t I I ~. I FORM2A (See rule 4) NOMINATION PAPER Election to the House of the People No: 0 ~ IHP/2019/RO ) b DI.; ~ ~c Oate 22 1_!2!1...J20 19 Time: _2 > a 2- Ph . ~- Signature ornO I ARO STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE PART I (To be used by candidate set up by recognised political party) I nominate as a candidate for election to the House of the People from the , Parliamentary constituency. --- . Candidate's name Father's/mother's/husband's name His postal address .............................................................................................. His name' is entered at S. No in Part No of the electoral roll for "(Assembly constituency comprised within) .. Parliamentary Constituency. My name is : and it is entered at S.No. ...................... in Part No. of the electoral roll for . .... * (Assembly constituency comprised within) : '" . ....................... Parliamentary constituency. Date Signature of Proposer 1 PART II (To be used by candidate NOT set up by recognised political party) We hereby nominate as candidate for election to the House of the People frorn . the., ..f b')..D.U.M.I>.UM Parliamentary Constituency. Candidate's name J.1.\.RIJ.i:-I..KuMAR.;.hs. Father's/mothcr's/husband!:s name ..Lh.T.E..RPtMAN.L. K~~I-f\..D.AS ...... ;.. Hispostal address .P.:1:::?"..t>.l;-,~.~K.~.6_y.U.KILTo. W N t:\Q.R:t.J-J .. 2.1.fhR.<bh~.~~.).~1).kM.Tf.t;-.:r.(JUo'G,) His name is entered at S.No ta~ in Part No 4.~ ofthe electoral roll for lJ.b.)..eXP.HAN.NAwl1.1?. ~(Assembly constituency comprised within) ........... \1.;. J3. A~.sf.\T. Parliamentary consti tuency. We declare that we are electors of the above Parliamentary Constituency and our names are entered in the electoral roll for that Parliamentary Constituency as indicated below and we append our signatures below in token of subscribing to this nomination:- Particulars of the proposers and their signatures Name of Elector Roll No. of Full Name Signature Date S. No. component Propeser Assembly Constituency Part No. of S. No. in Electoral that part Roll 1 2 4- 5 6 --7 1 2 3 4 5 6 9 - 10. (10 I DUM DIlM UT'T(::)~ N.B.- There should be ten electors of the constituency as proposers. 2 PART III I the candidate mentioned in Part I/Part II (Strike out which is not applicable) , . assent to this nomination and hereby declare that- (a)I am a citizen of India and have not acquired the citizenship of any foreign Sate or country. (b) I have completed '.1 years of age; [STRIKE OUT cCi)or c (ii) BELOW WHICHEVER IS NOT APPLICABLE] (c) (i) I am set up at this election by the . party, which is a recognised National Party/State Party in this State and that the symbol reserved for the above party be allotted to me. OR (c)(ii) I am set up at this election by the .~QfY.I/?\k.l.$..T...v.t';u.T.';f...~.Ff.':'!.T.~F..9.P...~'Y.P.{flLC.~~ party, which is a registered-unrecognised political party/that I am contesting this election as an independent candidate. (Strike out which is' not applicable) and that the symbols 1have chosen, in order of preference, are: - (i) ~f\:T.7.lf;{{.~.. :r..Q.(,_C.H (ii) &!3.:T. (iii) CRl..A.s.s. : .. (d) my name and my Father's/Mother's/Husband's name have been correctly spelt out above in F.:tx4~.I.$.H (name ofthe language); (e) to the best of my knowledge and belief, 1am qualified and not alsd disqualifie for being chosen to fill the seat in the House ofthe People. *1further declare that 1am a member ofthe **Caste/tribe .which is a scheduled **caste/tribe of the State of.. .in relation to (area) in that State. I also declare that 1have not been, and shall not be nominated as a candidate at the present general election/the bye-elections being held simultaneously, to the House of the People from more than two Parliamentary Constituencies. vT~.· Signature of Candidate - + Score out the words "assembly constituency comprised within" in the case of Jammu and Kashmir, Andaman and Nicobar Islands, Chandigarh, Dadra and Nagar. Haveli, Daman and Diu and Lakshadweep. *Score out this paragraph, if not applicable. **Store out the words not applicable. N.B.-A "recognised political party" means a political party recognised by the Election ('ommission underthe Elettiqn Symbols (Rcscrvat ion and Allotment) Order, 1968 in the State concerned. 3 l... PART IlIA (To be filled by the candidate) (l)Whetherthecandidate- Tf>..RuN kUMF'tR J)t\S (i) has been convicted - No (a) of any offence(s) under sub-section (1); or (b) for contravention of any law specified in sub-section (2), v ..of section 8 oft?e Representation of the People Act, 1951 (43 ofI951); or YeslNo . (11) has been convicted for any other offence( s) for which he has been sentenced to imprisonment for two years or more. If the answer is "Yes", the candidate shall furnish the following information: (i) Case/first information report No.lNos .t:l~ .. (ii) Police station(s) ~~ .. District(s) ..