.opitt-nA NO J Ppi VAL erantabrat Karraata . - Certificate No. I N-KAP25p622214118 R • Certikaie Issued Qate 27-Mar--20-1 0.5:24 PM AtcOurit: Reference NoNAQ0 (FI)f kacref108/ BELGAUM3j-r.&BL Urtique Do Raterence. SUBEN:OKACSFLO807271368688570R Purcheeed:by AN6ADI-sORESH CHANNABASA f;PA Description of Documerit : Ar,ticre 42 Afficia:yit ..Description : AFFIDAVIT Oonsigeretion`Price (Rs.) {Zero} First•i?arty CHANNAIMSAPF,:.-- - • • ..:-.... Secong Party F...17.URNING OFFICER-02 B.ELAG-AVI P_ C- •••Stamti-OUty Paid. f3y • • :: •.NGADi- 80.1,1a1:1:_Ci-.1ANNABAAPPA . • ,••• . • :parhp. 400.. E. • :- ..(One:1-fp.hcrOONy)-:- • tdatrivliiay al( anis?,ra e. Ptruip,3"- Comp,va:16 gdS, g 14 - • • 14'11 ik • .Arinekuie Additional Affidavit fo be submitted by candidates ::from :02 g.EL40AVI.• • , • . ,1 P:',v-05...,?,:i:,..fty • .•,:*ri ,:!•:'-'•'• -' 14 i ':zir:',1: (,•'131Zi,,,Y1frf,4"..5^..tr i•V V:l',ri..3 az-'.^.••::::::itz,:•;ii..it;.p.e6t .' ..," ,![-Ili q !.1111?-• ••••...i;sI•i. ,?f,j!:,,,,,, ,! •r-,:',.41•:* . '• 3 ••.„, 9,,,i,; , I -..,1:,;1•_:•'•iz ;i-:Z '..;1„t•i,i.:'-'"•"`'3 ,.-. '-'2%! ,IS,'"i..;: =1"•41.••:•-,4.•!•.:', ,, I,' •4g.,; ' :" ",;• '1 (i"..-;",:),.., I% 4:' i•.:::4.,.•.'.:*,i.-f, II! I V. t-.'lf.1*j'ilt' Ai ',q.,:git," alt Ai SLR Sri (n(.-.1Ze of candidate) Son of cHANI‘Ai31 ..• 1,§AIPA• Aged'. year, resident of ."srpQRTr% -sAMPIGE. ROAD,. • VISHWE:SfiyiP:,.RAYYA. • . ••• • , . •• . • ' ' • . • . el ection, unaerr I-hbve b,een allotted go\it,,otcommodation:ai. dny:lirne dyring theperiod-of 100 _ • . • . " • . .10.yearS priOr lo.theidcite .of• nofifroot ion Of 4116: curient election-:. • OR .goyt.;':'0.•CcOr.riPnOdation at No:.3,....)0U.11-.-.401\jig•11-IN, • •, , • . .DELHI110011 .:(0)60110n:.-.1126.d.ddris of• last:• .10 .yedr ..pridr--to the 'date of.. notification. of the. , .660ent.e1:4otton, and there. are no arrears- of any .dt.fe-:tO:•iae.::1:• -.5cird. 'tov,icitras:.:r6nt !.. far the Water and • • telephono at :the sdd:accomi-nodoilor-1-16s: : : (lhe:-•daie•habk:1 be then la$f-dae of-:the 3d month prior to, month in which-.1hp.: el 00r) dhhd . • , • • . (id): ".11(3, dO.es-. c'prtif.100• . - •..'frarril1 • • .• .I;, the= deponent -above harfied, do...hereby verify and Oedate thaf'.121*.<266ve: statements dre,tOl'itct to::the best of toY.kn.olOdge, and-np of it.is' falser:: D.PONERIT (;\140gt410 Bq.ORP , Ili G., Ac(ovot.oirc.ii,16.try • FORM 2A (,,Vty ruh: N()NTIN All ON TAP R EIcTtiorrio Pe() 1ru uLsrtturat. \:i r, ICh PA R 1'I 01::P.Atet: Elf 1W ,GW, CO EN u :IS E(3'i'Aty('I.;LCABL pART 1, &id bY.Ctiiidithife- St. Lip h r 'cogniF:ed politictii2pail)1 - . 1.noni nine zis:zic:int:liciaie 1iNr-.'efeelitin :10:th...c House -pi" Lhe 13.wp [ion.) lilt! 02- --13E1,41G;\ 1 Candidate name AN(7A1)1 Rit:Sil Father*sikrt ;?-111.1s1i-ankr-s' rutIlle !ANNA BA SA IVA addret 'SPOORTi" 13.0Ab, V1SHWESH \C'ARAYNA 11.E.LAOAVI (.1i 9. 'name is.entereV ac sAo 1149 in Nit'NO OS: 61 the' .electni"zti rcill 11- 13ELAGA.V1 OTTAR 1(iksSernbly 114(31cl-icy comjirisrid within) ,OZ Parliamentary Constituency, r\tv nattic V. "AP A. Siff- SIDARA. 