Government of Karnataka

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1 INDIA NON JUDICIAL Government of Karnataka Certificate No. Certificate Issued Date Account Reference Unique Doe. Reference,n' Purchased by Description of Document' Description wh. Consideration Price ( R M Artie AFF 0 MYSOREdSOUT, H3/ KA-MY K UDDLINGAIAI}e I First Party Second Party Stamp Duty Paid By Stamp Duty Amount(Rs.) NA DDLINGAIAHm, MUDDLINGAAH, Li^4p milif31111i' KOJI N,',I11'ullhrlf V a ^I... J.i Please write or type below this line Affidavit to be furnished by candidates alongwith Nomination Paper Before the Returning Officer For election to the Legislative Council (name of the House) From Karnataka South Teachers Constituency (name of the constituency) I, M.LAKSHMANA, son of Late. Muddalingaiah, aged 47 years, resident of No. 3, 3id Main, Paramahamsa Road, Yadavagiri, Mysore , (mention full postal address), contd...2 umpry wan: The aufentldty of the Stamp Certificate FM JfA ec W edlon Centers (ACCS), SHCIL Offices and Sub -registrar Oil a (SROS). The Contact Delells ofacco, SHCIL Offices am SR re avaan H.M. the Web site bwx.amleclamp.wm

2 -:2:- a candidate at the above election, do hereby solemnly affirm and state on oath as under - (Strike out whichever is not applicable) (1) I am a Candidate set up by Indian National Congress (name of the political Party) / am contesting as an Independent candidate. (2) Details of PAN and status of filing of Income tax return: SI. No. h L;om. LL.B., 'i w V;c th ursrac') t^w,rnataka) Names 1 M. Lakshmana 2_ K.M.Roopashree wife L. Varshitha 3 (Dau g hter) 4 L. Adithya (Son) Permanent Account Number (PAN) The financial Total income year for which shown in the last Income Income Tax tax return has P Return (in been filed Rupees ) PAN No. ABSPL6014E Rs. 1,76,182/- PAN No. AGXPR4777L Rs. 1,39,223/- Minor - NA - - NA - Minor - NA - - NA- (3) The following case(s) Is / are pending against me in which cognizance has been taken by the court: SI. No. Offence Descri ption The details of cases where the court has a) 143, 145, 353 RAN 34 IPC (a) taken cognizance, Sections of the Act b) 143, 341, 114 RNJ 149 PC and description of the offence for which cognizance taken: c) 143, 341, 353, RNJ 149 IPC a) II Court JMFC (City) at Mysore (b) Name of the court, Case No. and Date of - CC No. 2989/2007 order taking cognizance: Date: Nil b) III Additional First Civil Judge Junior Division and JMFC at Mysore - CC No. 2579/ Date: 26/07/2007 c) III Additional First Civil Judge Junior Division and JMFC at Mysore - CC No. 3591/2008 Date: Nil contd...

3 (c) Details of Appeal(s) Application(s) for revision (if any) filed against the above order(s): - Nil - 4. Cases in which I have been convicted by a court of law (other those referred to In Form 26) : (a) The details of cases, Sections of the Act and description of the offence for which convicted: Not Applicable (b) Name of the Court(s), Case No. and Date(s) of order(s): Not Applicable M Punishment imposed: Not Applicable (5) That I give herein below the details of the assets (movable and Immovable etc.) of myself my spouse and all dependents: A. Details of movable assets. Note: 1. Assets in joint name indicating the extent of joint ownership will also have to be given 2. In case of deposit / Investment, the details including Serial Number, Amount, Date of Deposit, the Scheme Name of Bank / Institution and Branch are to be given 3. Value of Bonds / Share / Debentures as per the current market value In Stock Exchange in respect of listed companies and as per books in case of non - listed companies should be given. 4. Dependent, here means a person, substantially dependent on the income of the candidate. 5. Details including amount is to be given separately in respect of each investment. SI. Description Self Spouse(s) Dependent) Dependent2 NO. M.Lakshmana K.M.Roopashree L.Varshitha L.Adhhya (i) Cash in hand Rs. 50, 000/- Nil Nil Nil (ii) Details of 1 ) PNB, DD Urs t) KB, DD Urs 1 ) KB, DD Ur5 1) KB, DD Urs Deposits in Road, Mysore Road, Mysore Rs. Road, Mysore Rs, Road, Mysore Bank accounts, Rs. 5 Lakhs FD 30 Lakhs FD 10 Lakhs FD Rs. 10 Lakhs FD (FDRs, Term 33500DA ^posit5 Date: Date: Date : Date: if f Y (j f contd...4.f T;c ri^ i i, i Hn.uRA^,:.^

