FIFTY

RUPEES

5.50 2O 9
Rs.50
INDIA
INDIANON JUDICIAL
AZ 477935
5blppT6 aftaaTS TAMILNADU
/7-83 v 2 1

Moa totyai GsSH KUMAR

ENDOR
O UR,
o16.

FORM 26
(See Rule 4A ofthe Conduct of Election Ruies, 1961)

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH

NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION
TO THE TAMIL NADU LEGISLATIVE ASSEMBLY
FROM

120,COIMBATORE SOUTH Constituency

PART-A

,Smt. VANATHI SRINIVASAN wife of Sri. Su. Srinivasan,

aged 50 years, permanent resident of Sreevatsa Shivà Apariment,

304, Fourth Floor, 145 (0ld No.208), Dr.Rajendra Prasad Road, 100 Feet
Road, Tatabad, Coimbatore-641 012, a candidate at the above Election, do here
by solemnly affirm and state on oath as under

() I am a candidate set up by BHARATIYA JANATA PARTY.

TARY
RABH

UBLIC
GoVTOF
T. PRESINDI
 urth Fkor. 45 Ci Ne 8 Dr Ranemra Pasara
anaadomitatere

Fabuk m Vanuh

R 91
Ril.4
VANATHI SRININ ASAN ACAP

S . SRINV ASAN
SPOE SE
R&l&s

R i.
ioe Appivai
ar Cogurcen
KALASH V SRINN ASAN

Dependen-

) Pemding criminal cases

ieciare ther there is no

CABLE n t ahma
(i) The following criminal cases are pend1ng against
me

the candidate, then tick this alternative

(If there are pending criminal cases aga1nst
details of all pend1ng cases in the Table
and score off alternat1ve (1) above, and give
below)

Tabic
No.30!2016
(a FIR No. with name and
) Crime No. 182/2016 2 inCrime
C2 Race Course
in B-8 Variety Hall
address of Police Station Road Police Station. Police Station, (L & 0)
concerned
(L& 0) Coimbatore Coimbatore
2) CC.No.368/2017 STC.No.2602/2016
Case No. with Name of Judicial Magistrate Judicial Magistrate
the Court No. 3, Coimbatore
No. 5. Coimbatore
(c)Section (s) of concerned Sections 147,294(b) Section 171(c)
Acts/Codes involved
& R/W171F & 188 of IPC
(give no. of the Section, 506(11) of IPC
of IPC. etc) Allegation that
(d) Allegation that there distribution of
was a Group class pamphlets in temple
Brief description of during election with party symbol
offence campaign with rival during election
party campaign.
have
(e) Whether charges YES YES
been framed (mention
YES or NO0)
( f I fanswer against (e) 04.01.2019
above is YES, then give 02.07.2018
the date on which charges
were framed
(g) Whether any Appeal
Application for revision
has been iied against the NO NO
proceedings (Mention

YES or N0)

(6) Cases of convietion

not been convicted for any criminal offence.

(0)I declare that I have
the candidate has not been convicted and write NOT
(Tick this alternative. if
APPLICABLE against alternative (i1) below)
OR
APPLICABLE
offences mentioned below- NOT
n) I have been convicted for the off alternative
then tick this alternative and score
(Ifthe candidate has been convicted,
above, and give details in the Tabie below)
(i)

RY

UBL 038

SOVT.9
KDIRES
Page 3 of 15 IND
 Iub
Appuli albe Aylia
Appdin alte Apliotbe
ctiumaul Ath/lon
involved (ptve o of tthe Mat Hot Hat
Applie alle Apulie alle Aplin ale
(d)
Appli alhe
Applicable Applinabl
ol Not
Daten ol nden Appli able Aplhe alde
Convictiom Applicable
Not
'unbncnl iipoc Applir nlle Appulin ale
Applie nble
Whcther any appal h
Decn iled agaist NM
Applin alble Applo alle
COmVlin order Appleuble
(MentonYISor N0)
I1 anwer to (p) alove is Net
(h)
Applicable
YIS,give detansand Applcabte Applicnble
pesent saluus of appeal
abnl all
to date inlomatm
lo my peolitital atly
(6A) I have given lull and qp given i
c s e s agasl
e a d aboul all Cah l cmVili
pending Cmnal
paragraphs () and (6)
ol applcalle slulel cealy
write NO
(Candidates to wlhom ihs lcm
atnove)
APPLICABEIN VIIW OFTNTRISIN (1)ad 600),
ad imvable
(ovalle
delails ol the asse
Thal gve hercm below he
(7)
spouse und
all dependents
ete ) of mysell, my
assets:
A. Details of movable will
ndicalnp he
cxlenl ol jont werhup
Note 1 Assets In jonl a n e
alo have to be given
Mumber
ihe details uncluling Sial
ol deposil/lnveslmcl,
Note2 n Casc
Nane l ank/ lustitum
Amount, Date ol Deposl, Ihe hene,
ad Branch arc to be given
the cuCt aiket valu
Valuc ol Bond»/Sharc/Dcbentuicn as pei
hooks
Nolc and a per
respect of
linted companies
in Stock Ixchunge in
Cae ol on-lslcd compamCN sltuled be given
he candidate or
m c a n s parcnts,
Non) daughter) o
Note 4 Dependcnt whetier by
lo the andidate
and any other pers0nrelatcd nd
pouse means l h
have sepate
hlood t maipe wh
lor tlher velilund
0n the cadudate
who are dependent
PUB
OVT OY I N O
Note 5 Dctails mcluding amount is to be given scparately in respect of cach
Investment