3.1.1A R and ; (interea S.No 1 0;111 • :(,[&.:10ri I roll for 11- 1 AGAVI UTTA EZ (A sscriihIN .k\-jthoi) 02.— 1) EI \;(.; A \-'1. Ptirly.mwritilyy • t?.."2.3.0.3.20,1 Sigo t liroposer , . • lily panjy liereby oc)p-ijo4o as cfrii lldaiG fo'.etc -thn to .the. 116.use the 1 collie . . Parliament-a COITS,(!:("11:.:iley . - ; itatllilr .. ... , . .... postal address„..... ...... .... .. ... ... .. • •s.Tfi.inip. . .. • • . • ' . , .... ...,•.•. ,,,,, •. %• 1)111). • (1).'i)(:\Y61]rt-.1 re. (,(7•0 below Avc •• ().1-s. Piirtictillir•N 0 1 ills p t-6 pos0-..s 11 ti LI t-11 0 r s if; bat u os .. -. Lno.••• atrie ()I- . frketOr Roll No 'of-• , KTt.iiity- 1 ,ii,711iiiire_.. 'Dille z. : . componelit. - . ..i)roposo! • .. • ,. .. • t --,--------y--.,--: .... A s.i-t•!1-111)I'v . }'.alt '1-4(.i,,,i)1 - ,.f..,.` 0 ; In . C.:4Th ,'I. j4 ul...1.1ey 1 1I;?e1c)r;[1 '11-iot m..11- ... Roli 1.)'t2. -1.tm 61(2ct(IN•() cons w.•; proppsLt. • ' , PARTII1 ani.lidaW.:int::nlioni.:(1 in 1.):.irtll•Ptit-I-11.(in'i ()in notitti)p,licd,)to.) ass ni .to . • , • nation 111(.1 red . t ci CriiniSh".1 0. 0 ...n0Y rO1Cif?•11' .541t040iinty,r (b) thAt. bavt2;comple(cd• .63. .cat oroge: [S TA c(i) W1-1 ICI I IiVEK (1)) (1): 00!.1•01-!•jc,...1'.ari, by A.RATIYA.:JANATA-:P. ARTY pqrty.;•:whieh).$- VctognIs.q(1.-M.Itipnal Pary/E4t-102• P; ++y initi .Sidle and that. [he :yini.101 '•••• i;es'41:41;(41..F61.f.th • OIZ:' • •)-(1i) thIlt...latn.e40 at tlii. 7 etectit.)0;,Asr.th .,,,;,....,,,, ,,, ,, ,, , ,, ................................ Oart}.-.riiich1:\a-:ic-f-tisered7-unr(".:-.C6gnied 0OlitiCal.. pat ly/iliat I - am ..Orttistirti-,;.this election tt an nth -ctrididat...*,. (Strike otti.,A3,-Iiiell is• not -.applicabte) and thzit- . the .$)'mhols 3:have'hosen.: in••orkler ol prelcronee. are.----- ((1) • that ny) nanic trod my. fath .risinriptiter';-,/h ps- .11(t-ti'l)id):;., nanie:- ilave.1;01. :c(;rree. sth,.;iielt :nut'. 1. -- • • abovein ante.O1'. the.ltaguage): _ - • . • ). that to .the he.si .oc- rrty•loto%tiocve and belief - I .tits qualified'and..noi alsO. di!iiitnilincEl (e. .- .. , • .. Tor being.cliu;:cw.to ,1j11. the kin in hel tOtiSe Or ti1C. Pect)1C., further cleClare that 1 am a tilehther of the :asteitribe \vhich is a scheduled ."cas.teitribe..ol. the-State ul in. -relation.. to. (area) in :that State-.- - ,. ... N. :. I also c.i.elAre. that 1 ha.!,,i:itot been. and ..,hzill:nOt.. be\--iOniinated as a candidate thi z pres'ent . the 1-loits:e:- or ai e B'ol't general •electionithe bye-electiorts.bel4,..• held sinittlfo'neosti. \i,.t.6 .16.01.0 than 11Vo Plifii aillell wry COnstituencie. 1.`;c dre out th;....,..vords ate-',citseO1 .farrittiti itnd • . Kashinit. Andaman.and u-h. Dadra and .:',4t ar 1):11Man.4tnd : Lziksirod;Vvecp.. out this pz..ii.tt!trillh. if 661 !cipliticohic:,.. 4-.S.:61'0 t.hc.c..-;,vorcis not ;t0'plicat?le. N,13.---A ."recognised ro iti. at p[trty." means .a. politiea1 party :recognised b tlie • F.Ic!ction Commission under tie kleztiort .SvMhOls (keery,ntion and AilOtment) 19(igin the Statc, concerned, PART WA - . (To be Idle d t.i'y the catididate), (1) h'een -• (a) 01 any.. p I leni.t()..1.1 tide r ski b••Setti() (1.1..