4 (iii) including saving 2) PNB, W 2) PNB, W Market, 2) KB, W Mohalla, 2) PNB, SJCE, Mys accounts), Market, Mysore. Mysore Mysore Rs. 2,50,000/- FD Deposits with Rs. 7 Lakhs FD Rs. 5 Lakhs FD Rs. 2 Lakhs FO DA Financial 07500DA A Date : Institutions, Date: Date : Date : Non Non- 3) SBI, Yadavagiri, Banking Mysore. 3) Vjaya Bank, 3) PNB, SJCE, Financial Rs. 5 Lakhs FD Santhepet, Mys. Mysore. ' - tl Companies and Rs. 2,50,000/-FD Rs. 2,50,000/-FD Co-operative Date: DA Societies and 4) Punjab & Sindh Date: Date: the amount in Bank, Mysore. each such Rs. 6 Lakhs FD deposit S1299/07AC202-L7 Date : Details of investment in Bonds, Debentures I Shares and units - Nil - -Nil- -Nil- - Nil - in Companies / Mutual Funds and others and the amount (iv) Details of Investment on Investment on Investment on Investment on investment in Insurance Policy Insurance Policy is Insurance Policy is Insurance Policy is NSS, Postal is Rs. 1,99,007/- Rs. 21,619/- per Rs. 6,493/- per Rs. 12,789/- per Savings, per annum annum annum annum Insurance Policies and investment in any Financial Instrument in Post office or Insurance Company and,the amount contd...5 No. of NTrtct ons

5 -: 5: SI. Description Self Spouse(s) Dependent) Dependent2 No. Name(s) Name Name M.Lakshmana K.M.Roopashree L.Varshitha L.Adithya (v) Personal loans / advance given to any person or entity including firm, Company, -Nil- -Nil- -Nil- -Nil- Trust etc., and - other receivable from debtors and the amount. (vi) Motor Vehicles/ 1. Hero Honda Aircrafts/ Yachts / KA09H3939 Ships (details of ( 1991) Make, Rs. 26,000/- Registration No. 2. Ford Ikon etc. year of KA09N2775 purchase and (2003) -Nil- -Nil- -Nilamount) Rs. 6 Lakhs 3. Corolla Allis KA09P7115 (2008) Rs. 15 Lakhs (vii) Jewelry, bullion and valuable 100 gms gold & thing (give details - Nil- Silver -Nil- -Nilof weight and Rs. 2,00,000/- value) (viii) (ix) - Nil - -Nil - -Nil- Any other assets such as value of claims / interest Gross Total Value Furniture Rs. 10, 000/- Rs.46,85,0071- Rs. 39, 71,619/- Rs.14, 56,493/- Rs.12,62,7891- contd... :...6 Nrr.,1Qf 'c;rsctions

6 6:- B. Details of Immovable assets Note: 1. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated 2. Each land or building or apartment should be mentioned separately in this format. SI. Spouse (s) Dependents Dependent2 Descri ption Self No. Name(s) Name Name M.Lakshmana K.M.Roopashree L.Varshitha L.Adithya (I) Agricultural Land Kuluvanahalli, Location(s) Nelamangala Tq, Survey number(s) Bangalore Dist. Survey No. 62 (II) Area (Total measurement 1 acres 20 in Acres) guntas, Whether inherited property (yes or No) - NA- Date of purchase in case of self acquired property - NA - - NA - - NA - - NA - - NA - - NA - Yes - NA - - NA - - NA - Cost of Land (in case of purchase) at the time of -NApurchase Any Investment on the land byway of development, construction etc. Approximate current approx. value market value Rs. 20 Lakhs - NA - - NA - - NA - - NA - Non-Agricultural Land Location(s) -NAurvey number (s ) Area (Total measurement in Acres) - NA- Whether inherited property (yes or No) - NA - - NA - - NA - - NA - contd...7

7 -: 7:- (Iil) Date of purchase in case of self acquired property - NA - - NA - - NA - - NA - Cost of Land ( in case of purchase ) at the time of - NA- -NApurchase Any Investment on the land byway of development, construction etc. Approximate current market value Commercial Buildings (including apartments) Location(s) Survey number(s) Built up Area (Total measurement in sq. ft.) Whet her inherited property (yes or No) Date of purchase in case of self acquired property - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - - NA - Cost of Land ( in case of purchase) at the time of - NA - - NA - - NA - - NA - purchase Any Investment on the property by way of development, construction etc. Approximate current market value - NA - - NA - - NA - - NA - contd... 8 "o C tlprl8 wz^

