NOMINATION FORM-I (See rule 3) ELELCTION TO THE GENERAL SEATS • Election to the constituency ..of *NationarAssenibiy1 • " Provincial Assembly of MIKTDc K 1-1-AE (Name 9f the Province) (To be filled in by the proposer) (1) / MO1-VA Ai/tvi A 14e_A- F '(name tit: the proposer) Lf having National Identity' Card No o 31.1-80 registered as an elector at serial number E in the electoral roil for MK:kr 11- 1-1- li;i-i N el...1,101itgra, fvfl., .. , , aPtetfri t-fiE-S.: in '''""tirr '11i7fr•ifyN N Te,hsil/Taluka in "I /C--P° Oil'74 \---S District/Political Agency do - hereby propose the name of 41-1 NA-Wr‘ -l" -C4 >421+ whose address is VI LIZ-CV; C- 0 Qi ULA A4 4-1110CPtlidate for election ' to . general scat ' from constituency. (2) • . I 'hereby certify that I have not subscribed to any other nomination paper either as proposer or seconder. 'Date et 3 '— )3 Sir ratite of Pfoi5oser (To be filled in by the seconder) (1) i kNkt p&-U L--- (name of the seconder) having National identity Card 1414 q 11ELIJI — registered as an electOr at serial number in the electoral roll ... for electoral area in M /1" Tehsil/Taluka in kilt(Pi/KX/MS District/Political Agency do hereby second the nomination of ' 1)1-.1 A-wPrz_ whose address is 1/1 ---tht 4 14jks2 SOP,- , , a candidate for election to general seat from - Constituency. ' (2) , I hereby certify that I have not subscribed to any other nomination paper either as proposer or seconder. bat e.2.1 —3 -.20 /3 Signature of S conder Note: Please fill in the Form in capital letters. ' *Strike off the words not applicable Price : R.F.20/- „,T1 e..,sio;As :Le; PS -64,6i 2 DECLARATION AND OATH BY THE PERSON NOMINATED 1..t I, the above mentioned Candidate, hereby declare on oath that,— (1) have consented to the above nomination and that I fulfill the .qualifications Specified in " Article 62 of the Constitution and I am not subject to any of the dis-qualifications specified in 'Article 63 of the Constitution or any other law for the time being in force for being elected as • a member of the National Assembly/Provincial Assembly. *(ii) I belong to PM441fAt'l PE°91X-C PA41-`1 PKLItI'Ml""t41"1" anffariCielt2ficate from (Name of political party) that. political party showing that I am a party candidate from the above said constituency is attached. OR I do 'not belong to any political party. the above, mentioned candidate, solemnly swear that,— „ . (i)f I believe in the absolute and anqualified finality of the Prophethood of Muhammad (Peace be ;a., upon him), the last of the prophets and that I am not the follower of any one who claims to be ,. a Prophet in, any Sense of the word or of any description whatsoever after Prophet Muhammad (Peace be upon him), and that I do not recognize such a claimant to be Prophet or a religious reformer, nor do I belong to the Qadiani group or the Lahori group or call myself an Ahmadi. will s be faithful to the declaration made by the' Founder of Pakistan Quaid-e-Azam Muhammad Ali Jinnah, that ,Pakistan would be a democratic state based on Islamic principles •'Of social. justice. I will bear true faith and allegiance to Pakistan and uphold the sovereignty and integrity of PakiStan and that I will strive to preserve the Islamic Ideology which is the basis for the creation of Pakistan. I' hereby solemnly declare to the best of my knowledge and belief that,— (i) no ,loan fof an amount of ,two million rupees or more obtained from any bank, financial institution, cooperative society or corporate body in my own name or in the name of my spouse or any of my' dependents, or any business concern mainly owned by me ,or the aforesaid, 'stands unpaid for more than one year from the due date, or has got such loan , written oft; and ,, my spouse or any of my dependents or a business concern mainly owned by me or the aforesaid, is not in default in payment of government dues or utility charges, including telephone, electricity, gas and water charges of an amount in excess of ten thousand rupees, for over six months, at the time of filing of nomination paper. el" ote: *Strike off the words not applicable. 65 **For Muslim candidates only. 40,04‘:. 0'cac)44 te • I, hereby solemnly affirm that,— (i) The list containing the names of my spouse(s) and dependents is correct and no name has been left out. (List attached) (ii) Neither I nor my spouse(s) nor any of my dependents mainly owns any cbmpany .except the following: Explanation.