}c· R~.A-<.J £@ dt1·.IHI TELANGANA K. RAJESWA~I 2 B 91 . N~: >5S' Date.ll/0S/2019 Licenced Stamp Vendor LICENCE No.16 -II -43/2017 Sold'fl : Komatireddy Laxmi H.No.6-3-382, Near Himalaya Book World W10. : Komatireddy Rajgopal Reddy, RJo. Nalgonda. Beside Petrol Pump, Punjagutta For~10m Self FORM 26 HYDERABAD (SOUTH) DISTRICT (See rule 4A) Mobile No:+91-8686669973 I. ,I ,I Affidavit to be filed by the candidate along with nomination paper before the returning officer for election to Legislative Council of Telangana State from Nalgonda District - Local Authorities . Constituency PART-A II KOMATIREDDY LAXMI** wife of RAJGOPAL REDDY KOMATIREDDY Aged 47 years, resident of 2-19, B VELLEMLA, NARKETPALLY MANDAL, NALGONDA DISTRICT., a Icandidate at the above.election, do hereby solemnly affirm and state on oath as under:- I \~\\_, i \~ 1 SANDHI SR!NIVAS REDOV M.A., LL.B., i ADVOCATE s NOTARY • Appointed by Govt. of A.P INDIA I G.O.M.S. No. 385, Lr. No. NRi1981212011 R€3i: 7-8-74, Sri Nagar Colony, P"dnagalRoad. NLG. I Office: S.PT Market, N.A.LGONDA- 508 001 (AP) (1) I am a candidate set up by INDIAN NATIONAL CONGRESS PARTY(** name of the political party) f** am Gontestingas an Independent candidate. (** strike out whichever is not applicable) (2) My name is enrolled in Nakrekal Assemhly(95), Telangana State (Name of the constituency and the State), at Serial No.136 in Part No 160 with EPIC No.WPI0344309 (3) My contact telephone number (s) is fare 9849211221 (Mobile), 040-23606068 (Landline) and my e-mail id is iaxmikomatireddv99(wgmail.q)111 and my social media accounts are ... Facebook: NIL Twitter : NIL Website : NIL (4) Details of Permanent Account Number (PAN) and status of filing of Income Tax return: Sl. Names PAN The financial year Total income shown in for which the last Income-tax return (in Rupees) No. Income-tax return for the last five Financial has been filed Years completed (as on 31st March) 1. fK. LAXMI AKTPK2762Q FY 2017-18 i) Rs.1,17,16,370/- (FY17-18) Self FY 2016-17 I,ii) Rs. 1,16,87,710/- (FY16-17) FY 2015-16 ~iii)Rs. 57,17,940/- (FY15-16) FY 2014-15 iv) Rs. 72,90,100/- (FY14-15) FY 2013-14 v) Rs. 58,40,770/- (FY13-14) 2 IKOMATIREDDY AEOPK0470J FY 2017-18 i) Rs. 34,83,550/- (FY17-18) iRAJGOPAL IREDDY FY 2016-17 ii) Rs.1,42,77,180/- (FY16-17) Spouse FY 2015-16 iii) Rs.33,51,880/- (FY15-16) FY 2014-15 iv) Rs.32,70,320/- (FY14-15) FY 2013-14 v) Rs. 33,33,230/- (FY13-14) 3 HUF (If Candidate is Not Applicable FY 2017-18 i) Rs. Nil/- (FY17-18) KartaiCorparcener) FY 2016-17 ii) Rs.NiI/- (FY16-17) KOMATIREDDY AAFHK7953R FY 2015-16 iii) Rs.Nil/- (FY15-16) RAJGOPAL REDDY) spouse - FY 2014-15 iv) Rs.Nil/- (FY14-15) karta in HUF FY 2013-14 v) Rs. Nil/- (FY13-14) 4 Dependent - 1 Not Applicable Not Applicable i) Not Applicable , .>: 4f?~<;\'2J ~v- .. SANDHI SR~N!Vt',~ REDO¥ MA, Ll.B. ADVOCATE & NOTARY Appotnted by Govt. ofAP !NDIA G.O.M.S. No. 385, Lr. No. NPJ19812/2011 Resi: 7-8-74, Sri Nagar Colony, Pianagal Road i\JLG Office: S.PT. Market, NALGONDA - 508001 (AP), .. Not Applicable ii) Not Applicable Not Applicable iii) Not Applicable Not Applicable iv) Not Applicable Not Applicable v) Not Applicable 5 lOependent- 2 Not Applicable Not Applicable i) Not Applicable Not Applicable ii) Not Applicable Not Applicable iii) Not Applicable Not Applicable I,iv)Not Applicable Not Applicable I'v) Not Applicable 6 lDependent- 3 Not Applicable Not Applicable i) Not Applicable Not Applicable I,ii)Not Applicable Not Applicable I,iii)Not Applicable Not Applicable Kiv)Not Applicable Not Applicable ~v)Not Applicable Note: It is mandatory for PAN holder mention PAN and in case of no PAN, it is should be clearly stated "No PAN allotted". (5) Pending criminal cases (i) I declare that there is no pending criminal case against me• ., (Tick this alternative if there is no criminal case pending against the Candidate and write NOT APPLICABLE against alternative (ii) below) OR (ii) The following criminal cases are pending against me: NOT APPLICABLE (If there are pending criminal cases against the candidate, then tick this alternative and score off alternative (i) above, and give details of all pending cases in the Table below) Table (a) FIR No. With name and address Not Applicable Not Applicable Not Applicable of Police Station concerned ~:;~\iJ SANDHI SB~N~V.