8 V -: 8:- St. Description Self Spouse(s) Dependent) Dependent2 No. Name(s) Name Name (iv) (v) (vi) Residential Buildings (including apartments) Location(s) Survey number(s) - Nil - -Nil- -Nil- Area (Total measurement in sq. ft.) - Nil - -Nil- -Nil- Built up area (Total measurement in sq. ft.) - Nil - -Nil- -Nil- Whether inherited property (yes or No) M.Lakshmana K.M.Roopashree L.Varshitha L.Adithya No.3, 3r Main, P.H. Road, Yadavagiri, Mysore sq.ft 1800 sq. ft. No -Nil- -Nil- -Nil- Date of purchase in 2001 case of self acquired - Nil - -Nil- -Nilproperty Cost of Land (in case of Rs. 13 Lakhs purchase) at the time of -Nil- -Nil- -Nilpurchase Any Investment on the Yes land by way of Rs. 10 Lakhs development, - Nil - -Nil- -Nil- construction etc. Approximate current Approx. Value market value Rs. 25 Lakhs - Nil - -Nil- - -Nil- Others (such as interest in - Nil- -Nil- -Nilproperty) Total of Current LMAI:Kat value of (1) to Rs.45,00, Nil- -Nil- -Nil- * Al. St )T_ El. e.e uvcr'c,., n LL.8.,.c f c

9 SI' No (i) (ii) -:9:- (6) I give herein below the details of liabilities f dues to public financial institutions and Government:- (Note : Please give separate details of name of Bank, institution, entity or Individual and amount for each Item) Description self Spouse Dependent 1 Dependent K.M.Roopashree L.Varshitha L.Adithya Loan or dues to BankfFinancial Rs.3,79,426 as on 19/05/2012 Institution (s) Vehicle Loan from Karnataka Name of the Bank or Bank Ltd., D. D.Urs Road, FI Mysore Amount outstanding - NA - - NA - - NA - Nature of loan Loan br dues to any (i) Loan from Smt. Lakshmi - individuals / Entity Rs. 10,00,000 other than mentioned (ii) Loan from K C Marigowda - in (i) above. Rs.10,00,000 - NA - - NA - - NA - Name(s) (iii) Loan from Shivamurthy - Amount outstanding Rs. 5,50,000 Nature of loan Any other Liabilities - NA - - NA - - NA - - NA - Grand total of liabilities Rs. 29,29,426E - NA - - NA -. Government Dues: Dues to departments dealing With Government accommodation Dues to department dealing with supply of - NA - -NA - - NA - -NAwater Dues to departments dealing with supply of - NA - - NA - - NA - - NA - electrici Dues to department dealing with supply of - NA- - NA- - NA- - NAtelehones / mobiles conta... No. of Cofractiona

10 Dues to departments dealing with Government transport (including aircrafts and helicopters) Income Tax Dues Wealth Tax Dues Service Tax Dues Municipal I Property Tax Dues Sales Tax Dues Any other dues Grand total of all Govt dues NA- (7) Details of profession or occupation: (a) M.Lakshmana ( S e.f) Principal Kamataka Regional Institute of Engineering, Mysore (b) K.M. Roopashree (Spouse): House wife (8) My educational qualification is as under: (Give details of high school/ University education with full form of the certificate I diploma / degree course) (Name of the School / College / University and the year in which the course was completed) 1 ' Std. to 7'" std - Government Primary School, Kuluvanahalli, Nelamangala Tau I k Ban, 9store Dist 8'" Std. to gth Std. Bangalore City Corporation High School. Gavipuramguttahally, Bangalore M.T.G. High School, Thyamagondanahalli, 10" Std. Nelamangala Taluk, Bangalore Dist. Hanumantha Nagar, Bangalore PUC (Science) - PES College, - The Institution of Engineers(I), Kolkata, Engineering Degree Year (M.Tech.) - ISIM, Mysore University contd... I1

11 -: 11 r (9) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (8) ABOVE: Name of the Candidate Full Postal Address umber and Name of the Constituency and State Name of the Political party which setup the candidate (otherwise write' Independent) (a) Number of cases in which conviction order passed (other than those referred to in Form 26) (c) Total Number ofpending cases where the court(s) have taken cognizance PAN of Sri. M. Laksh No. 3 3 Paramahamsa Yadavagiri, Mycore Karnataka Sou 020 th Teachers Constituency Indian Nationa l Congress mana - Road, Year for otal Income which last shown Income Tax Return filed (a) Candidate : M Lakshmana Rs. 1,78, (b) SpouseKM Roopashree Rs. 1,39, (c) Dependents (a) L Varshdha and (b) L. Adilhya I - NA - De s II of Assets and Liabilities i n ru ees Descri tion selflf s use Dependent 1 De dent 2 M.Lakshmana K.M.Roo ashree L. Varshitha L. Adith a A. Movable Asset 85.46, 85, , 71,619/- Rs.14,56,4931- Rs. 12,62,789/- Total value B. Immovable Asset (i) Purchase Price Rs.23,00,000/- - NA - - NA - NA - and Development Cost of Immovable property (Total value _ NA_ (ii) Approximate Rs.45, 00,000/- - NA - current market price of asset Total slue rnntd...12 No. of Agu-W118