-ot's • • (b) i.2). e1.:1:91'4143 (t1 1:c)' I`relic e(*) lor Vlik-11.11e•Itas beeii • sentnced I.Prt\i•,0 y.!itt*S t)1` bit..)!!0, • 3 • I l' the-onswer . tht enlididitte chaff rurnish tile bIlmvinet lormation: i., Case/First i lOrmation report No./Nog• NOT APP LICA BL ii, sti;ttion(s) Of A PP-LICABLE . ... - cctioti(to t)1.111( brfer description the oll'ence(s 'or \Nit ic If he has been convicted NOTAPPLICABLE Daiek collvIetIonN NcY1 APPLICABLE (7fitirt(5) ettntid.flie NOT APPLICABLE. ' osvci . I initieate iscrio4 u-apriminoient(s). 'n /o ne NOT_ AP.PLICABLf ate(§) NOT APPLICABLE: 1.. '11thit)(5;): fired agailmi a bOve•c...orietioli(-.) NOT APPLICA E. • 1. L find ais o lappef11(,)/4001ientiori(s) for reviSionf1ICci- NOT' A P r-LICARE •• •Niyne.•; th,e *efillyt(S) fippenl(s)/apillicaf ion( s) Itir revision t • . N., .• • • . • , 801)01(s),IPPliliQfitib rcvisioi „basihnVe been d -)osed Cl APPLICABLE the said,aiii)ealis)'tipplicationt..;) int. 11.) heei disp(y.):ed ti. 'NOT' APPLICABLE Nature or order(s)-pas...“m.NOT APPLICABLE (). •ththe e Litt ciidatti.I:t hold ing:..;thy.Cdri-c.c' of prni • .(1fIvet.titytent„ of india• or 'Ile ortile• free 1103.1 NOT APPLICABLE: tkilictli.er 1116' Cfindicibte has•l*jt.-deelareclJuSolVent any" Court? N() (-• -cell discharged.insolvency NOT APPLICABLE tinder .'. bilegifittee Odlicr eite6.• -any loteigh efincliditte t i •Or• •• ccitititrirt.'"?• (;)•. -•f•-•• -I 11•Yes'..g.ive:detui OT. AP P. L1C A Bla: ‘k:Itether:tiie.'c.finidine hu•s•beon.di.t;(10iillfleci inder St:ic r.8 lin •et 'nu .0 rde r or : the'Presidelit'L: Nc) (yes/ No rotyl-,tit:h..*disqualiltied NOT APPLICABLE_ (0) wus dslo‘'oity t% hit holding oiii - .undcr:the:Goerrnyterit prinCINiOr the CKWerurnem ortm) St4te.3 N(Y, No) -Yas.• the date orsuch-dismi.ssai NOT APPLICABLE' Whether: the elndidflie has any subsisting- contrtietc-) xVith the• Government either in individual capacity' or by trust .or partnership in which the, candidate has it sh,are for I or. any. good::: to that Gov{:rt1111e11t or -.1..01" eNecutioli. ;vorks undertaken by ih;ii Gdvit•srlinicht? NO (Az' NU) . .. • •• • Yesc..:With, which covernmeni, .and details st-Msstilt007 contract(s) NOT APPLICABLE'. • .. \A/killer rhantiving .61Ch1-:'0r MiirtapiiO1!. Secretary -Or any" bOnirilif 0i- • Chrporzitipntpt. )qpet iv.e.soctet;,.) to..the Capital' 01• w t—-entra - itr.LinmentZ C1r . ... _ . ... .. • -/No).--.. State (ioverhntehi... •. ..,- ha..1.-Kktil.4s,... .. th6h •6venty-lly'pereeni ....... Share?.... 2 .. - NO (.\.. , . :-.I1 Yes:. with y,AliehIGoverolnehl :.mci. the„d00.11,5-.thereor NOTmiri.J.CABU _ . :.. (9)-Whiater' the canaidate.:htis.been dillgOalitiE.d..-by (13.: conwnissi-un undee (:.tititi- IDA of the.suid • .. :AO N (V-t7IN0). • 11.yds,iiie,' date..i,),P. i!.ftit.4.iii ric..til roll NOT ..AP. .P.f4i CAB LE. - G'ik.V I Stgriat tti'e r tidida 1)att 28•(13.2{119 1-V fro. be I,itje0- b the Returning Sei ]al 140,- ripm-h:ration• Nper ....