ABSTRACT STATEMENT OF ELECTION EXPENSES

Transcription

1 ABSTRACT STATEMENT OF ELECTION EXPENSES Date: Place: Signature of the Candidate Name 1

2 PART41: ABSTRACT STATEMENT OF ELECTION EXPENDITURE OF CANDIDATE Total Election Expenditure (in Rs.) Expenses in public meeting,rally,prooession etc.:-i. a: Expenses in public rneeting,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 meeting, rally,procession etc. mentioned in S.No. (Enclose as per Schedule-3)) I I I I I Campaign, through print and electronic media including cable network, bulk SMS or internet and Social media(enclose as per Schedule -4+4a)) Expenditure on campaign vehicle(s), used by candidate(enclose as per Schedule-5)) I I I I I I Any other campaign expenditure I I I Grand Total 2 I r i

3 S. No I II PART41I : ABSTRACT OF SOURCE OF FUNDS RAISED BY CANDIDATE Particulars Anoint of own fund used for the election campaign (Enclose as per Schedule-7) Lump sum anarnt received from the party( Qes) in cash or cheque etc.(enclose as per Sdhedule-S) 524/56/2036 Amount (in Rs.) Total Lump sum amount received from any personcompany/fimvassociations/b gift or donation etc-(enclose as per Sc hedule-.9) ^Y of persons elt. as loan, ^^^ jl ^5^ I 3

4 PART IV S2assn036 Before the District Election offi cer... FORM OF AFFIDAVIT (District State/Union Territory) Affidavit of Shri/Smt/Ms son/wife / daughter of ' hereby solemnly and sincerely aged years, r/o state and declare as under (1) That I was a contesting candidate at of... the general election/ bye election to. the from... House of the People Assembly... / Legislative... Parliamentary/ Assembly constituency....., the result of which was declared on (2) That 1/my election agent k ept... election agent in a connection separate with and theindus a account of all expenditure incurred / authorised date of declaration of the result thereof, both days abovetine.elution by me / my between... (the date on which I was nominated ) and the (3) That the said account was maintained in the Register famished Register its elf is annexed hereto with the supporting the Returning Officer for the purpose and the said vaudrers/bilis mentioned in the said account authorised (4) That the by account me of my election expendit as annexed hereto includes all items of election or by my and election agent the pawl expenditure ocuper or other individuals Pa which sponsored me, other associations withheld/ and susuppo^ng suppressed therefrom me, in connection with the election (other, and nothing / body of esoo section 77 ( than the expense on travel of leaders covered b has been concealed ' or 1) of the Representation People Act 1951). of the Y Explanations 1 and 2 under (5) That the Abstract Statement of Secti on Expenses annexed as Annexure 11 expenditure incurred or authorised by me, my election agent, the lc the said account also indudes all body of persons and other indmduals me, supporting party which sponsored me, other Mons / - in connection with the election. (6) That the statements the ^l g ^ (1) ( nothing is false and nothing material has bee ng Con. 5) are true to the best of my knowledge and belief, that Deponent Solemnly affirmed /swom by... ' at...this day of before me. ( Signature and seal of the Attesting authority, i.e. Commission or Notary Public) Magistrate of the first Class or Oath 4

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6 Schedule- I S24/ Nil Expenditure in public meeting rally procession etc. (i.e. other than those with Star Campaigners of the Political Party) Source of Expenditure Amt. Amt. total Am owrt uth. h. irs.) l. rty(in penditure in public meeting rally, procession etc. with the Star Campaigner(s) as apportioned for nwnwml narfu.,r...4.., Pportioned to candidate(i.e.: other than Amount of expenditure on public meeting rally, procession etc. with the star campaigner(s) apportioned to the candidate (As other than for general emarks, if any Source of Expenditure FA Total "t' by Amt. by Amt didate/ Amount Pol. Party ent (in Rs.) I Oihers(in C" (in Rs) Rs) 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) Amt by Candidate/ agent (in Rs) Amt. by Pol. Party (in Rs) Amt. by Others(in Rs) (V^ 01 H dq 6

7 Schedule- 4 S24/56/2036 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 rnedium(electro address of media address of nic/print) and provider(print/elect agency,reporter,str duration rorsc/sms/voice/ca inger, company or ble TV. social any person to whom charges/commissi on etc. paid/ Source of Expenditure Total Amount Amt by Amt. by Pd. Amt by Others ( in Rs.) Candidate/ Party (in Rs) agent (in Rs) 1 btal Schedule- 4a Details of expenditure on Campaign through print and electronic media including cable network bulk SMS or intemet and Social Media etc. Including 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 bthe Y political party sponsoring the S. No Nature of Name and Name and medium(eledro address of media address of nidprint) and provber(print/elect agency, reporter,str Source of Expenditure duration ronic/sms/voicetca inger,company or ble TV,social any person to Total Amount Amt by Amt by Pol_ Ate, by (in Rs whom.) Candidate/ Party (in Rs) Others LT chedule..5 tails of expenditure on campaign vehicle (s) and poll expenditure on vehicle ( s) for candidate 's election campaign Hirin cha es of Vehicle Rate for Fuel Drivers Hiring of charges(if charges(if vehicle( not covered not covered maintena under hiring ) under Total amt incurred/au th.(in Rs.) Amt by Source of Expenditure Amt. by Pol. Amt. by Candidate/ Party (in Others agent (in RCi 7 C- I

8 S24/56/2036 Amt. by Pd. Amt by Party ( in Others Remarks Cash challan used for Nomination Cash-in-Hand tails of Lump sum amount received from the party (ies) in cash or cheque or DD or by Account Transfer DD/Cheque no. Total Name of the Political Party I Date I Cash I with details of etc amount I Remarks, If drawee. I inrs. any (VI 8

9 Schedule- 9 S24/56/2036 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 No Name and Address Date Cash with details of ban,gift or donation drawee bank etc. Total Rs. amount Remarks, if in any 1 Total 9

10 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 /2036 (b) If the vehicle is owned by the candidate /his relative/ cost of hire of all such vehicles agent are used for election purpose,, notional 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, by any person/ provided by the Political Party; or provided 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: 10