Note 6 Details should nclude the interest in or owncrsh1p of offshore assets

Explanation For the purpose of this Form, the express1on "offshore assets
inchudes detanls of all deposits or investments in Foreign hanks and
any other body or mstitution abroad, and details of all assets and
liabilities in foreign countries

S.No. Deseription Self Spouse Dependent-1

NiL
Casin in hand Rs.22.000 Rs.38,000/ Indian Overseas
(11) Details of Indian Overseas Indian Overseas
Deposits n Bank, Bank, Bank
Bank RK Nagar Branch. RK Nagar Branch. RK Nagar Branch,
accounts Chennai 28 Chennai 28
Chennai 28
SB A/c. No. SB Ac. No
SB A/c. No
TDRs, Tcrm 064101000019995 064101000014298 064101000027676
Deposits
Rs.68,000/ Rs.95,000/-
andall other Rs.4,75,000/-
types of
Deposits
including
Indian Overseas State Bank of
saving
India
accounts) Bank Venkat Narayana
Deposits Gandhi Nagar,
with Coimbatore. Road
Financial SB A/c. No. Mandaveli
Institutions 39131 SB A/c.No.
Rs.1,50,000/- 10150928974
Non-
Rs.56,40,036/-
Banking
Financial
India Post alc.
Companies
and
Chennai.
A/c.
Cooperative No.4163750994
societies and
the
Rs.15,00,000/
amount in
cach such
deposit

wwgulT

UBLI
coV EXPIRt
O FI N D

Page 5 of 15
 Description Self Spouse Dependent-1
Ne.
(1i) Detals of AxisBlucch1p| Canara Robeco
nvestment in Fund(Folio No quity Hybr1d Fund
Bonds 91082763763) (Folio No NI
Debentures shares Cost Value as 10918250295)
and units in on1 4 09.2020 Cost Valuc as on

Rs. 5,04,833/- 14.09 2020

compames Mutual
Funds and Rs.15,07,366/-
others and the Current Value as
Current Value as on

amoun on12.03.2021. 12.03.2021

Rs.6,92,234/ Rs. 19,72.972/-
No. of Units of Units Held:
Held: 17,449 82 No.
9,243.69

2 Kotak Equity 2. Mirae Asset

Hybrid Equity Fund
Opportunities
Fund (Folio No. (Folio No.
6608328/70) 70522875533)

Cost Value as on Cost Value as on

13.04.2020 24.02.2020
Rs. 10,09764/- Rs. 20.20.728/-

as on
Current Value as Current Value
12.03.2021
on 12.03.2021
Rs. 24,97,996/-
Rs. 14,08,954/- Held:
No. of Units
No. of Units
i,30,355. i 7
held: 8,53741

LIC Policy No.