~\SREDDY M.A., LL.B.. ADVOCATE &. NOTARY Appointed by Govt. ofA.P INDIA G.O.M.S. No. 385, Lr. No..NRI19812J2011 Re3i: 7-8-74, Sri Nagar Colony, PBnagal Road, NLG. Off;·,,, S.PT Market, NALGONDA- 508 001 IA.P) (b) Case No. with Name of the Not Applicable Not Applicable Not Applicable Court (c) Section(s) of concerned Not Applicable Not Applicable Not Applicable Acts/Codes involved (give no. of the Section, e.g. Section .•..... of fPC, etc.). (d) Brief description of offence Not Applicable Not Applicable Not Applicable (e) Whether charges have been Not Applicable Not Applicable Not Applicable framed (mention YES or NO) (t) Ifanswer against (e) above is YES, Not Applicable Not Applicable Not Applicable then give the date on which charges were framed (g) Whether any Appeal! Not Applicable Not Applicable Not Applicable Application for revision has been filed against the proceedings (Mention YES or NO) \"7\"Jr<1 SANDHI SRINIVAS REDDY M.A., LL.B.. ADVOCATE & NOTARY Appointed by Govt. of A.P INDIA G.O.M.S. No. ~85, tr. No. NRi1981212011 RB3i: 7-8-74, Sri Nagar Colony, PBnagal Road, NLG. Office: S.PT Market, NALGONDA - 508 001 (A.P) 4 (6) Cases of conviction (i) I declare that I have not been convicted for any criminal offence. ./ (Tick this alternative, if the candidate has not been convicted and write NOT APPLICABLE against alternative (ii) below) OR (ii) I have been convicted for the offences mentioned below: Not Applicable (If the candidate has been convicted, then tick this alternative and score off alternative (i) above, and give details in the Table below) (a) Case No. Not Applicable Not Applicable Not Applicable (b) Name of the Court Not Applicable Not Applicable Not Applicable (c) Sections of Acts/Codes involved Not Applicable Not Applicable Not Applicable (give no. of the Section, e.g. Section ....... of IPC, etc.). (d) Brief description of offence for which convicted Not Applicable Not Applicable Not Applicable (e) Dates of orders of conviction Not Applicable Not Applicable Not Applicable (t) Punishment imposed Not Applicable Not Applicable Not Applicable (g) Whether any Appeal has been NO NO NO filed against conviction order (Mention YES or No) (h) Ifanswer to (g) Not Applicable Not Applicable Not Applicable above is YES, I give details and present status of appeal I // \_J /5 ~;\~' , SANDHIS REDDY U~ M.A., LL.B., ADVOCATE & NOTARY Appointed by Govt. of A.P iNDIA G.O.M.S. No. 385, lr, No. NRJ1981212011 RS'i: 7-8-74, Sri Nagar Colony, PBnag[:ljRoad NLG. it-.I r~(· -_ (6A) I have given full and up-to-date information to my political party about all pending criminal cases against me and about all cases of conviction as given in paragraphs (5) and (6). NOT APPLICABLE [candidates to whom this Item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6 (i), above J Note: 1. Details should be entered clearly and legibly in BOLD letters 2. Details to be given separately for each case under different columns against each item. 3. Details should be given in reverse chronological order, i.e., the latest case to be 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 of2011. (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: I. Assets in joint name indicating the extent of joint ownership will also have to be given. Note: 2. In case of depositlInvestment, the details including Serial Number, Amount, date of deposit, the scheme, Name of the BanklInstitution 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. 'Dependent' means parents, sonts), daughter(s) of the candidate or spouse and any other person related to the candidate whether by blood or marriage, who have no separate means of income and who are dependent on the candidate for their livelihood. Note: 5. Details including amount is to be given separately in respect of each investment Note:6. Details should include the interest in or ownership of offshore assets. Explanation,- For the purpose of this Form, the expression "offshore assets" includes, details all deposits or investments in Foreign banks and any other body or institution abroad, and details of all assets and liabilities in foreign countries'; ~(:.;,,-J/}~«\'-~ l,i::::, '" ND~.l1SRtNIVAS REDO"" 6 ,,,,t!-»"k n MI..A ,LL.B... ADVOCATE 3"NOTARY A ointed by Govt. of A.P INDIA ().g.~.S. No. 385, Lr. No. NPJ~981212011 R~':i:7-3-74, Sri Nagar cOlony,~~~ag;b~~~'(~L~; ',-;"ce: S,PT Market.