~V.L. No: 5/200;'-. 1.CHIPUIlDfJ Form 26 (See rule 4A) ~ Affidavit to be furnished by the candidate before the returning officer for election to

Transcription

1 30AA ~.~~AStamp Vendor. ~V.L. No: 5/200;'-. 1.CHPUlDfJ Form 26 (See rule 4A) ~ Affidavit to be furnished by the candidate before the returning officer for election to AP LE&SLATVE ASSEMBLY from YELLAREDDY constituency ~ '(,ESMA BASKER RAO, Son! daughter/ wife of MANK RAO age about 34 Year residence of AREPALLY, candidate at the above election, do hereby solemnly affirm! state on oath under: B Conti :2 page,

2 :: 2:: 2. have not been convicted of an offence( s) [other than any offence( s) referred to in sub-section (1) or sub-sc tion (2), or covered in sub-section (3), of section 8 imprisonment for one year or more. f the deponent is convicted and punished as aforesaid, he shall furnish the following information. (i) Case/ First information report No/ No. (ii) Court(s) which punished. (iii) Police station(s) District (s) State (s). For which the candidate has ever been charged..... (iv) Date(s) on which the sentence (s) was/ were pronounced. (v) Whether the sentence(s) has/have been stayed by any count(s) of competent JurS.. dicon ti. y Place: cllareddy Date: g, 1,'),.e9{O t:.e.~~ Signature of Deponent VERFCATON, the above - named deponent, do hereby verify and declare that the contents of this affidavit are true and correct to the best of my knowledge and belief, on part of it is false and nothing material has been concealed therein. fir- Verified at.. ~~~ this day of JUl~O. R &J'fJ Signature of deponent Note: The columns in the Form which are not applicable to the deponent may be struck off. ~~c D. PRADEEP REDDY M.A., LL.M. Advocate & Notary Appointed by the Govt. of A.P. Kamarcddy h.Q.t..Nzb,

3 ~OLc;Sl~~~ 31Tr~ 81. No..1.L.et~ DL7;J~ Sold tog.... R 0 ANDHRA ' R~../ff4.: PRADESH &~d~ li...,/),,,,,.0 ~(~ ,n.-' C, SA MAR. Stamp Vendor, f. V, L. No.2 OF ~». KAMAREDgt Affiftvit to be furnished by candidate along with nomination paper Before the Returning Officer it For election to'a.p. STATE LEGSLATVE ASSEMBLY From YELLAREDDY constitnency,.sma BASKER resident ofrrepally, RAO, son! daughter / wife of MANK RAO aged 34 years, candidate at the above election, do hereby solemnly affirm and state on oath as unler:- ajnot accused of any offence. Conti 2 page,

4 .to) V her em elow t e etails 0 the asse s ill vab e, )' icariug. te of joint owners ip will also have to be given) S. Description ~ou' 1>..._i.l. Spous (s) Dene ident-l Deptl deu t-2 Dependent-S, o. Name(s): Name: Name: etc. Name: (i) Cash c-n't qtn1,,- t:jij,..- =-AJl r 1f4')' foc~ 1-1--' _qtylr_--+-- l _ (ii) DeJ)osits. n Banks, Financial JJ: ~ <fj-~lr c-j'lr ~r~ lr nstitutions and c=: JJ'~(r / Non-Banking Financial Companies (iii) Bonds, Debentures and Shares in companies c- fllr c-1fl1- ~r- ~ 1- ~1r,-/Vr' 1 ~ (iv) Other Financial instruments NSS, Postal Savings, LC, Policies, etc. r-~\"- t-nlr- ~fv"... ~~\r- r-~ 1,--. (v) (vi) (vii) Note: Motor Vehicles (details of '1,.-.-}.NV- _~lr- A» t,- fj.' l.--...,...-v'- make, etc.) Jewellery (give details of weight and «: value) Other assets, such as values of claims / interests =r= ~ ~btb l-- ~;r.-ptr- --~'-..-v: lr=...-~l"-...-~l'-- e-: ~ l,.- --~,- ~~t.,... Value of Bonds / Shares / Debentures as per the latest market value in Stock Exchange in respect of listed companies and as per books in the case of non listed companies should be given. *Dependent here means a person substantially dependents on the income ofthe candidate. ~;~ ~~ l ~~~~==~=

5 l -~ ,,..,.., t-\ 1 Ld'.J r (')U.:.d.... lye indicated! J J '~---L:---- Description,Self " - (i) Agricultural Land J _ ame: - or on(. q»1,. ~~~ 1- Survey number(s) ~~ V:J~ ~~ /,- - Extent (Total measurement).4c.-1-b o - current market value,,?-j:>,/) o» L... pt (ii) Non-Agricultural Land - Location(s) - Survey number(s) - Extent (Total measurement) - current market value ~\r J$fr- ~)- ~pr1 r+- (iii) Buildings (commercial and residen tial) - Location(s) ~ ~- - Survey / door number(s) - Extent (Total measurement) - current market value ~~':-r- ~lr ~ ~JJHr- (iv) Houses / Apartments, etc. - Location(s) prl J-A"f- ~"'l...- ~l~ - Survey / door number(s) - Extent (Total measurement) - current market value.-/-"it,.. (v) Others (such as interest in property) /1$lr- M'r- pt/ M"L, lwl,-

6 .. g e ai S or each item S.N - Description (a) (i) Loans from Banks Name and address of Bank / Amount outstanding Financial nstitution(s) / as on... <lj.:zf~/h Department(s) ~r,.- institutions and overnme t d es:- rtsfr- D (ii) Loans from financial institutions --~~ ~~ (iii) Government dues:- (a) dues to departments dealing with government c-m'1 r: accommodation (b) dues to departments dealing with supply of f1jl \,.- -- water M't ( (c) dues to departments dealing with supply of electricity fj" r=:.-- f'tt-l r=> (d) dues to departments dealing with telephones ""-1,- (e) dues to departments dealing with government transport (including aircrafts and helicopters) ~ M.,-,-- }Jt'~ (f) other dues, if any ~tp~ ~/ V ~.ro c:::i NU (( t41 APpointed by ~ ~ Go'/\. 01 A.P. 1i:' ~ \NO\A! <'~ 1:'0 - \S'~. 0""503 \' \ <;) 1ft (,- M~1,.- -V- ---}J"rv- ~fj' ~'<-'~ ~.

7 ,-:".. o _0 0 -o--r Na ie a ad re-s of'ba i t t---o- --_ _ ~J) g surcharge [A so in icate tl e assessment year upto which ncome Tax Return filed. Give also Permanent Accoun.,S 0 o/;r.! l bj (). (ii) Wealth Tax [Also indicate the assessment year upto which Wealth Tax return filed.] (iii) Sales Tax [Only in case of proprietary business] (iv) Property Tax

8 () er :- fn'l""o (""f ~('h"o' TTni pr~itv ~nrl thp P~in which the course a como e e S ou also be given.) c VERFCATON Y7~.~ ~HEPONENT, the deponent abovenamed, do hereby veri ~d 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 therefrom. Verified at ~~~this the _-=-er day of J~,2010 \~J~' ~,~tn' DEPONENT ~o D. PRADEEP REDDY M.A., LL.M" Advocate & Notary Appointed by the Govt. of A.P. Kamareddv - 5()3i 11..;Ot;.,Nzh