LIC Policy No.
LIC Policy No. 308297053
(iv) Details of 717331459
717629598
investment in
(28.03.06) Sum Assured
NSS, Postal (28.01.04) Sum assured
Insurance Sum assured Rs. 10,00,000/-
Savings, Rs.3,00,000/
Rs.1,50,000
Policies and
investment in any

Financial LIC Policy No.

in Post LIC Policy No.
Instrumen! 716415198
717629601
office or
Insurance | (28.03.00)
Company and the (28.03.06)
Sum assured
Sum assured
amount Rs.5,00,000/
Rs.3,00,000/

Reliance Life
Bajaj Allianz LIC
Policy No.
Insurance
0015597082

(02.02.06)
Contract
Premium
No.51285653

Rs.10,000/-
Initial sum

assured
Rs.2,50,000/

nnyul

PUB
A BL

GoVT
EXPIRLS
OF IND

Page 6 of i15
A
escnphom pende
SHfe insurance
Police No
iES4520502
Sum 213urcd
Rs.25,00,000
(vPersonal
loans advance
gven to
any person or

entity including
firm, Company NIL NTL
Trust etc and
other receivables
from debtors
and the amount

(vi) Motor Toyoto Innova Hyundai Vema

Regn No NIL
Vehicles Aircrafts Regn No
TNO64334
Yachts Ships TNO6J1006
(details of Make Year 2013 Year 2009
Registration No Rs.16,00,000/ Rs.7.12.500
etc, Year of
Purchase and Toyoto Inova Regn
No TNU6J5555
amount
Year 2015
Rs.15.50,000/

Maruti Suzuki
Baleno
Regn No.
TN66 AA 0055
Year 2019
Rs. 6,50,000

95 sovereigns of 6 sovereigns of sovereigm

(vil) Jewelry. bullion
and valuable gold and gold Rs.43,000
diamond bangle Rs.2.58,000/
thing (gve details
of weight and Rs.45.29,415/

value)
1 kg silver
Rs.71,400-
Legal books Legal books
(V111) Any other assets
such as value of jOurnals Ournals NIL
Worth Worth
Claims interest
Rs.2.00,000/ Rs.7.00.000/
Rs.1,88,97,504/ Rs.11.38.000/
(1X Gross Total value Rs.98,49,003/

PUB
Page of 15
GoVT O FI N O
 B.Dctaiisof Immovableassets:
Noie 1 Propertics in jont ownership indicaling the extent of joint owncrship
will also have to be ndicated

Note 2 F a c h l a n d o rb u i l d i n g o r a p a r t m e n t s h o u l d b e m e t i o n e d s e p a r a t e l y

in this format

Note: 3. Details should include the interest in or ownership of oflshore assets

Dep
S ende
Desenptio Seli Spouse nt-1
No

Agricultural land Madampatti ( ) Sithandi Village

(i)
Location (s) Village Madhurandhagam
Survey number(s) Thondamuthur Taluk, Chengelpet
New S.F.No. 138/1
SRO
S.F No.254/2B2
NIL
(2)Inampoondi Village,|
Walajabad SRO,
Sriperumbudur Taluk
Kancheepuram District.
10
SFNo.73/9 &

Area (Total (1) 78 cents NIL

measurement in One Acre (2) 75 cents

acres) (1) Self acquired

Whether inheited NIL
property
Yes (Settlement)
(2)Self acquired
(Yesor N0) (1) 04.09.2008
Date of purchase in NIL
case of self acquiredd Not Applicabie
(2)24.11.2008
property
Cost of Land (in case (1) Rs4,00,000/-
NIL
of purchase) at the Not Applicable (2) Rs.1,50,000/-

time of purchase
Any lnvestment on
(1) Sma!! shed & pump
the land by way of NIL
set Rs.75,000/-
NIL
development,
construction etc.
(2)NIL
(1) Rs.15,00,000/- NIL
Approximate Current
Rs 20,00,000/-
(2)Rs.25.00.000/-
market value

UBL
INDI
oVT.X
EXPIRES

Page 8 of 15
NO Descnption Self Spouse Pepend
(1) Non- (SE No 710 SF No $4 NIL
Agricultural TS No 454)
Land New Ward ), Block
Karanthaner Village
Nanguneri Taluk
OcationS) 5, Nallur Vilage. irunelvel1 Dstnct
Suncy irupur lot No 373 & 374
numberts)
(2) SF No 255/15.
Thazampur
Kclambakkam Taluk
Area (Total (1) 30 cents
measurement in (1215 sq mtr) 6 06 cents NIL
f) (2) Extent 2105 sq ft
Whether (1)YES
inherited (Settlement Deed
propcrty (family settlement)) NO
NiL
(Yes or N0) (self acquired)
(2) NO
selfacquired)
Date of purchase
in case of self 30 09 2009 NL
(2)02 04 08
acquired property

Cost of Land (in

case a
(2) Rs.11.95,000- Rs.26,980 NIL
purchase) at the
time
purchase
Any Investment
on the land by
way of NII NII NII
development,
construction etc.

