Government of Karnataka

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1 INDIA NON JUDICIAL Government of Karnataka e-stamp e,k-* aeol. o LAW-49 1C1,29 Certificate No. Certificate Issued Date Account Reference Unique Doc. Reference Purchased by Description of Document Description Consideration Price (Rs.) First Party Second Party Stamp Duty Paid By Stamp Duty Amount(Rs.) IN-KA L 16-Apr-213 1:36 PM NONACC (FI)/ kacrsf18/ VIJAYANAGAR/ KA-BN SUBIN-KAKACRSFLO L PRIYADHARSHINI S V Artic 4 Affidavit AFFIDAVIT (Zero) PRIYADHARSHINI S V ELECTION COMMISSION PRIYADHARSHINI S V 2 (Twenty only) ra \sse.. flinqalliru MEN POLITAN AL, REA 1, Pase write or type below this line Form 26 (See Ru 4A) Affidavit to be fid by the candidate along with nomination paper before the returning officer for the ection to Assembly. From Rajarajeshwari Nagar 154 constituency 1 Statuatory Art: \ ORRECTIONS.. 1. The authenticity of the Stamp Certificate can be verified at Authorised Colction nters (ACCs), SHCIL Offices and Sub-registrar Offices (SROs). 2. The Contact Details of ACCs, SHCIL Offices and SROs are availab on the Web site "

2 PART -A I, S.V.Priyadharshini (Priya Dharshini Iyer S.V.) D/o Dr.S.Natarajan lyer compted 39 Years resident of 11,7th main BEML 3rd stage Rajarajeshwari Nagar Bangalore -98, a candidate, do hereby somnly affirm and state on oath as under: - 1. I am a candidate setup by Janata Dal (United) 2. My name is enrold in Rajarajeshwari Nagar -154 Karnataka at serial No 378 in part No My contact tephone number is and my id is prjya.polit@gmailcom 4. Details of permanent account number (PAN) and status of filing of income tax returns: SI No Names PAN Financial year for which the last income tax return has been fid Total Income shown in income tax return (in rupees) 1. Self AFJPP6867J , Saumya Verekar AEKPV72H ,3, 3. Dependent -1 Prabhathi 4. Dependent -2 Devna 5. I am not accused of any offense(s) punishab with imprisonment for two years or more in pending case(s) in which charge(s) has/have been framed by the court(s) of competent jurisdiction. If the deponent is accused of any such offense(s) he shall furnish the following information: - (i) The following case(s) is /are pending against me in which chirges have been framed by the court for an offense punishab with imprisonment for two years or more: * ( tc, REC1. No. LA'41 4':.i La-29 '.411. LuiFtu P Ay IT.7' 424* a) Case/first information report No./ Nos together with compte details of concerned police station/district/state b) Section(s) of the concerned Act(s) and short description of the offence(s) for which charged c) Name of the court,case No. and date of order taking cognizance: d) Court(s) which framed the charge(s) e) Date(s) on which the charge(s) was /were framed 2 T No. OF r_1,rrections.nit

3 Whether all or any of the proceeding(s) have been stayed by any court(s) of competent jurisdiction(s) (ii) The following case(s) is /are pending against me in which cognizance has been taken by the court by the court other than the cases mentioned in item (il above: a) Name of the court,case No. and date of order taking cognizance: b) The details of cases(s) where the court has taken cognizance, Section(s) of the concerned Act(s) and description of the offence(s) for which cognizance taken c) Details of Appeal(s)/Application(s) for revision (if any) fi against the above order 6. I have not been convicted of an offense(s) other than any offense(s) referred to in sub- section (1) or sub section (2), or covered in sub-section (3), of section 8 of the representation of the peop act. 1951(43 of 1951) and sentenced to imprisonment for one year or more. If the deponent is convicted and punished as aforesaid he shall furnish the following information: In the following cases I have been sentenced to imprisonment by a court of law: a) The details of cases(s), Section(s) of the concerned Act(s) and description of the offence(s) for which Convicted: b) Name of the court, case No. And date(s) of order(s): c) Punishment imposed: d) Whether any appeal was/has been fid against the conviction order. If so, details and the present status of the appeal: /RE f. No. \ 7. That I give herein below the details of assets (movab and immovab etc.) of myself my spouse in all dependents: A. Details of movab assets. el: Assets in joint name indicating the extent or of joint ownership will also have to be given ote2: In case of deposit /investment the details including serial number, amount, date of deposit, the scheme name of the bank /institution and branch are to be wen. 3 Na.OF R RECTIONS...IELL

