INDIA NON JUDICIAL. Government of Karnataka. e-stamp. (Zero) 20 (Twenty only) FORM 26 (See rule 4A) AFFIDAVIT

Transcription

1 1 INDIA NON JUDICIAL Government of Karnataka e-stamp 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 Q 21-May :45 PM NOCC (FI)/ kacrsfl08/ MYSORE SOUTH8/ KA-MY SUBIN-KAKACRSFL Q NITHYANDA SHETTY Article 4 Affidavit AFFIDAVIT o (Zero) NITHYANDA SHETTY NITHYANDA SHETTY 20 (Twenty only) FORM 26 (See rule 4A) AFFIDAVIT ;,.. :s "'\'),;,, )... Before The Returnin Officer for election to LEGISLA. N\'iSO(~ V \,.rl.' "J:: COUNCIL from KARTAKA SOUTH-WEST TEAC \ \)'ei-~~~~~~. %~I 1-S-C;) t.;. CONSTITUENCY ~~;f ( X rv~/ sia... ory AI,", 1 The authenticity of this Stamp Certlflca~ified at "www shcilestarnp com' Any discrepancy In the details on this Certificate and as available on the websrte renders It Invalid. 2. The onus of checking the legitimacy is on the users of the certificate. 3. In case of any discrepancy please inform the Competent Authority.

2 2 PART-A 1. MR NITHYANDA SHETTY. Son ofh B BABAYYA SHETTY aged 37 resident of No.3-39 Shanthi Nilaya Ampar Post, Kundapur Taluk, Udupi District, , candidate at the above Election, do hereby solemnly affirm and state on oath as under. 1) I am a Candidate not set up by Any Political Party and I am contesting as an INDEPENDENT CANDIDATE. 2) My name is enrolled in 118, BYNDOOR CONSTITUENCY, KARTAKA STATE at serial No. 370 in Part No Teachers Constituency at serial No. 86 in Part No.62. 3) My contact Telephone Number is are , and my id is nithya6623@gmail.com. and my social media account(s) are (i) Rtn.Ampar Nithyananda Shetty (face book) (ii) & (whatsapp No.) (iii) personal website is 4) Details of Permanent Account Number (PAN) and status offiling ofincome Tax Return: SI.No. Names PAN The Financial Total Income year for which the last Income tax return has been filed shown in Income tax return (in rupees) MR NITHY ANDA 1. SHETTY BSXPS3144R ,59,109/- MRS SUBBALAKSHMI 2. FXRPS8100N NOT FILED SHETTY..,.). SIRIDEEPA SHETTY 5) I am not accused of any offence (s) punishable with imprisonment for two years or more in a l, '<.(91...:

3 . \ ~, (i) 3 The following case (s) is / are pending against me in which charges have been framed by the Court for an offence punishable with imprisonment for two years or more:- (a) Case / First information Report No./Nos. / together NOT APPLICABLE with complete details of concerned Police Station / District / State (b) Section (s) of the concerned Act(s) and short NOT APPLICABLE description of the offence (s) for which charged. (c) Name of the Court, Case No. and date of order taking NOT APPLICABLE congnizance: (d) Court(s) which framed the charge (s) NOT APPLICABLE (e) Date(s) on which the charge(s) was / were framed NOT APPLICABLE (f) Whether all or any of the proceeding(s) have been NOT APPLICABLE stayed by any Court(s) of competent jurisdiction (ii) The following case (s) is / are pending against me in which congnizance has been taken by the Court (other than the cases mentioned in item (i) above): (a) Name of the Court Case No. and date of order taking NOT APPLICABLE cognizance (b) The details of cases where the court has taken NOT APPLICABLE cognizance, section(s) ofthe Act(s) and description of the offence(s) for which cognizance taken (c) Details of Appeal (s) / Application (s) for revision (if NOT APPLICABLE any) filed against the above order (s) 6) I have beenlhave not been convicted of an offences(s) (other than any offence(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 People 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 s of cases, section (s) of the concerned NOT APPLICABLE

