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ST2T ^ pTT 2JT/ L' (`) cil' s( ( ) ITeT^T- - ' / ' ZTU .. ^ ............. -ice 3T^n (vi) cuzlI 2T 3TF2TZ Ot ^ • fn • /a F45 -ja 2TV21 trFua 31V '5ZM1 cT 3rf'2T^4% __ c 2^ `^'' 31^E 3^ 3N 3V 3^t i'I ,q5 3 ^Tr 3T ^' caW 3T^t ^F3VTZ `T `ice' %r 9 t .3t 1 2TTwT " 3rr^T ..a'^ W A n ne%UI'C- 1 'G 9" BY CANDIDA 1 T11 TO BE FURNISHED AFFIDAVIT NOMINATION PAPER Before the Returning Off-ice' of the House) Ivr A0 a tname, For election to^.iec3 •^G VVVV Q. constituency From ....g.,. (rtalt?zw• /r^ (Name of the Constituency) e of Son'cl v1 ^ cat , 1, aged .....y.s" 14 ........ L .+P resident of .^/.i. Lt ' :, ruler: Candidate at the above election, do hereby solemnly aflirm and state on oath ,t (Strike out whichever not applicable) ^ ch cog ¢aitce pan been i n WWh i n ( s) is/are pencg 34t/^ ^0 1. The following case 5 '72"3 VI / taken by the court :- U) 3Y/I32-13 9T F' C (n) vis II^yB//49f h cognizance fi) Section of the Act and description of the offence for whic taken: has taken cognizance: (ii) The Court which Case No.: 3 5108 , Date of order of the court taking cognizance : >( 7 tiled of appeal(s) i application (s) for revision. etc. if any. against (^) •hnve Order taking cognizance : x (2) That I give herein below the details of the assets (immovable, movabic. N u ll, balance. etc) of spouse. my dependents and myself: (A) DETAILS OF MOVABLE ASSETS (Assets in joint name indicating the extent of joint ownership will also have to he given) SI. Dc c iption self, Spousc(S ) f Dcpenden t i Dcpcndcat- Depcuntaa No. Name(s) Name Name etc. Name (i) Cash 2S, ►N^r k (ii) Deposits in Banks , pr xa Financial Institutions #/c/Vb - 314548 F And Non-Banking 99 CO Financial_ Companies (iii) Bonds, Debentures and Shares in - x - - com p anies x (lv) Other financial instruments, NSS, i postal Savings , [IC Y y^ x x I 'olicirs. clr. (v) Motor Vehicles (Details of make, x etc . ) X X (vi) Jexxelleiy (go^c details of ecig hl ,^ 7 rind value) ^,A X` -QJJo k k (v1) Other sets , such v , Q as values ui claimy y uvescst's ^C X Note: Value of Bonds! Shares / Debentures as per the latest market value in St:;ck Exchange in respect of listed companies and as per books in the case of non listed companies should be given. 1? Asst: fS B. i)F'I'Al1,s OP 1rs1MOVAIil , joint ownership will also extent of [Note : Properties in joint ownership indicating the have to be indicatedi -1 ^ D-pu:^tcnt-'_ ^ t 'N Spouse(s). Dependent Self hunt Description Mimic(s) Name I Agricultural Land- - Locations(s) - Survey number(s) Extent (Total measurement) Current market