4 e3: value of bonds/share/debentures as per the current market value unstock exchange in respect of listed companies as per books incase of non listed companies should be given. e4: dependent here has the same meaning as assigned in explanation (V) under section 75A of the representation of peop act, 1951 e5: details including amount is to be given separately in respect of each investment SI no Description Self (INR) Spouse(INR) (i) Cash in hand 4,,/- 2/- Depende nt-1 (INR) Depende nt- 2(INR) (ii) Details of deposits in bank accounts (FDRs, term deposits and all other, types of deposits including saving accounts.), deposits with financial institutions, non banking financial companies and cooperative societies and the amount in each such deposits Karnataka Bank,city civil court branch SB account 2,64,546/- 1B, rajarjeshwari nagar - 71/- Axis bank,bansha nkari branch 45/- Axis Bank,Rajaraj eshwari Nagar7 1B Rajarajeshwa ri nagar 8 rupees 4, Axis Bank ltd Periodic deposit scheme (iii) Details of investment in bonds, debentures/shares and units in companies mutual funds and others, and the amount I (iv) Details of investment in NSS, postal saving, insurance policies and investment in any financial instruments in post office or insurance company and the amount. ersonal loans/advance en to any person or Ars RE IL Nn. LAW-49 1.CL-N9 RASE ATH.A. x r 6 1.1IRU \Mb LITAN REA 144* Metlife smart GOLD PPT 5 CT 1 Rs 95,,/- Damodar 7 441).'OF CORRECTIONS... L L 4

5 (vi) (vii) (viii) entity including firm, company, trust etc. and other receivabs from debtors and the amount Motor vehics/aircrafts/yatchs/s hips (details of make, registration number etc. year of purchase and amount) Jewelry, bullion and valuab thing(s) (with details of weight and value) Any other assets such as value of claims /interest pundalik in 25 Santro four wheer model of 21 model bearing number KA-41 MH 294 purchased in the year 211 for rupees 4,3,/- 1.5 kg gold; value 39/- 1 kg silver value 5/- Tata safari dicor four wheer of 21 model bearing number KA 1 MG 253 purchased in the year 21 I for rupees I 1,2,/-. (ix) Grand total value 1,52,1,/- 13,83,/- B. Details of immovab Assets: e 1: properties in joint ownership indicating the extent of joint ownership will have to be indicated e2: each land or building or apartment should be mentioned separately in this format. SI no Description Self Spouse Dependent 1 Dependent 2 (i) Agricultural land Location(s) Survey Number(s) Area (total measurement in acres) Whether inherited property (yes or no) Appli cab illawi + * REGD. No. I( LAW-4S LCL4 9 :R+GHJd H.A. fo,,an tpr, of Date of purchase in case of self cquired property ti No. OF COFkRECTIONS

6 (ii) " Cost of land (in case of purchase) at the time of purchase Any investment on the land by way of development, construction etc. Approximate current market value. NON Agriculture land Location(s) Survey Number(s) Area (total measurement area in sq ft) Whether inherited property (yes or No) Date of purchase in case of self acquired property Cost of land (in case of purchase) at the time of purchase Any investment on the land by way of development construction etc, Approximate current market value (iii) Commercial buildings (including apartments) Location(s) Survey number(s) as, -vt RECTO. No, LAW 49 LCL-S 9 RAW ML IR Area (total Li? i. \n easurement area H.A. 'PM MAN, F CORRECTIONS N' 6

