Entered in the Notarial Registration \~

mm~~~"~~.m

\ Book Page No. 3~Serial

No. u.\

<:'!oLc;S~;,Sa~
S.L
Sold To .....
For Whcftn

N~67D"'f"'t.... ;f rD j J; (J.Jllhrl ""'A7~~ ~,J.~l:f..k.h~t?r .

.2.-672--

ANDHRA PRADESH
11)

l .k.~

.-f:f7 '2J7
FORM 26 (SEE RULE 4 A)

PF
-

56AA ~341 ~1

llcen~edStampVefWii201

~N NO. 12-20-0041 "5th'Road, ANANTAPUR.

@AFFIDAVIT TO BE FURNISHED

BY THE CANDIDATE

BEFORE THE RETURNING

OFFICER

FOR ELECTION TO A.P.LEGISLATIVE

ASSEMBLY 2012 (NAME OF THE HOUSE) FROM ANANTAPUR URBAN CONSTITUENCY

I. G. LALITH KUMAR Son of Late G. NARAYANA SWAMY. Aged about 40 years, Resident of D.No; 2-480-C, 3Rd Road, Anantapur City & District, a candidate at the above Election, do hereby solemnly afTirmand state on oath as under:1.

I afi, not accused of any offence (s) punishable with imprisonment two years or more in defending in which charges has/have been framed by the courts of competent Jurisdiction is accused of any such offence(s) he shall furnish following information.

If the depjnent
I. ~

ii.
iii.

iv.
v.

vi.

Case / First information Report /No (S) NOT APPLICABLE Police Station State(s) District(s) NOT APPLICABLE ~ Sections of the concerned Act(s) and Short description of the offence (s) for which ~ candidate has been charged NOT APPLICABLE .Court (s) which framed the charges NOT APPLICABLE lDate on which the charges (s). NOT APPLICABLE -Whether all or any of the proceedings (s) have been stayed by any Court (s) of 'com nt jurisdiction. NOT APPLICABLE

EN1(ATESW A~~,,~~~

.Agvocate &. Dist. NOTARV 'Ir!s.l!Jt Road, ANA TAPlW

.J

.1

-22. I have not been convicted of an offence(s) referred to sub section (1) or Sub section (2) or covered in Sub Section (3) of Section (8) of the Representation of People Act 1951 (43 of1951 ) and sentence to imprisonment for one year or more. If the deponent information .
. I.

is convicted

and punished

as aforesaid,

he shall furnish

the following

ii. iii. iv. v. vi.

Case / First Information Report No/No (s) NOT APPLICABLE Court(s) which punished NOT APPLICABLE Police Station Dist (s) State(s) NOT APPLICABLE Sections of the concerned Acts and short description of offence for which the candidate has been charged. NOT APPLICABLE Date(s) on which sentence(s) was/ were pronounced NOT APPLICABLE Whether the sentence(s) has/ have been stayed by any court(s) of competent jurisdiction. NOT APPLICABLE

Place ANANTAPUR Date 21-05-2012 Verification:

Signatu~ponent

I 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 and no part of it is false and nothing material has been concealed therein.

Verified at Anantapur on the 21ST day of May 2012.

Signature ~ponent

IEntered in ;h~ Notarial ReQj~t'rati~;! Book Page No. ;Lo-Serial ~No.1:..1:::..i

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Sold To For.

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PRADESH
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""'Ltcenst!d Stil.mp.v~" L N NO. 12-20-004120't-

~Oylf~DA

f.

". 5th Road, ANANTA PUR

Affidavit to be furnished by the candidate along with Nomination Paper Before the Returning Officer for election to Legislative Assembly of Andhra Pradesh (Name of the House) from ANANT APUR URBAN CONSTITUENCY (Name of the Constituency)

I, G LALItH KUMAR Son of Late G. NARAYANA SWAMY, Aged about 40 years, Resident of D.No; 2-480-C, 3Rd Road, Anantapur City & District, a candidate at the above Election, do hereby solemnly atrm and state on oath as under:1. I am a candidate set up by BHARATIYA JANATA PARTY (Name of the political party). 2. Details o~Pan and status of filing of Income tax return:
st
No.