· t;.lt. State(s) . (iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been convicted ti.~ , . (iv)Date(s) of conviction(s) ttA .. (v) Court(s) which convicted the candidate N~ .. (vi)Punishment(s) imposed [indicateperiodofimprisonment(s) and/or quantum offine(s)] HA. (vii)Date(s) of release from prison t-4~ . (viii)Was/were any appeal (s)/revision(s) filed against above conviction(s) ...~ .... YeslNo .(ix) Date and particulars ofappeal(s)/application(s) for revision filed ..N:A . e-'O " " " ~ .. ,,~. • " ;, .. ~ .. ~ .. 10 .. c .. ; " .. , "4O .. -~ • ., c -'--."" " " !._ '" _o _:_. '" '" ..:.:... .. '" .~ '" (x) Name of the court(s) before which the appeal(s)/application(s) for revision filed ~ ············ (xi) Whether the said appeaI(s)/application(s) for revision has/have been disposed of or is/are pending t.if\ . (xii) If the said appeal( s)/application(s) for revision has/have been disposed of- (a) Date(s) ofdisposal ~~ . (b) Nature of order( s) passed ~.,..., ; . (2) Whether the candidate is holding a~'y office of profit under the Government of India or State Govemment? ......... (YeslN'o) -If Yes, details of the office held .t:f.f't.. v (3) Whether the candidate has been declared insolvent by any Court? ...'....... (YesINo) -If Yes; has he been discharged from inso lvency ..N A . (4) Whether the candidate is under allegiance or adherence to any foreign country? . .:(yesiN6) -If Yes, give details ".tl'~ " . (5) Whether the can~idat~ has been dis(quali~~ under section 8A of the said Act by an orderofthePresldent. ', , \YeslNc) -If Yes, the period for which disqualified ~A . 4 (6) Whether the candidate was dismissed for corruption or for disloyalty while holding office under the Government of India or the Government of any State? (Yes/No) -If Yes, the date of such dismissal Nh. (7) Whether the candidate has any subsisting contract(s) with the Government either in individual capacity or by trust or partnership in which the candidate has a share for supply of any goods to that Govetpment or for execution of works undertaken by that Government? (Yes/No) -If Yes, with which Government and details ofsubsistingcontract(s) Nr, .. ................. ,.., . (8) Whether the candidate is a managing agent, or manager or Secretary of a company or Corporation (other than a cooperative society) in the capital of which the Central Government or State Government has not less than twenty-five percent share? .......... (Yes/n"b) . -If Yes, with which Government and the details thereof.. Nt.. ~ .. (9) Whether the candidate has be~~disqualified by the Commission under section lOA of the saidAct.. (Yes/No) -If yes, the date ofdisqualification N-f\ .. Place: ...~.I.\~~~kT .. Date: ....2R.!.q1 ~ ~ . PART IV (To be filled by the Returning Officer) p' Serial No. of nomination paper ...6.6J.!±:P.!~.t.1R-:o..";..t ~ D l.) M b L> (V\ (., This nomination was deliv~ to me at my office at..4;:..9.7.-RJihour) on ..~.'h.:.~ ...~( date) by the "candidate/proposer. (name of proposer · .................................. ) . ~/ Date .....k.~..:..~:..!.I........ Returning eifficer PARTV Decision of Returning Officer Accepting or Rejecting the Nomination Paper I have examined this nomination paper in accordance with section 36 of the Representation ofthe People Act, 1951(43 of 1951) and decide as follows» •••• OJ ...... , •••••••• I •••••••••••••••• ;, •••• , ;, • ., ., • ~.:)" ) ..... '.3 I • ':> " " ,.., (I "" , :. ~ j • ~ l .1., • ;) ••• ) ~ ••• I •••• to •••• ,. ,} • j ••• n •••• ;; •••••••••••••••••• , •••••• 0' ••• Date . Returning Officer 5 q~q q411H WEST BENGAL Y 838260 IeftIn tat It_ N• ....l ...."'" FORM 26 (Seerule 4A) . tFFIDAVIT TO BE FILEDBYTHE CANDIDATEALONGWITH NOMINATlqN PAPER BEFORETHE RETURNING OFFICER FOR ELECTIONTO THE HOUSE OF THE PEOPLE FROM 16, DUMDUM PARLIAMENTARY CONSTITUENCY' PART-A I. , I, Tarun Kumar Das,son of Late Ramani Kanta Das,aged 61 years, resident of 49, Lake Town, Block _ B, Kolkata _ 700 089, WesTengal, a candidate at the above election do hereby solemnly affirm and state on oath as under ;_ (1) I am a candidate set up by Socialist Unity Centre of India (Communist). (2) MAame is enrolled in 17, Barasat Parliamentary'Constituency of West Bengal, in 116, BidhannagarAssembly se~'ent at Serial. No. 188 in Part No. 46. (3) My!if:ontacttelephone number(s) is/afe 8334838336 and my e-mail id is [email protected], my social media acc .untts) is/are NIL. Page10/10 003J1.6 SerialNam No .. .......~:::...... ..,A Rv JI) \t.Ut-ta !lAS . Addre s- , . 71, P2li .. " ,._'.-14} 1 '1·, APR '1019 ~I'- .':' , t " ., ," .." " . " , . ';.!t .',. (4) Details of Permanent Account Number (PAN) and status of filling of Income Tax Return: SI.