7 in sq tt) Built-up (total measurement square feet) area in Whether inherited property (yes or no) Date of purchase in case of self acquired property Cost of property (in case of purchase) at the time of purchase. Any investment on property by way of development. Construction, etc. Approximate current market value (iv) Residential Building (including apartments.) Location(s) Survey Number(s) Area (total measurement in square feet) Built-up area (total measurement in square feet) Whether inherited property (yes or No) Date of purchase in case of self acquired property Cost of property (in case of purchase) at the time of purchase 11,7th main, BEML 3rd Stage, Rajarajeshwa ri Nagar, Bangalore-98 site no sq ft 75 sq ft NO 19/5/23 7,98,25/- A sil investment 6,,/- 7

8 on land by the way of development etc. Approximate current market value (v) Others (such as interest in property) (vi) Total of current market value of (i) to (v) above 3,5,,/- 3,5,,/- 8. I give herein below the details of liabilities/dues to public financial institutions and government:- (e: pase give separate details of Bank, institution, entity or individual and amount before each item SI no Description Self Spouse Dependent- 1 (i) Loan or dues to Housing Motor bank /financial Loan Of vehic loan institution(s) name 3,,/- of 6,8,/- of the bank or with State financial institution bank of India amount outstanding, Indiranagar Nature of loan branch Education Loan Of 17,,/- with State bank of India indiranagar branch Dependent-2 REGO. Ho. N. 49 LCD.-25 K ' As t1.1 ta 4. a I. E..: G LUI1U. 9LITAN RE A 4 id 4 P.- 47 Personal loan of 7 with ICICI Bangalore Personal loan 3,5,/- with HDFC Bangalore Motor vehic loan of 2,,/- 8 No OF CORRECTIONSAML-

9 Loan or dues to any 1\ : I, other individuals/entity other than mentioned above. Name(s) Amount outstanding, Nature of loan Any other liability (ii) (iii) (iv) ). ti '-,, Grand total of liabilities 59,5,/- 6,8, Government dues Dues to departments dealing with government accommodation. Dues to department dealing with supply of water Dues to department dealing with ectricity Dues to dealing with supply of tephones/mobis Dues to department dealing with government transport (including aircraft and helicopters) Income tax dues Health tax dues Service tax dues Municipal/property tax dues Sas tax dues Any other dues Grand total of all government dues Whether any other liabilities are in dispute, if so, mention the amount involved and the uthority before 'eh it is pending. personal loan of rupees 3,5,/- Housing Loan Of 3,,/- before DRT 9 F CORRECTIONS L

10 Bangalore Education Loan Of 17,,/- Before DRT Bangalore 9. Details of profession or occupation: a) Self Legal Practice/Advocate b) Spouse Self Employed 1. My education qualification is as under: School Conferred Degree Year of comption Coventry University Master of Laws in July 21 (UK) International Law (Give details of highest school/university education mentioning the full form of the certificate/diploma/degree course, name of the school/colge/university and the year in which the course was compted) PART-B 11. ABSTACT OF THE DETAILS GIVEN IN (1) TO (1) OF PART A: 1. Name of the candidate Smt Priyadharshini Iyer SV 2.,Full postal address No. 11,7`" main BEML 3rd stage Rajarajeshwari Nagar, Bangalore Number and name of the constituency and state 154-Rajarajeshwari Nagar assembly constituency, Karnataka Name of the political 4. party which setup the candidate Janata Dal (United) (i) Total number of pending cases where charges 5 have been framed by the court for offenses punishab with imprisonment for two years or more (ii) Total number of pending cases where the court have taken cognizance (other than the cases mentioned in the item (i) above) 6. Total number of cases in which convicted or sentenced to imprisonment for one year or more (except for offenses referred to in sub section (1), (2) or (3) of section 8 of representation of the peop Act of, 1951 PAN Of Year of which Total income shown nil AR last income tax to 1

11 SI no A. B. return fid (a) Candidate AFJPP6867J ,15,462 (b) Spouse AEKPV72H ,3, (c) Dependents 8. Details of assets and liabilities in rupees Description Self Spouse Dependent-1 Dpendent-2 Movab assets (total value) 1,52,1,/- 13,83, /- Immovab assets (i) Purchase price of self acquired immovab property Development/construc tion cost of immovab property (if applicab) Approximate current market price of 7,98,25/- 6,, (a) Self acquired assets (total 3,5,,/- Value) (b) Inherited assets (total value) 9. Liabilities (i) Government dues (Total) Loans from bank, 59,5,/- financial institutions and others (total) 1. Liabilities that are under dispute (I) Government dues total Loans from bank, 51,5, financial institutions and others (total) 11. Highest education qualification: Master of Laws in International Law (United Kingdom) (Give details of highest school/university education mentioning the full form of the certificate/diploma/degree course, name of the school/colge/university and the year in which the course was compted) 6,8,/ of'corrections±11.l 11