Ncflnes

Permanent Account Number (PAN)

U
1.

The financial year for which the last income-tax return has been filed

Total income shown In Income Tax Return ( in Rupees)

2.
3. 4. 5.

Self G. GALITH KUMAR Sp~se G. Aparna Devi De1ndent 1 (Daughter) G. IMA SHRIYA Dependent 2 (No) Deflndent

AMGPK2790R BARPD0369P No
No No

20112012 20112012 Not filed Not Filed Not Filed

Rs 4,41,000 I Rs 1,80,0001 Not applicable Not applicable Not applicable

...

3 (No)

(3) The following case(s) is! are pending against me in which cognizance has been taken by the court:SI. No.

,.

Offence

Description NIL

(a)

The details of cases where the court has taken B;ognizance. Sections of the Act and description !;lof the offence for which cognizance taken: Name of the court, Case No. and Date of order kin co nizance: ----' etail of A ~ s I Application(s) for revision filed a ainst the above order s

NOT APPLICABLE NOT APPLICABLE

ENKATESWAfi!:\ RAG
1'1OT ARY. Anan~apJllDi.")

-24. Cases in which I have been convicted by a court of law (other those referred to in Form 26): (a) (b) . (C)
The details of cases, Sections of the Act and description of the offence for which convicted: Name of the Court(s), Case No. and Date(s) of order(s) : Punishment imposed:

NIL NOT APPLICABLE

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 Bankl 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) S.No. (i) (ii)

Description
Cash in hand 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 deposit Details of investment in Bonds, Debentures/shares and units in companies/Mutual Funds and others and the amount. Details of investment in NSS, Postal Savings, Insurance Policies and investment in any Financial Instrument in Post office or Insurance Company and the Amount Personal loans/advance given to any person or entity including firm, Company, Trust etc. and other receivables from debtors and the amount. Motor Vehicles/Aircrafts/ Yachts/Ships (details of Make, Registration No. etc, Year of Purchase and amount) Jewelry, bullion and valuable thing (give details of weight and value) ny other assets such as value c Claims/interest Gross Total value

Self
Rs 20,000 /Rs 4,631 t- in Savings Bank Alc With H.D.F.C Bank, Anantapur Rs 2,000 1- in Savings Bank Alc With Axis Bank, Anantapur

Spouse
Rs 5,0001NIL

Dependent-1
NIL

Oependent-2

Dependent.3 NIL

NIL

NIL

NIL

NIL

(iii)

NIL NIL

NIL NIL NIL

(iv)

LlC Policy worth of Rs 8,50,000 /-

Lie Policy worth of Rs 75,000 /-

NIL

NIL

NIL

(v)

Nil

Nil

Nil

Nil

Nil

(vi)

TATA VISTA AP 02 AF 4449 2010 Rs 4,58,000 /20 grams gold worth about Rs 50,000 I-

TVS Star City AP 02 P 1584 2006 Rs 46,000/150 grams gold worth about Rs 3,75,000 /NIL

NIL

Nil

Nil

(vii)

(viii) (ix)

15 grams gold worth about Rs 32,000 /NIL Rs 32,000/-

NIL

NIL

NIL NIL

NIL NIL

c..
"OTARY.

..... RAO
(016&.)