Approximate () Rs 99,00,000/-
Current market Rs.50,000 NIL
vaue (2)Rs.21,00,000
(ii) Commercial
BuildingsS
(including NIL
NIL N!L
apartments)
-Location(s)
Survey
number(s)

p w yy/
OTAR
PUBBL
INDIA
GoVT OF
 Tesentton Selt Depend
Spomse
Buult up Area ( Total em-
measurement in sq NII
tt NII NII
Whether inhented
NII NI NI
e s or N0)
Date of purchase in
case of selt NIL
acquiied pOpety
NIL NII
Cost ot preperty (in
case of purc hase) at
NIL NIL NIL
the time ot purchasc
Anv Investment on
the pproperty by way
of development NIL NIL NIL

construction etc
Approximate Current
market value NIL NIL NIL
(IN) Residential Buildings ()"Ivy Terrace. (1)Jointly with
(including Floor (7E). Spouse equal
apartments.) Ekattur Village. share, mentioned NIL
-Location(s) OMR, in this Self
Survey number(s) Kelambakkam Column for Sr.
Taluk. Chengalpet No 1
District
(Jointiy with spouse (2) Flat
equal share) No.304 Fourth
Floor, Door
(2) Residential house No 208/15,
19/10, Pattammal Dr Rajendra
Street, Raja Prasad Road,
Annamalai Puram, Coimbatore
Chennai 600 028. 641012.

Area ('Total (1) 407 sq.ft (UDS) () 50% share

TTICasureTEi in sy. 50% share (2)676 sq.fi NIL
ft) 2) 1936sq.f (UDS)
Built up Area (Total (0) 1293 sq ft (50% (1) 50% share in
measurement in sq. share) 1293 Sq ft NIL
ft) (2) 2800 sq ft (2) 1337 sq.ft

Whether inherited () NO (Self (1) NO

property acquired) (Self Acquired) NIL
(Yes or NO) (2) YES
(Settlement Deed (2) NO
datcd 25.3.13 (Selt Acquircd)
(family settlement)

PUB
TAR

ATO
INDI
Pagc 10 of 15
VT. OF
 Desciption Self Spouse
Depend
Cn-
Date of purchase in (1) 29 03 2012 (1) 29 03 2012
case of self (2)02 03 2017 NIIL
acqured property
Cost of property (in dRs4,07.000- )Rs 4,07,000/-
casc of purchase) ai (UDS) (UDS)
the time of purchase Rs 45,19,265 Rs 45,19,265
Rs49,26,265 Rs 49,26,265 NIL
Halfshare Half share
Rs 24,63,133/ Rs 24,63,133/
2) Rs.56,00,000/-

Any Investment on
the land by way of NIL NIL
NIL
development
construction etc.
Approx1mateCurrent ()Rs 33,00,0007- d) Rs.33,00,000/- NIL
market Value (2) Rs.3,3 ,00,000/ (2) Rs66,00,000/-
(V) Others (such as NIL NIL
NIL
interest in property)
(V1) Total of Current
Rs 5,03,00,000/- Rs.1,39,50,G00/- NiL
Markci Vaiue of (i) io
(v) above

(8) I give herein below the details of Iliabilities/

dues to public financial
institutions and government.
institution, ent:ty or
(Note: Please give separate details of name of Bank,
individual and amount for each item)

S Self Spouse Dependent-

Description
No. (1)
(1) Loan orduesto LIC Housing
Bank/Financiai Loan, Chennai
Institution(s)
Rs. 10,37,082/
Name of Bank or
Home Loan
NIL (2) NIL
Financial institution
State Bank Of
Amount Outstanding
Nature of loan India,
Coimbatore.
Rs4,09,522/
Car Loan
04n or dues to an2Y
Other individuals/
Entity other than
mentioned above. NIL NIL NIL

Namefs)
Amount outstanding
Nature of loan
Any other liab1lity_ Rs.22,00,451/- Rs.22,83,360/- NIL
Grand total of NIL
Rs.22,00,451/-Rs.37,29,964/-
Liabilities