4 4 Act(s) and description of the offence (s) for which convicted. (b) Name of the Court(s), Case No. and date(s) of NOT APPLICABLE order (s): (c) Punishment imposed: NOT APPLICABLE (d) Whether any appeal was/has been filed against the NOT APPLICABLE conviction order. If so, details and the present status of the appeal: 7) 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. Note: 2. In case of deposit 1Investment, the details including serial number Amount, Date of Deposit, the scheme Name of the Bank IInstitution and Branch are to be given Note: 3. Value of Bonds 1 Share 1Debentures as per current market value in Stock Exchange in respect of listed companies and as per books in case of non-listed companies should be given. Note: 4. Dependent here has the same meaning as assigned in Explanation (v) under section 75A of the Representation of the People Act, Note: 5. Details including amount is to be given separately in respect of each investment. SI.No. Description Self Spouse Dependent-I (i) Cash in Hand 30,000 5,000 (ii) Details of deposits in Bank S.B Alc. in SBI S.B Alc. in accounts (FDRs, Term Kundapura Branch SBI Deposits and all other types of Kundapura osits including saving Bal: 1,946/- Branch ts, Deposits with IInstitutions, Non- S.B Alc. in Bal:

5 5 ~ Banking Financial Companies and Co-operative Societies and Syndicate Bank. Kallianpura Branch the amount in each such deposit. Bal: 873/- S.B Alc. in Corporation Bank Kundapura Branch Bal: 1085/- S.B A/c. in Vijaya Bank. Kundapura Branch Bal: 1665/- S.B Alc. in Vijaya Bank. Gulwady Branch Bal: 459/- (iii) Details of Investment in Bonds, Nil Nil Debentures / Shares and units in Companies / Mutual Funds and others and the amount (iv) Details of Investment in NSS, LIC of India Postal Saving, Insurance Premium Policies and Investment in any Pol.No Premium 7336/ Financial Instruments in Post Mode Yearly Office or Insurance Company Y and the amount Y Y Y ;.,.,...'

6 Y H Postal Y Kotak-l0350-Y (v) Personal loans 1advance given Nil Nil to any person or entity including firm, company, trust etc., and other receivables from debtors and the amount. (vi) Motor Vehicles 1Aircrafts 1 Car- Swift Desire Nil Yachts 1 Ships (details of make, KA 20 Z 5914 Registration No. etc., year of Rs.5 Lakh Purchase and amount) MotorBike KA Rs (vii) Jewellery, bullion and valuable Chain and Rings Chain and thing(s) (give details of weight 35 Grms Bangles and value) Value- 96, Grms. Value- 8,75,0001- (viii) Any other assets such as value 2,00,0001- Nil of claims 1 interest (ix) Gross Total Value 8,62,028/- 8,81,1001- B. DETAILS OF IMMOVABLE ASSETS: Note: 1. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated. Note: 2. Each land or buildingor apartmentshouldbe mentionedseparatelyin this format Description Self Spouse Dependent-1

7 7 (i) Agricultural Land Location (s) Survey Number(s) Area (Total measurement in Acres) N/A N/A N/A Whether inherited property (Yes or No.) N/A N/A N/A Date of Purchase in case of self acquired N/A N/A N/A property Cost of land (in case of purchase) at the time N/A N/A N/A of purchase Any investment on the land by way of N/A N/A N/A development, construction etc. Approximate current market value N/A N/A N/A (ii) Non-Agricultural Land: Location (s) Survey Number (s) Area (Total measurement in Sq.ft.) Whether inherited property (yes or no) Date of purchaser 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.,/:~.:~~;f~:::..',:",: :" -, t'... 1,;'\" \~~!~~~urren!,i. f ~"-;"~ _. ~ ",,:I '''' t,'.: -v,.;.~. ' -. -t. " </t","')_', ("> ':" ",'.) ~o 0... <h i Lj... '\ -J,.. ~. :,:. ",V ' J, -c.., +~.'... \ ~c~<t::...:">/ ~),.." _-- ~o ~" ",. \, '...,' marketvalue '-