~222607

NIL Rs 5,01,000/

Rs 13,84,631/

\INKATE~WARA
Anantapur

-3B. 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)
S.No. (i) Description Agricultural Land Location(s) Survey number(s) Area (Total measurement acres) Whether inherited property (Yes or NO) in Self Spouse Dependent-1 Dependent-2 Dependent-3

NIL NIL NIL NIL

NIL

NIL

. NIL

NIL NIL NIL

NIL NO NIL NIL NIL

Date of purchase in case of self acquired property

NIL

NIL

NIL NIL NIL

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 Description Non-Agricultural Land Location(s) Survey number(s)

NIL NIL NIL NIL

NIL NIL NIL NIL NIL NIL

NIL Self

NIL Spouse

NIL Dependent-1

NIL Dependent-2

NIL Dependent-3

S.No. (ii)

NIL

NIL

NIL NIL NIL

Area (Total measurement sq. ft.) Whether inherited property (Yes or NO)

in

NIL

NIL

NIL

NIL

NIL

NC

NO

NO

NIL

NIL

pate of purchase in case of sel 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

NC

NO

NIL

NIL

NIL

NO

NO

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NO NIL

NIL NIL NIL

~~

II. VEN~A"S. Advocate

--

a.e.., gl Ois. NOT ;),RY &. lNANT AP\..l\A

W RAt'-\A

~~

-;;p.:
~

'115,l~tROiild,

-4S.No. (iii) Description Commercial Buildings (including apartments) -Location(s) -Survey number(s) Self NIL Spouse NIL Dependent-1 NIL Dependent-2 NIL DependentNIL 3

NIL Built up Area (Total measurement in sq. ft.) 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 the property by way of development, construction etc. Approximate Current market value (Iv) Residential Buildings (including apartments,) -Location(s) - Survey number(s) Area (Total measurement in sq. ft.) Built up Area (Total measurement in sq. ft.) 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 the property by way of development, construction etc. Approximate Current market value (v) Others (such as interest in property) Total of Current Market Value of (i) to (v) above NIL NIL NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

Nil

NIL

NIL

.
NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

(vi)

NIL

NIL

NIL

NIL

NIL

c::a-

A ,'Au
. !!l.L,

VENKA lEtiW ~ 'B.A

Advocate &. O\st. NOT RY 'J75.1!1t Road, AN NTAPUP

-5(6) I give herein below the details of liabilities/ dues to public financial institutions and government:(Note: Please S. No. qive separate details Description of name Self of Bank, institution, entity or individual and amount for each item) Dependent-2 Dependent-2 Dependent-1 Spouse

(1)

Loan or dues to Bank/Financial Institution(s) Name of Bank or FI Amount outstanding Nature of loan

a). Vehicle loan Rs 3,93,1201Gold Loan of b). Rs 40,0001- from CoBank, Operative Town Anantapur Loan of Rs c) Gold 60,0001- from Axis Bank, Anantapur d) Loan of Rs 75,0001From L1C of India, Anantapur

NIL

NIL

NIL

NIL

Loan or dues to any individuals/ Entity other than mentioned in (i) above. Name(s) Amount outstanding Nature of loan Any other liability Grand total of liabilities

NIL NIL

NIL NIL NIL

NIL Rs 5,68,1201-

NIL NIL

NIL NIL

NIL NIL

NIL NIL

(2

Government Dues: Dues to departments dealing with government accommodation Dues to departments dealing with supply of water Dues to departments dealing with supply of electricity Dues to departments dealing with supply of telephones/mobiles Dues to departments dealing with government transport (including aircrafts and helicopters) Income Tax Dues

NIL NIL NIL NIL NIL

NIL NIL NIL NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL

NIL NIL NIL

NIL NIL NIL

NIL NIL NIL

NIL NIL NIL

NIL NIL NIL

Wealth Tax Dues Service Tax Dues Municipal/Property Tax Dues Sales Tax Dues Any other dues Grand total of all Govt. dues NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

(7) Details of profession or occupation: a. Self: - Business b. Spouse: - Business (8) My educational qualifications are as under:
(Give details of highest School/University education with full form of the certificate/ diploma/ degree course)

(Name of the School /College/ University and the year in which the course was completed.)
SI. No Name of the School luniversity Sheperd E.M School, Good Anantapur L.R.G. Higb School, Anantapur 2. ~tional Sai 8aba high School, Anantapur 4.. Nat~~al Sai 8aba high School, apur o.RA Course Completed L.K.G To 2"U Class Year

1.

