 20,00,000/ (v) Others (such as interest NIL NIL NIL NIL NIL in prooertv (vi) Total of current market NIL NIL NIL value of (i) to (v) above Rs. 78,25,000/ Rs. 75,50,000/.

(8) I give here below the details of liabilities/dues to public financial institutions and government:

Note: Please give separate details of name of bank, institution, entity or individual and amount before each item.

SI.No Description Self Spouse Depen Depend Dependent dent1 ent2 3. Iii Loans or dues to Bank/Financial institutionls\:· Name of the Bank or Uco Bank Indian Bank NIL NIL NIL financial institution Puducherry. Ariyankuppam

Amount outstanding Rs. 7,67,000/- Rs.4,77,000/- NIL NIL NIL

Nature of Loan 4 wheeler loan Home loan NIL NIL NIL

Name of the Bank or Indian Bank Sundaram financial institution Ariyankuppam Finance NIL NIL NIL Puducherrv. Amount outstanding Rs :5,85,000/- Rs.7,30,000/- NIL NIL NIL

Nature of Loan 4 wheeler loan 4 wheeler loan NIL NIL NIL Name of the Bank or Sundaram Finance financial institution NIL NIL NIL NIL Amount outstanding Rs :3,86,000/- NIL NIL NIL NIL Nature of Loan 4 wheeler loan NIL NIL NIL NIL Name of the Bank or Sundaram Finance financial institution NIL NIL NIL NIL Amount outstanding Rs :5,42,000/- NIL NIL NIL NIL Nature of Loan 4 wheeler loan NIL NIL NIL NIL Name of the Bank or Uco Bank financial institution Puducherrv NIL NIL NIL NIL Amount outstanding Rs.1,27,57,310/- NIL NIL NIL NIL

Nature of Loan CC, Term Loan NIL I NIL NIL NIL ~oTA~,y

0 P. SELvissou ~ 0 PUDUCttEHY E ~ ltegd.Ne.7101 ~ ,-t I ~ ' t.~F.'N'{ O

(9) Details of profession or occupation

(a) Self: Business, Bharat Gas distributor (Sree Ramachandra Gas Agencies) (b) Spouse: Business

(10) My educational qualification is an under: a) Self: B.Tech, Pondicherry University 1997 (b) Spouse: BTech, Pondicherry University 1997 PART-B

(11) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART-A:

1 Name of the candidate R.K.R. ANANTHARAMAN 2 Full postal address 18/1 School Street, Nonankuppam, Ariyankuppam post, Puducherrv 605 007 3 Number & name of the constituency and state 01 - PUDUCHERRY 4 Name of the political party which set up the candidate PATTALI MAKKAL KATCHI (otherwise write "independent" 5(i) Total number of pending cases where charges have been framed by the Court for offences punishable with NIL imprisonment for two vears or more 5(ii) Total number of pending cases where the court(s) have 1 case (the other 2 cases are taken cognizance (other than the cases mentioned in item(i) pending as charge sheet not above) vet filed) 6. Total number of cases in which convicted and sentenced to imprisonment for one year or more (except for offences Nil referred to in sub-sections (1) (2) or (3) of section 8 of the Representation of the Peo ile Act, 1951 l 7 PAN of Year for which Total income shown last income tax return filed a) Candidate ADGPA7503B 2012- 2013 Rs : 221240/ b) Spouse ACOPL6812D 2012- 2013 ' Rs: 57830/ c) Dependents NIL NIL NIL 8 .Details of Assests and Liabilities in Rupees SLN Description Self Spouse Depen Depe Depe 0 dent1 ndent ndent 2 3 A Movable Assets (Total Rs.49,96,800/ Rs.42,82,638/ Nil Nil Nil Value) B Immovable Assests I Purchase price of self Rs.52, 10,000/ Rs.45,73,000/ Nil Nil Nil acquired immovable property II Development/constructio Rs.20,00,000/ Rs.10,00,000/ Nil Nil Nil n cost of immovable property after purchase (if applicable) Ill Aooroximate current market price of (a)Self acquired assets (Total Value) Rs.78,25,000/ Rs.75,50,000/ Nil Nil NII (b)lnherited assests Nil Nil Nil Nil Nil (Total value) 9 Liabilities I Government dues Nil Nil Nil Nil Nil (Total) II Loans from Bank Nil Nil Nil Financial Institutions and Rs1,68,37,310/ Rs.12,07,000/ other (Total)

x 10 Liabilities that are under dispute : I Government dues Nil Nil Nil Nil Nil (Total) II Loans from Bank, Nil Nil Nil Financial Institutions and Nil Nil other (Total) 11 Highest educational B.Tech B.Tech Nil Nil Nil qualification Pondicherry Pondicherry University University 1997 1997

(Give details of highest School/University education mentioning the full from of the certificate/diploma/degree course, name of the School/College/University and the year in which the course was completed.

Note: Details of all pending cases in which cognizance has been taken by the court, irrespective of the quantum of punishment of framing of charges will have to be disclosed (EC l's clarification no.3/4/2012/SDR date 26.9.2012)

VERIFICATION

I, the deponent, above named, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief and no part of it is false and nothing material has been concealed therefrom. I further declare that:

(a) there is no case of conviction or pending case against me other than those mentioned in items 5 and 6 of Part A and B above : (b) I my spouse, of my dependents do not have any asset of liability, other than those mentioned in items ?and 8 of Part A and items 8,9 and 10 of Part B above

Verified at ... Puducherry...... this the ...... 51h ...... day of ... April. ..2014......