12 -:12:- 8. Liabilities (i) Government - Nil - -Nil- - Nil - -Nildues (Total) (ii) Loans from Bank, Financial Institutions and others (Total) Rs.29,29,426/- -Nil- - Nil- - Nil- 9. Highest educational qualification rtificate I diploma / (Give details of Schools / University education with full form of the ce degree course) as completed) (Name of the School/ College I University and the year in which the course w 1 Sid. to 7r' std - Government Primary School, Kuluvanahalli, Nelamangala Taluk, Bangalore Dist. 8th Std. to 9'h Std. - Bangalore City Corporation High School, Gavipuramguttahally, Bangalore. - M.T.G. High School, Thyamagondanahalli, 10'" Std Nelamangala Taluk, Bangalore Dist. PLC (Science) - PES College, Hanumantha Nagar, Bangalore Engineering Degree - The Institution of Engineers ( I), Kolkata Year-1990 VERIFICATION I, the deponent above named, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed there from. I further declare that : (a) There is no case of conviction or pending case against me other than those mentioned in times 3 and 4 above ; (b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 5 and 6 above. Verified at Mysore this the 21 " day of May ut TMY MYSnRr nist. (NA7, ATANAI

13 INDIA NON JUDICIAL Government of Karnataka e-stamp CertificateNo. ill ll "u- Certificate Issued Date i,i Account Reference Unique Doc. Reference S Purchased by M Description of Document Artie Description AFFI Consideration Price (As)1I1'... 0 Ef MVSORE SOUTH3l KA-MY K iuddalingaiah DDALINGAIAH.-. First Party Second Parry. N A --- -: ( pet 1 UDDALINGAIAH.,, Stamp Duty Paid By Stamp Duty Amount(Rs.)......Please write ortype below this line... FORM 26 (See rule 4A) Affidavit to be furnished by the candidate before the Returning officer for election to name of the House) from Karnataka South Teachers Constituency Legislative Council ( (name of the constituency) I, M.LAKSHMANA, son of Late Muddalingaiah, aged about 47 years, resident of No.3, 3'S Main, Paramahamsa Road, Yadavagiri, Mysore , candidate at the above election, do hereby solemnly affirm / state on oath as under S. of^ n StatuHOry Alert : ACC e) SXCIL Oee Ra and Sul'-Wee" "' (SR05). 1. The authen k,dy of the Stamp Cvtlcae can be etaunn bk n Y. The Contact Details of ACCS. SNCIL Offices anu SR areavea v 1be well6lte'wee'. ebcleelarrf.com-

14 h ble with imprisonment for two years or 1. I am not accused of any offence( s) punts a more in a pending case ( s) in which a charge ( been framed by the court(s) of s) haslhave competent jurisdiction. If the deponent is accused information:./ Nos. - Nil (i) Case I First information report No of any such offence(s) he shall furnish the following (ii) Police Station(s) Not Applicable District(s) Not Applicable State(s) Not Applicable (iii) Section(s) of the concerned Act(s) and short description of the offence (s) for which the candidate - has been charged (iv) Court(s) which framed the charge(s) (v) Date (s) on which the charge (s) waslwere framed (vi) Whether all or any of the proceeding (s) have been stayed by any court( s) of competent jurisdiction Not Applicable - Not Applicable Not Applicable - Not Applicable 2. I have been/have not been convicted of an offence (s) other than any offence( s) referred to or covered in sub-section ( 3), of section 8 of the in sub-section(1) of sub-section (2), and sentenced to imprisonment for one Act, 1951 (43 of 1951) Representation of the People year or more., he shall furnish the following If the deponent is convicted and punished as aforesaid information: (i) Case I First information report No.l Nos. -NIlcontd... 3

15 (ii) Court( s) which punished Applicable (iii) - Nu Applicable State s) - Not Applicable (iv) Section( s) of the concerned Act(s) and short description of the offence (s) for which the candidate has ever been charged (v) Date (s) on which the sentence( s) waslwere pronounced (vi) Whether the sentence (s) has / have been stayed by s) of competent jurisdiction any court( - Not Applicable - Not Applicable - Not Applicable - Not Applicable Place : Mysore VERIFICATION Signatur e of deponent and declare that the contents of this, do hereby verify I, the above named deponent of idavit are true and correct to the best of my knowledge and belief, no part of it is false and nothing material has been concealed therein. Verified at Mysore this 21" May Signature of deponent AST Y ME