12 VERIFICATION I. 1, the deponent, above name, do hereby verify and declare that the content of this affidavit are true and correct to the best of my knowdge and belief and no part of it is false and nothing material has been concead there from. I further declare that a. There is no case of conviction or pending case against me other than those mentioned in items 5 and 6 of part-a and B above; b. I, my spouse, or my dependents do not have any asset or any liability, other than those mentioned in items 7 and 8 of part A and items 8,9 and 1 of part B above Verified at Bangalore this the 166 day of April REGD. No. \ LAW-42 LC 1...1""D9\ 4 RAC:WE:C:1H.A. BENCAt U Oft This Document Entered at PONEN Sl. NO Page Isto.a SWORN TO BET Vol. No Datelta;.1.; ME NA H e.sc., LL.s E-1 affidavit should be fid latest by 3: PM on t Mfs t NOTARY PUBLIC #13,111oiarn, RIgCHUNCHANAGIRI COkilotEX nominations AYANAGAR,SENCIALURU 56 4 NOTE-2 affidavit should be sworn before an Oa commissioner or magistrate of the first class or before a notary public NOTE-3 all columns should be fild and no column should be ft blank.if there is no information to furnish in respect of any item, either '' or " applicab", as the case may be, should be mentioned. 116 APR 213 e-4 the affidavit should be either typed or written gibly and neatly t. GOVERNMENT OF KARNATAKA WITHDRAWN THE USE OF OTARY STAMPS WITH EFFECT FROM , HENCE NOT AFFIXED. SVADMINSEL o. OF CORRECTIONS..

13 Ection Immediat / By Fax/Ca ag ELECTION COMMISSION OF INDIA Nirvachan Sadan, Ashoka Road, New Delhi-111. No. 56/44/211/PPS-Ilicga, Dated: 13th April, 213. To The Chief Ectoral Officer, Karantaka, 13angalore. Sub:- Allotment of reserved symbols under Para 1 of the Ection Symbols (Reservation & Allotment) Order, Janata l)al (United)- regarding. Sir I am directed to refer to the subject cited and to state that "Janata l)al (United)" a recognized State party in the State of Bihar, having reserved symbol 'Arrow' in the said state, has rcqueted the Commission for concession under Paragraph 1 of the Ection Symbols (Reservation and Allotment) Order, 1968 for allotment of the said symbol 'Arrow' to its candidate being set up by the party at the current general ection to the s- Legislative Assembly of Karnataka from all the 224(two hundred twenty four) assembly constituencies of the State. The Commission has decided to extend the concession sought by the b in 7 party under paragraph.1 of the Ection Symbols (Reservation and Allotment) Order, Accordingly, the candidate set up by the "Janata Dal (United)" at the current general ection to the Legislative Assembly of Karnataka from all the 224(two hundred twenty four) assembly constituencies of the State shall be allotted the symbol 'Arrow '. The Returning Officers may be informed that the candidates set up by "Janata D. filliedr -art.eligib for the allotment of the symbol 'Arrow ' under / 1 5 /TR 213 :) ---;;;--;.',5*,/

14 paragraph 1 of the Symbols Order, 1968 subject to strict fulfillment of each of the provisions of paragraph 13 thereof. Yours faithfully, (VARINDER KUMAR) SECRETARY 1. Copy forwarded (BY SPECIAL MESSANGER) to the General Secretary,,Janata Dal (United), 7, Jantar Mantar Road, New Delhi-111, with reference to his tters dated and I-Ie is informed that the party and the candidates must comply with each of the provisions of Para 13 of the Ection Symbols (Reservation and Allotment) Order, Copy to:- Pr.Sccy. ( TK )/ South-II/ Guard Fi.

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