— For the purpose of these declarations, the expression-7- (i) "loan" shall mean any loan, advance, credit or finance obtained or written off on or after the 31st day of December, 1985, but shall not include the loan the recovery of which 'has been stayed or suspended by any order of a court or tribunal, including the High Court and the Supreme Court; (ii) "mainly owned" shall mean holding or controlling a majority interest in a business concern; (iii) "taxes" include all taxes levied by Federal Government, Provincial Government or a Local Government, but shall not include taxes the recovery of which has been stayed or suspended by any order of a court or tribunal; (iv) "government dues and utility charges" shall, inter (ilia, include rent, charges of rest hcinses or, lodges owned by the Federal Government, Provincial Governments, local, governments or, corporations, established or controlled by such governments, but shall not include the government dues and utilities charges the recovery of which has been stayed or'susliended by any order of a court or tribunal. I, the above mentioned candidate hereby declare on oath that,— (i) I have opened Account No.1461 Z.7 with Js PIIRPUAKI-)115 (Name and Branch of scheduled bank) and have deposited therein' an amount of Rs. (amount in words) , for the purpose: of election expenses. (ii) I shall make all election expenditures out of the money deposited in the aforesaid account; (iii) I shall not make any transaction towards the,election expenses through an' acco'unt, other than the above account. .1 *6 I hereby declare on oath that no case of criminal offences was pending against Me; six months prior to filing of this nomination. OR . I hereby declare on oath that following cases of criminal offences were pending against me, six months prior to filing of this nomination: Number of case Name of the Court keFt=f2'LICU No. -8/11-12-cor A-c-4-0 cs a-r-A-ofa-1 -IN Gout.; . mo. iv kpr<Aok 7. My educational qualification is RA- LL' 8. My present occupation is. 9. My National Identity Card No. is 10. My National Tax Number, if any is 3 -2- 173 6 7— 47 • 4 The statement of assets and liabilities of my own, spouse (s), dependent;. ss on 3Oth June, IWCIP4ed! : • The income tax paid by me during the last three years is Oven.hc.reunder:- If;.:5,)11.7.`,V11./.;, • Total!Incoane , **Source of Income Tax Year r Total income Tax Paid ' 81-6? 060 ' 1.1-1741(1 _23 1 a 60 Coo -13,6coo s4-1-4-ky _-(37/ , 780°' . 1,3 bexa •, .cAL_A-e-y >a)--- 1 78p0.0 Attach'cppies 'of incoMe tax returns of the years mentioned above. orethan'oneSources of incoine,,attaCh detail. How ,many times traveled. abroad during last three years 'and cps inc )ed thereon. (Attach copy of •:41),0 passport and 'detail of expenditure). CSZe, ttiAtaime... • he agricultural income tax paid by me during the last three years is given below: Land Holding Agricultural ' Total Agricultural Income Income Tax Paid • 6110( 0 0 0 AttaCh copies.of agricultural tax returns of the last threc'years mentioned above. ".If you have been elected Member of National Assembly/Provincial Assembly what according to you 'Avas.the.,single• most imp rtantant contribution C2p, rrw,cle. for the benefit of your constituency (attach detail, if any). S-64- r.v.;•.,..1.• .... ; . Whether you have.paid any sum by way of contribution or otherwise, to the political Apart w rtiy. arded you.partY ticket for this election, and if so how much (attach detail, if any). Whether you have received any sum from the party which has awarded you ticket, if so ,how much . (attach detail, if any). 1■AtL- • iii A hereby solemnly affirm that the information given at serial No. 13, 15, .16 and 17 is true and correct and.nothing has been concealed. ,•, I hereby assure that I shall abide by the Code of Conduct issued by the Election Commission. 1,1 Signatt>re of Candidate ff the words not applicable o‘st,z:i4 ,,„he 7 LIABILITIES LIABILiTIES Amount ' Remarks ' , . ... , (i) Mortgages secured on Property or land ' i . '(ii) Unsecured Loans owing, 1 • . i • ' (iii) Bank Overdraft . {r'°, (iv) Bank Loans . , .,• (v) Amounts due under Hire Purchase • I Agreement ' . , (vi) House Building Loans • , ... t (vii) Advances from Provident Funds etc. (viii) Other debts due* ' " I . (ix) Liabilities in the names of minor . ' i I ,' i ( children (in respect of assets standing si i their names) . ' • . PPersonal expenditure 23, tfs, SJ 7- . • ,, , , Total expenditure (i) + (x) . Increase/DecreaSe 1 - , • . , 9• • ., . *Details to be annexed. VERIFICATION /It,/ 1.1,4-NA- % itt-A-0 ,..:i.SI,o, W/o, D/o 114014A-MW /-aO hereby solemnly declare that,the above,stateMent'Of the'aisets and liabilities of myself, my spouse(s), dependents as on OtIt 'June, .