8 4. (iii) Commercial Buildings (Including apartments) Locations(s) 8 Survey Number(s) Area (Total measurement in Sq.ft.) N/A N/A N/A Built -up Area (Total Measurement in N/A N/A N/A Sq.ft.) Whether inherited property N/A N/A N/A (Yes or No) Date of Purchase in case of self Acquired N/A N/A N/A property Cost of Property (In case of purchase) N/A N/A At the time of purchase. Any investment on the property by way of N/A N/A N/A development, construction, etc. Approximate Current Market value N/A N/A N/A N/A (iv) Residential Buildings (Including Apartments) Lacation (s) N/A N/A N/A Survey Number(s) N/A N/A N/A Area ( Total measurement in Sq.ft.) N/A N/A N/A Built up area (Total measurent in Sq.ft.) N/A N/A N/A Whether inherited property (Yes or No) N/A N/A N/A Date of purchase in case of self Acquired N/A N/A N/A property ~Co~S'?~ Property (In case of purchase) at the N/A N/A N/A l,.o:<::::~ ~~;"\Y ',» ~- ~ time,6fmtrchase. '" :;:.---- I---~l.. "...-""I..t -'. -'....'/~;:~~~"'~mnt on the land by way of N/A N/A N/A,,~~.~... '"J. ~, 'i :... ~ 1'1 -C,'...c o',,'i-> i.t',-.' "p ~.~4. ~." ( ) 'c';',./'«1 <v-tl c.' ; -, «.:' <+;;J... '>,...,~, 0..;... c: "".,'". " - ~./. :),.,.. >" der~'. ', C, {I;;,... '... l.-j.~ ~~ I,,"" ',nnf. ~

9 9 III development, construction, etc. Approximate Current Market value N/A N/A N/A (v) Others (such as interest in property) (vi) Total of Current market Value of (i) to (v) above. (8) I give herein below the details of liabilities Idues topublic financial installations and Government :- (Note: Please give separate details of name of Bank, institution, entity or individual and amount before each item). SI. Description Self Spouse Dependent-l No. (i) Loan or dues to Bank!Financial Institution (s) Name ofthe Bank or Financial Institution, Amount outstanding Nature of loan. Vijaya Bank, Gulwady Car Loan -Rs.30,OOO/ & Gold Loan Rs.1,OO,OOO/- Corporation Bank, Kundapura- O.D. - Rs.1,60,OOO/- Loan or dues to any other individuals /Entity other than mentioned above. Name(s) Amount outstanding Nature 0 loan Any other liability Grand Total of liabilities Rs.2,90,OOO/- (ii) Government Dues: "'-tcl 0' l,orrect'()r"'.~

10 10 All Dues to department dealing with supply of water Dues to department dealing with supply of electricity Dues to departments dealing with supply of telephone/mobiles. Dues to departments dealing with Government transport (Including aircrafts and helicopters) Income Tax dues Wealth Tax dues Service Tax Dues MuncipallProperty Tax Dues Sales Tax Dues Any other dues (iii) Grand total of all Govt. Dues. (iv) Whether any other liabilities are in dispute, if so,mention the amount involved and the authority before which it is pending. (9) Details of profession or occupation: (a) Self: MR NITHYNDA SHETTY - Assistant Professor (Management Unaided staft) (b) Spouse: MRS SUBBALAKSHMI SHETTY - Housewife (9A) Details of Source ofincome: (a) Self: MR NITHYNDA SHE TTY - Salary and LIC Agency Commission (b) Spouse: MRS SUBBALAKSHMI SHE TTY - Housewife BA in Mangalore University MA in Mangalore University M.Phii in Dravidian Universtiy, Kuppam-2011

11 .. (Give details of highest School/University education mentioning the full form ofthe certificate/diploma/degree course, Name of the School/College/University and the year in which the course was completed) 11 ~, r?,1

12 12 PART-B (11) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART -A: 1 Name of the candidate MR NITHYANDA SHETTY 2 Full Postal Address No.3-39 Shanthi Nilaya Ampar Post, Kundapur Taluk, Udupi District, , 3 Number and Name of the Constituency and State 118, Byndoor, Karnataka 4 Name of the political Party which set up the Independent candidate (Otherwise write "Independent") 5 (i) Total number of pending cases where charges have been framed by the Court for offences punishable with imprisonment for two years or more (ii) Total number 0 pending cases where the court(s) have taken cognizance (other than the cases mentioned in item(i) above. 6 Total number of cases in which convicted and sentenced to imprisonment for one year or more (except for offences referred to in sub-sections (1), (2) or (3) of section 8 of Representation of the People Act, 1951). 7 PAN OF Year of which Total Income last Income Tax Shown. Return Filed. 8 Details of Assets and Liabilities in Rupees SI.No. /-:~:;;.:::.:::_~ -:--[Zy ~ Car - t'>-,. IY.,.._ I-"" ~. " '\ '- ~ ~. c}- ;0. MotorBike.. ~~.",'> ';Z <;),J ~ Description Self Spouse MR NITHYANDA BSXPS3144R Rs.4,59,109/- SHETTY MRS SUBBALAKSHMI FXRPS8100N Not filed SHETTY Sirideepa Shetty Rs.5,00,000/- Rs.30,000/- ; '~~e. il'')"~.,,.0 \ ~e ~il 9;' '... ",CO ~ \<;-~?VERN~«,~ 1 ~;>-. e ~ \ Gold Rs.96,000/- Rs.8,75,000/- - _~\,0' o~ a. I I, "'"~-., '(

