Mo D rv^g^f^ viskoq'k. Name of the Candidate. Number and name of Constituency. III Name of State/ Union Territory Uttar Pradesh. Nature of Election

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1 ABSTRACT STATEMENT OF ELECTION EXPENSES PART- I I Name of the Candidate VISHANT II Number and name of Constituency 57 Modi Nagar III Name of State/ Union Territory Uttar Pradesh Nature of Election IV (Please mention whether General Election to State GENERAL ELECTION TO ASSEMBLY- Mar-217 Assembly/ Lok Sabha/Bye-Election) V VI Date of declaration of Result Name and Address of the Election Agent 11-March-217 VISHNAT MODINAGAR VII If candidate is set up by a political party, Please mention the name of the political p arly Rajlok Party VIII Whether the party is a recognised political party Yes Date:,9-OLI-2) - Place: Mo D rv^g^f^ Sianature of the Candidate Name U I'S tlpn T viskoq'k 1

2 PART-II : ABSTRACT STATEMENT OF ELECTION EXPENDITURE OF CANDIDATE Amt. Amt. Amt. Incurred/Auth. Incurred/Auth. Incurred/Auth. Election S. No Particulars by Candidate/Ele by Pol. Party(in Rs.) by Others(in Rs.) Expenditure (in Rs.) ction agent(in Expenses in public meeting, rally, procession etc.:-i. a: Expenses in public meeting,rally,procession etc. (i.e.: other than the ones with Star campaigners of the Political Party(Enclose as per Schedule-1)) Expenses in public meeting, rally, procession etc. :-I. b: Expenses in public meeting,rally,procession etc. with the Star Campaigner(s)(i.e.: other than those for general party propaganda)(enclose as per Schedule-2)) Campaign materials other than those used in public 11 meeting, rally, procession etc. mentioned in S.No. (Enclose as per Schedule-3)) Campaign, through print and electronic media including cable network, bulk SMS or internet and Social media(enclose as per Schedule-4)) Expenditure on campaign vehicle(s), used by candidate(enclose as per Schedule-5)) IV Expenses of campaign workers/agents(enclose as per Schedule-6)) V Any other campaign expenditure Grand

3 PART-III : ABSTRACT OF SOURCE OF FUNDS RAISED BY CANDIDATE S. No Particulars Amount (in Rs.) Amount of own fund used for the election campaign ( Enclose as per Schedule -7) 62 II III Lump sum amount received from the party ( ies) in cash or cheque etc.(enclose as per Schedule-8) Lump sum amount received from any person /company/firm/associations/ body of persons ell. as loan, gift or donation etc.(enclose as per Schedule-9) 62 3

4 Schedule-? Expenditure in public meeting rally, procession etc. (i.e. other than those with Star Campaigners of the Political Party) Source of Ex penditure Amt. Amt. Incurred/Auth. Incurred /Auth. mt. Incurred/Auth. Nature of Expenditure otal Amount b y Candidate / by Pol. Pany( in Others in Y S.No. in Rs.) Election Rs.) s.) ehicles for transporting visitors E recting Stage. Pandal & Furniture, Fixtures, Poles etc. 3 Arches & Barricades etc. Flowers / garlands 5 inng Loud Speakers, Microphone, Amplifiers Compares tc. 6 rosters, Hand bills, Pamphlets, Banners, Cutouts, oardings 7 Beverages like lea, water, Cold Drink, Juice etc. 8 pigital TV-Boards Display, Projector Display, Tickers oards, 3D Display 9 Expenses on celebrities, payment to musicians, other artists remuneration etc. Illumination items like serial lights, boards etc xpenses on transport,helicopter/aircraft/vehicles/boats lc. charges (for self,celebrity or any other campaigner ther than Star campaigner) Power consumption /generator charges 13 Rent for Venue Guards & security charges Boarding & Lodging expenses of self,celebrity, party functionary or any other campaigner including Star ampaigner Other expenses I 6