1979 1981 1987 1990

~~ ~

3"u to 5 Class 5'" to Xth Class

Intermediate (M.P.C)

p..

Ira

-6(9) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (8) ABOVE of the candidate GORIMANAPALLI 2-480-C, and state LALITH KUMAR

1.

Name

2.
3.

Full postal address Number and Name of the constituency

3Rd

Road,

Anantapur

City & District,

272, Anantapur

Urban, Andhra Pradesh

4.

Name of the Political party which set up the andidate (otherwise write 'Independenf) a) Number of cases in which conviction order passed (other than those referred to in Form 26 c) Total number of Pending cases where the ourt (s) have taken cognizance

BHARATIYA JANATA PARTY

Nil NIL

5.

6.

1) 1.
~AN of

PAN

No:Year for which last income tax return filed AMGPK2790R BARPD0369P 2011-2012 2011-2012 Not Filed Not Filed Not Filed Total income shown Rs 4,41,0001Rs 1,80,0001Not Applicable Not Applicable Not Applicable

~). Candidate b) Spouse:

c) Dependents No 1 (Daughter) 3. HIMA SHRIYA Pan Not obtained d) Dependents No 2 (no) e) Dependents No 3 (no)

6.

Details

of Assets Description

&

Liabilities Self Rs 13,84,6311 Spouse Rs 5,01,0001 Dependent-1 Rs 32,000/Dependent-2 NIL Dependent-3 NIL

S.No. A.
1---

Moveable Asset (Total value) Immovable Asset (i) Purchase Price and Development Cost of Immovable Property (Total Value) (ii) Approximate Current Market Price of Asset (Total Value)

B.

NIL

NIL

NIL

NIL

NIL

(1)

NIL

NIL

NIL

NIL

NIL

(2)

NIL

NIL

NIL

NIL

NIL

7
(1) (2)

lIabllitles'Government dues (Total)

...

NIL Rs 5,68,1201-

NIL Nil

NIL Nil

NIL Nil

NIL Nil

(ii) Loans from Bank, Financial Institutions And others (Total)

(8) Highest Educational Qualification (Give details of School 1 University education with full form of the certificatel diploma/ (Na me of the Schoof .Colleqe/ University and the year in which the course SI. No Name of the School/university Course Completed L.K.G To 2" Class 1. E.M School, Good Sheperd Anantapur L.R.G. High School, Anantapur 2. 3KU to 5'" Class 3.. National Sai Saba high School, 5'" to Xth Class Anantapur 4 .. National Sai Saba high School, Intermediate Anantapur (M.P.C)
VERIFICATION I, the deponent, ~ q-tt:reT5est there
.

degree course) was completed.) Year 1979 1981 1987 1990

above of I further

named, my declare

do

hereby and

verify belief,

and no

declare part of

that

the

contents and

of this

affidavit

are has

true been

r==__---.-:..
.; jl:: F

..rt.e.

knowledge that:

it is false

nothing

material

;:,:1.ned~le~:led
t, -

from.

,;.~ "";:L' r:"fa)' ,~...,.r ~

t~e~e-i~ no case of conviction

or pending

case against

me other than those or liability,

mentioned

in items

3 and
in items

4 above;

~t:l 2
~
.

.: (b) I, my spouse, or my dependents ~eri~ttlft~nt~~u"r this the

do not have any asset ST day of May

other than those

mentioned

5 and 6 above.

21

2012

~ .
DE ON NT

c;?S"Z
..
T ,.

i:t. KA ESWA A

,dvocate-Dlsl. 1S t u 1984~.104990-M\! 'd~T~h ~ ----

r '&1 f'V'~':\

--

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