Note 1 Affidav·1t should be filed latest by 3.00 p.m. on the last day of filling no ination Note2 Affidavit should be sworn before and Oath Commissioner or Magistrate of the First Class or before a Notary Public Note3 All columns should be filed up and no column should be left blank. If there is no infonmation to furnish in respect of any item either "NIL" or "NOT APPLICABLE" as the case may be, should be mentioned Note 4 The Affidavit should be either typed or written legibly and neatly. : ~ ; / SIGNED BEFORE ME

y1 ~~~/4\~IL\:

P.SELVARASSOU ,l!.A .. LL.B. ADVOCATE & NOTARY, Govt. of India, Regd. No. 7101, No.13,New Strett. PiII ili cl1pva dy, Puduchtrry - 605 014. 12

ANNEXURE XIV·A

Memo No...... Dated......

From: Returning Officer for Puducherry Parliamentary Constituency

To, ...... (Name of the candidate)

Sub.: Election to the House of the People from Puducherry Parliamentary constituency· Filing of the required affidavit.

You have filed your nomination paper for the above election today, but you have not filed, along with your nomination paper, the affidavit prescribed by the Election Commission vide its

Order No.3/ER/2003/JS-ll dated 271h March 2003 and or the affidavit in Form 26. A copy each of the said Form 26, Order and the format of the requisite affidavit is enclosed for your ready reference.

You are required hereby to furnish the requisite information in the prescribed affidavit, duly sworn before a Magistrate of the First Class or a Notary Public or Oath Commissioner appointed by the High Court.

It should be noted that the requisite affidavit must be furnished by you immediately and posltively before 3.00 p.m on the last date of filing of nomination i.e......

You may also note the consequences of not filing the requisite affidavit prescribed vide the above referred order dated 27-3-2003 as explained in para 16(3) of the said Order of the

Commission.

(Returning Officer)

O:ISANDS\A1\A1DOC\AMEND TO El.EC LAW.NOMI INSTNS__AFFlOAVITS\2013\NOMINATION FORMSIENGLISH\Foon-2A(House of lhe People)wllh revised Fam 26eng.doc.doc

ORIGINAUDUPLICATE

(Original to be kept with nomination paper and duplicate to be handed over to candidate)

CHECK LIST OF DOCUMENTS IN CONNECTION WITH FILING OF NOMINATIONS Name of Constituency ...... Name of Candidate Date and time of filing nomination paper SI.No. of nomination paper

Whether filed (write yes/no) SI. (if there is any Documents No. defect/shortcoming in the documents, the same should be Sn1>r.ified) 1 Affidavit in Form 26 a) Whether all columns are filled up

b) If not, which are blank column(s) (Please specify):

c) Whether the affidavit is sworn before an Oath Commissioner or Magistrate of First Class or before a Notary Public) 2 Certified extract of electoral roll (when candidate is an elector of a different constituency) 3 Form A and B (applicable in the case of candidates set up by political parties 4 Copy of caste certificates (if the candidate claims to belong to SC/ST) 5 Security deposit (whether made)

6 oath/affirmations (whether taken)

The following documents which have not been flied should be flied as Indicate below:

a) ...... should be filed latest by ......

b) Above mentioned columns in the Affidavit in Form 26 have been left blank. You must submit fresh Affidavit with columns duly filled up before the commencement of scrutiny of nominations, failing which the nomination paper will be liable to be rejected.

c) ...... should be filed latest by......

Received l( Signature of candidate Signature of RO/ARO

Date&Time: Place: N.B 1 The llffldavlt In Fonn 26 and Fonns A & B have to be filed latest by 3.00 P.M on the last date offl/Ing nominations 2 The nomination paper wit/ be rejected Ifa candidate falls to fl/I the blanks In Fonn 26 even afler f9trllnder by RO by the hour fixed for scrutiny ofnomination paper. 3 Oath has to be taken afler fl/Ing nomination papar and before the date fixed for scrutiny 4 Certified extract ofelectoral roll can be flied upto the time ofscrutiny 5 Security deposit should be mede either before fl/Ing of nomination papar or at the time of fl/Ing of nomination paper. Therefore, there /s no question ofIssuing notice for making the security deposit.

•

ORIGINAL/DUPLICATE

(Original to be kept with nomination paper and duplicate to be handed over to candidate)

CHECK LIST OF DOCUMENTS IN CONNECTION WITH FILING OF NOMINATIONS Name of Constituency ...... Name of Candidate Date and time of filing nomination paper SI. No. of nomination paper

Whether filed (write yes/no) SL (if there is any Documents No. detect/shortcoming in the documents, the same should be specified) 1 Affidavit in Form 26 a) Whether all columns are filled up

b) If not, which are blank column(s) (Please specify):

6 Oath/affirmations (whether taken)

The following documents which have not been filed should be filed as Indicate below:

a) ...... should be filed latest by ......

b) Above mentioned columns in the Affidavit in Form 26 have been left blank. You must submit fresh Affidavit with columns duly filled up before the commencement of scrutiny of nominations, iling which the nomination paper will be liable to be rejected .

...... should be filed latest by ......

Signature of RO/ARO

1 The affidavit In Fonn 26 and Fonns A & B have to be filed latest by 3.00 P.111 on the last date offl/Ing nominations 2 The nomination paper wt/I be rejected ff a candidate falls to fl/I the blanks In Fonn 26 even after reminder by RO by the hour fixed for scrutiny ofnomination ~r. 3 oath has to be taken after fl/Ing nomination paper and before the date fixed for scrutiny 4 Certified extract ofelectoral roll can be filed upto the time ofscrutiny 5 Security deposit should be made either before fl/Ing of nomination paper or at the time of fl/Ing of nomination paper. Therefore, there Is no question ofIssuing notice for making the security deposit