5 Schedule /57/152 xpenditure in public meeting rally, procession etc. with the Star Campaigner ( s) as apportioned to candidate ( i.e.: other than hose for general party propaganda) Amount of expenditure on public S. No Date and I Name of the Star Venue Campaigner(s) & Name of Party meeting rally, procession etc. with the star campaigner(s) apportioned to the candidate (As other than for general Remarks, if any Source of Expenditure Amt. by Amt. by Amt. by Amount Candidate/ agent (in Pol. Party Others(in (in Rs.) (in I Rs) Rs) 1 Schedule- 3 Details of expenditure on campaign materials, like handbills,pamphlets, posters, hoardings, banners, cut-outs,gates & arches,video and audio cassettes, CDs/DVDs, Loud speakers, amplifiers, digital TV/board display, 3 D display etc. for candidates ' s election campaign (i.e. other than those covered in Schedule- 1 & 2). No 1 I HAND BILL Nature of Expenses Amount (in Rs.) Amt. by Candidate/ agent (in Rs) Source of Expenditure Amt. by Pol. Party (in Rs) Amt. by Others(in Rs) I Remarks, if any DIAMOND P RINTERS HAPUR Schedule- 4 Details of expenditure on Campaign through print and electronic media including cable network, bulk SMS or internet and Social Media etc. for candidate No Nature of Name and Name and medium(electro address of media address of nic/print) and provider ( print/elect agency, reporter,slr duration ronic/sms/voice/ca inger,company or ble TV,social any person to whom charges/commissi on etc. paid/ Source of Expenditure Amount Amt. by Amt. by Pol. Amt. by Others (in Rs.) Candidate/ Party (in Rs) agent (in Rs) 1 7 V Sr`q^

6 ' S24/ Schedule- 4a Details of expenditure on Campaign through print and electronic media including cable network, bulk SMS or internet and Social Media etc.lncluding the paid news so decided by MCMC or voluntarily admitted by the candidate.the details should include the expenditure incurred all such news items appering in news papers TV/radio channels, owned by the candidate or by the political party sponsoring the S. No Nature of medium(electro nic/print) and duration Name and address of media provider ( print/elect ronic/sms/voice/ca ble TV, social Name and address of agency,reporter.str inger,company or any person to whom charges/commissi on etc. paid/ Amount (in Rs.) Source of Expenditure Amt. by Candidate/ agent (in Rs) Amt. by Pol. Party (in Rs) Amt. by Others payable, if any Schedule- 5 etails of expenditure on campaign vehicle(s) and poll expenditure on vehicle(s) for candidate's election campaign No Regn No. of Hirin g charges of Vehicle No. of amt. Source of Expenditure vehicle & Type Days for incurred/au Rate for Fuel Driver s of vehicle which th. ( in Rs. ) Amt. by Amt. by Pol. Amt. by Hiring of charges ( if charges (if used Candidate/ Party (in Others vehicle/ not covered not covered agent (in Rct maintena under hiring) under 8

7 Schedule- 6 S24/57/152 Details of expenditure on Campaign workers/agents No I Date and I Venue Nature of Expenses Candidates boots ( Kiosks)Setup for distribution of Expenses on Compaign workers I I Source of Expenditure No. of Rate workers/ agents amt. incurred/auth. (in Rs.) Amt, by Candidate/ agent (in Rs) Amt. by Pol. Party (in t3-s) Amt, by Others 1 Campaign workers honorarium/salary Boarding Lodging Others Schedule- 7 etails of amount of own fund used for the election campaign S. No I Date I Cash (in Rs DD/Cheque no. etc. with details of drawee bank I amount in Rs- Remark s 3-Jan-217 I NA NOTERY FEES PAY RAMPAL SINGH TO 23-Jan-217 I 1 23-Jan-217 I 5 NA NA OPEN NEW BANK ACCOUNT IN PNL: CHHALAN FEE TO ELECTION COMMISI ON I

8 Schedule- 8 S24/57/152 etails of Lump sum amount received from the party( ies) in cash or cheque or DD or by Account Transfer DD/Cheque no. etc. Sr No Name of the Political Party Date Cash with details of drawee bank amount I Remarks, if in Rs. an y Schedule- 9 Details of Lump sum amount received form any person / company/ firm/ associations/ body of persons etc. as loan, gift or donation etc. DD/Cheque no, etc. Mention whether amount Remarks, if No Name and Address Date Cash with details of loan,gift or donation in Rs. any drawee bank etc. 1

9 Note. 1.In Schedulem5:- (a) Copy of the order containing list of all vehicles for which permit issued by the Returning Officer to be enclosed. 524/57/152 (b) If the vehicle is owned by the candidate / his relative/agent are used for election purpose, notional cost of hire of all such vehicles, except one vehicle if owned and used by the candidate, notional cost of fuel and drivers salary for such vehicle, shall be included in total amount of expenditure in the above table. 2. In all schedules if any expenditure on goods and services, provided by the Political Party ; or provided by any person / company/ firm/association / body of persons etc. on behalf of the candidate, then the notional market value of such goods or services are to be indicated, in respective columns. 3. In Part-III, the Lump-sum amount of fund received from the political party or others or the candidate's own funds, should be mentioned date wise. In all such amounts are required to be first deposited in the bank account of the candidate, opened for election expenses. 11

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