13 ., Other 13 Assets Rs.2,OO,OOOI- A Movable Assets (Total Value) 8,26,0001- Rs.8,75,0001- B Immovable Asset (i) Purchase price of self - acquired Immovable property (ii) Development Iconstruction cost of immovable property after purchase (If applicable) (iii) Approximate Couuent market price of - (a) Self -acquired assets (Total Value) (b) Inherited assets (Total Value) 9 Liabilities (i) Government dues (Total) (ii) Loans from Bank, Financial Institutions and others (Total). 10 Liabilities that are under 2,90,0001- dispute: (i) Government Dues (Total) (ii) Loans from Bank, Financial Institutions and others (Total) 11 Highest Educational Qualification: Mr NITHYANDA SHETTY..-.I-r.';::::-:::':~--::; ::~ ~ift i\'1vi:-;'~~(),reuniversity /9~~.;" 1:... - ',\ ~,university -2005! :";_;" ~. ~(\l;. '? ~ C\.>.""( I... \ ~ ~'< "A~,. r { C l' -0 ~~~ nnfi p Universtiy, Kuppam-2011 :;;>,{' ~Q.. o~.q,. I, \ 'fjoj " \ '0' ">' ~ I ~ '<.. ""t:_,r. >. Me, <, N\,.

14 14 -, (Give details of highest School/University education mentioning the full form of the certificate /diploma/degree course, name of the School/CollegelUniversity and year in which the course was completed) VERIFICATION I, the deponent, above named, do hereby verify and declare that the contents ofthis affidavit are true and correct to the best of my knowledge and belief and 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 items 5 and 6 of Part-A and B above: (b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 7 and 8 of Part-A and items 8,9 and 10 of Part-B above. Verified at Mysuru this the 21st day of May / ~

15 INDIA NON JUDICIAL Government of Karnataka e-stamp 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 Q 18-May :19 AM SHCll (FI)I ka-shcill KUNDAPURI KA-UD SUBIN-KAKA-SHCll Q NITHYANDA SHETTY Article 4 Affidavit AFFIDAVIT o (Zero) NITHYANDA SHETTY NITHYANDA SHETTY 20 (Twenty only) ~uthorid;gnatol'/ For Stock Holding Corporation of In~iaLtd., Election to Karnataka Legislative Council form KARTAKA SOUTH-WEST TEACHERS CONSTITUENCY. I, Mr NITHYANDA SHETTY (Name of candidate) Son of Sri H,B. Babayya Shetty, aged 37 years, resident of No.3-39 Shanthi Nilaya Ampar Post, Kundapur Taluk, Udupi District, ''''"'0.' A<.". ~ "'~~~.~: "~"?RRECTICNS.;.;?,;~~,~~:C."..

16 A candidate at the above election do solemnly affirm and state on oath as under:- (i) I have not been allotted any govt. accommodation at any time during the period of last 10 years prior to the date of notification of the current election. VERIFICATION I, the deponent above named, do hereby verify and declare that the above statements are correct to the best of my knowledge, and no part of it is false. Verified at Kundapur this the 19th day of May Solemnly affirmed and the Conte"t~ <'It tl1'!o affidavit having been read OVflr ;, :htt depomnt and admitted b~' hip" '. ;,u, and Correct and signed I.t~.~..; mo. This...~ Q.~..daY of..tt.}.qj42o..lti at Kunda;Jra U NOTARI ~L...r:~l""l-r ", \1 st. No OTARY KUNDAPUD.1..H.a. 11~ ) {.""''''' "',..'1'.(,,_,,: ;,.,d::-.. '~NL' VI '.. J..Dt..... D 8' I"", t(~.~.~i~.~c' I No n;:;r""~~":-'''~''('\' "', '0 ' '" Of......i