FORM 26 (See rule 4A) I Affidavit to be filed by the candidate along with nomination paper before the returning officer for electijm to Lok Sabha from 17 - KHAMMAMllARLIAMENT constituency I PART-A . ' / (2) My name is enrolled in 112 - Khammam (Assembly Constituency), Telangana State at Serial No 291 in Part No 135. (3) Mycontacttelephonenumberis08742·233456 andmyemail id is [email protected] and my social media account(s) (if any) is/are (i) NIL (ii) NIL (iii) NIL (4) Details of Permanent Account Number (PAN) and status of filing ofIncome Tax return: Note: Deponent does not have an HUF and has no dependents. Total income The financial year for shown in Income-tax return SI. which the last Income- Names PAN (in Rupees) for the last five No. tax return has been Financial years filed (as on 3pt March) 1. Self AAJPC7192E (i) 2014-15 : 27,31,610/- ii) 2015-16 : 28,29,568/- 2018 - 2019 iii) 2016-17 : 25,11,0801- (iv) 2017-18 : 30,60,688/- (v) 2018-19 : 7,61,8881- 2. Spouse ADCPC2698B (i) ~014-15 : 3,94,42,113/- (ii) ~015-16 : 2,72,44,859/- 2018 - 2019 (iii) ~016-17 : 1,72,93,779/- (iv) ~017-18 : 10,25,06,854/- (v) ~018-19 : 10,01,38,766/- 3. HUF (If Candidate NIL NIL (i) IS NIL (ii) Karta/Coparcener) NIL (iii) NIL (iv) NIL (v) NIL 4. Dependent 1 NIL NIL (i) NIL (ii) NIL (iii) NIL ::E~ (iv) P~F<'~ NIL ~..:.:~~ • (v) ~~~DA. NIL • '": _. ~ {'l: A ~ '.p otary iI~n,,' r)i:g 2 k:-Q_~ '':''':'; ;"J:j;!!2~7/.~fl 5. Dependent 2 ~IL NIL (i) NIL (ii) NIL (iii) NIL (iv) NIL (v) NIL 6. Dependent 3... NIL NIL (i) NIL (ii) NIL (iii) NIL (iv) NIL (v) NIL Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should be clearly stated "No PAN allotted". (5) Pending Criminal Cases: (i) I declare that there' no pending criminal case against me. (Tick this alternative if ainst the candidate and write NOT APPLICABLE against alternative (ii) below) OR ~ii) The following criminal cases are pending against me. (If there are pending criminal cases against the candidate, then Tick this alternative and score of alternative (i) above, and give details of all pending cases in the table below) Table (a) FIR No. With FIR No.127/2015 NIL NIL name and address P.S. Khanapuram Haveli, of Police Station Khammam District, T.S. 3 (b) Case No. with PRC No.06/2018 NIL NIL Name of the Court II Addl. Judicial First Class Magistrate, Khammam, T.S. (c) Section (s) of Sections: 420, 506 IPC NIL NIL concerned Actsl Sections: 3 (i) (x) of SC/ST ACT Codes involved (give no, of the section, e.g. Section . ofIPC, etc.). (d) Brief description A crime was registered vide Cr. NIL NIL of offence No. 127/20 IS and after investigation, the crime was closed by filing a Final Report on 11.11.2015 as "FALSE" by the police. Thereafter, the de-facto complainant filed a Protest petition and basing on that the Hon 'ble Court has taken cognizance of the offence U/Sec.420, 506 of IPC and 3 (i) (x) of SC/ST ACT against the accused No.1 Smt. Renuka Chowdhury W/o Sreedhar Chowdhury vide PRC No. 06/2018 on the file of the IIAddl. Judicial First Class Magistrate, Khammam which is pending for trial. (e) Whether charges The Final Report/ Charge Sheet has NIL NIL have been framed been filed by the Police on 11.11.2015 (mention YES or as "FALSE". NO) No charges have been framed by the Court. (f) If answer against As above (el NIL NIL (e) above is YES, then give the date on which charges were framed NO NIL NIL 4 (6) Cases of Conviction: v0 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 foroffences mentioned below: N/A (lfthe candidate has been convicted, then Tick this alternative and score of alternative (i) above, and give details in the table below) Table (a) CaseNo. N/A N/A N/A (b) Nameof the Court N/A N/A N/A (c) Selection (s) of Acts/ Codes N/A N/A N/A involved (give no, of the section, (e.g. Section ............ of IPC,etc.). (d) Brief description of offence N/A N/A N/A for which convicted (e) Datesof orders of N/A N/A N/A conviction (f) Punishment imposed N/A N/A N/A (g) Whether any Appeal has N/A N/A N/A been filed against conviction order (mention YES or NO) ~..~- 5 (h) If answer to (g) above is YES, N/A N/A N/A give details and present status of appeal (6A) ~have given full and up-to-date information to my political party about all pending criminal cases V against me and about all cases of conviction as given in paragraphs (5) and (6). (Candidates to whom this item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above) Note: 1. Details should be entered clearly and legibly in BOLDletters. 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. S. Candidate is responsible for supplying all information in compliance of Hon'ble Supreme Court's judgment in W. P (C) No. 536 of 2011. (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 deposit/Investment, the details including Serial Number, Amount, elate of deposit, the scheme, Name of Bank/Institution and Branch are to be given. Note: 3.Value of Bonds/Share Debentures as per the 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: 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 of all deposits or investments in Foreign banks and any other body or institution abroad, and details of all assets and! liabilities in foreign countries'; HUF epende SI. Description Self Spouse nt-3 No. (i) Cash in hand s on28-02-2019 s on28-02-2019 IL Rs. 4,50,000 (ii) Details of deposit in s on28-02-2019 Bank accounts(FDRs, Term Deposits and all tate Bank of INDIA, other types of deposits India, Hubsiguda ubsiguda AlC including saving C 0.52191064661Rs. accounts), Deposits with No.52191060848 56160 Financial Institutions, s.I,44,958 Non-Banking Financial tate Bank of INDIA, Companies and State Bank of ubsiguda (Ganapthi Cooperative societies and India, inance) A/C the amount in each such Secunderabad AlC 0.52191010489Rs. 15000 deposit 0.10284054300 Rs.19546 tate Bank of India, IL IL IL IL ecunderabad AlC 0.10284054297Rs. 99079 Syndicate Bank, yderabad A/C DFC, Khairatabad AlC 0.3006243000001 o. 00211530008749Rs. 6 Rs. 43,38,936 State Bank of lexi Fixed deposit in India, New Delhi DFC, Khairatabad Date C f Opening 02nd Sept 2018 0.10023818969 erial No.50300213295691 Rs. 55,44,709 s. 44,19,087 /;'.. 7 HDFC, ixed deposit in HDFC, Khairatabad AlC hairatabad Date of 0.5010026248073 pening 9th Feb 2019 4 Rs. 21059 erial No.50300235910610 s.30,30,310 IJAYA Bank, BanjaraHills AlC otak Mahindra Bank No.4086010110033 imited, Somajiguda AlC 01 Rs. 17,72,691 0.3011537411Rs. otak Mahindra Bank imited, Somajiguda Ganapathi Finance) AlC 0.5311749624Rs. 99232 Total otal Rs. 1,18,41,899 . 1,41,79,417 IL IL IL IL {Details in nnexure-7A (ii (iii) Details of investment in s on31-03-2018 Bonds, debentures/ shares and units in Incon Engineers he Oxygen Equipment & companies/Mutuai funds Limited No. of ngg.Co.Ltd. No. of and others and the Shares 214594 hares 14573 Book Value amount. Book Value Rs. s. 85,55,517 13,94,861 XEECO Meditek Pvt. The Oxygen td. No. of Shares 203490 Equipment & IL IL IL IL Engg. Co. Ltd. No. of Shares 1310 Book Value Rs. neon Engineers Limited 7,69,075 o. of Shares 2057079 Fusion Chemicals & Products Pvt. Ltd. No. of Shares usion Chemicals & 5800 Book Value roducts Pvt. Ltd. No. of .14,20,884 hares 74200 Book Value t. Ltd. No. of usion Lastek Shares 10000 echnologies Pvt. Ltd. Book Value Rs. o. of Shares 263832 19,52,800 ook Value Rs. 11,95,02,704 8 OXEECO XEECO Technologies echnologies Pvt. vt. Ltd. No. of Shares Ltd. No. of Shares 42996 Book Value Rs. 05000 Book Value 4,79,231 Rs.9,73,750 ARSCO India Pvtttd No. Fusion Lastek f Shares 2582661 Book echnologies Pvt. alue Rs. 9,55,58,457 Ltd. No. of Shares 18076 Book Value ension Hydraulics Ltd. s.81,87,524 o.