A R Y A

LIC
ABHI

Page 11 of 15
()(GoVernment Dues: (A Has the (A) Ilas the (A las the
deponent been deponeni iecn deponent
Dues to departmentsnoccupaton of moccupation of been
dealing accommodation accommodatio noccupation
with government provided by the n provided by of
accomnolaluon Govement at the accommodali

any time during Government at on provided

|the last ten ycars any time during by the
before the date the last ten CGovernmcnt
before at any tume
of notification of ycars
current thc date of during the last
the
election NO notufication of ten Vears

current before the

the of
election? NO date
notification of
cuTTent
the
clection ? NO

(1n) Dues to departments

dealing
with government NIIL
NIIL NIL
transport
(including aireralis
and
helicopterS) NIL NII
(IV)Income Tax Dues NIL NIL
NIL NIL
(v)GSTDues N!
(Vi) Municipal /Property NII NI!L
Tax Dues NIL
(Vi) Any other dues NIL NIL
(vIi Grand total of all NILL NIL
NIL
Govt. dues
(Ix) Whether any other
Iiabilities are in
dispute, if so, NIL
mention the amount NIL NIL
involved and the
authority bclore
which it is pending
:
Details of profession or occupation
(9)
ADVOCATE
a. Self
ADVOCATE
b. Spouse

(9A) Details of source(s) of

income
:ADVOCATE & AGRICULTURE.
a Self ADVOCATE, AGRICULTURE & RENTAIL
b.Spouse
c. Source of income, if any, of dependents: NO.
company or companies
(9B) Contracts with appropriate Government and any public
entered by the candidate NO
(a) Details of contracts
into by spouse: NO.
(b) Details of contracts entered

(c) Details of contracts

entered into by dependents. NO.

UBLIO
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INDIA
Page 12 of 15
ovTS
 (d Details of contracts entered into by tiindu Undivided Family or Trust in

which the candidate or spouse or dependents have interest NO

(e) Details of contracts entered into by Partnership Firms in which candidate

or spouse or dependents are partners NO

) Details of contracts entered into by Private companies in which candidate

or spouse or dependents have share NO

(10) My Educational Qualification is as under

1. Bachelor of Science -
1987-90 - PSG Arts College. Coimbatore
2. Bachelor of Law 1990-93 Dr. Ambedkar Law College. Chennai
3. Master of Law - 1993-95- Madras University

PARTB
OF THE DETAILS GIVEN IN (1)
TO (10) OF PART-A:
(1) ABSTRACT Smt. Vanathi Srinivasan
Name of the candidate
304,
2 Full postal address Sreevatsa Shiva Apartment,
No. 208),
Fourth Floor, 145 (Old
Road,
Dr. Rajendra Prasad
Tatabad,
00. Feet Road,
Coimbatore -641 102,
of the No.120 COIMBATORE SOUTH
3 Number and Name
constituency and state TAMIL NADU
which BHARATIYA JANATA
Name of the Political party
set up the candidale (oherwise wTIte PARTY.

Independent') No.5,
criminal 1) Judicial Magistrate
Total number of pending
Coimbatore. CC.No.368/2017.
cases
of
2) Sections 147.294(b) & 506(ii)
IPC, allegation that there was a Group
class during election campaign.

1) Judicial Magistrate No.3,

Coimbatore. STC.No.2602/2016.
2) Section 171(c) R/W17IF & 188 of
IPC. allegation that distribution of
pamphlets in temple with party
Symbol.
Total number of cases in whichNI
6.
convicted Total income
Year for which last
PAN OF Income Tax return shown
filed
2020-2021
(a Candidate ACAPV7157M Rs.9,77,700
(Assessment Year)
2020-2021 Rs.79,61,940/
APZPS2846A
(b) Spouse (Assessment Year)
(c) Dependent NKXPS0236L NIL NIL

ARY

aBHU

PUBL
 Details of Assets and I
inbilities (inctuding offshore
Ihescnptionm
Moveable Assets
Selr aseets) in
rupees
pRuse
otal alue) Rs 98 49,(0 hependent
R 1 88 97 104
Immev able Asset R 111800
P'unchase piee
oi scli
acquired Rs36,58,133
Immovable Rs86,40, 113 NIL

1
property
Devclopment

construction
cost of
immovable NIL Rs 75,000- NIL
property after
purchase if
applicable
iiApprox1matc
Current
Market Price
of

(a)SSelf
acquiredassets Rs 54,00,000/- Rs.1,39,50,000- NIL
(Total value)

(b) Inherited
assets (Total Rs4,49,00,000/- NIL NIIL
value)
9Liabilities
(1) Government NIL NIL
NIL
dues (Total)
(1) Loans from
Bank, Financial Rs.37,29,964/- NII.
Rs.22,00,451/
Institutions and
others (Total)
10 Liabilities that are under d1spute
(1) Government
NIL NIL NIL
dues (Total)
i) Loans from
Bank,
Financial NIL NIL
NIL
nstituiions
and othersS
(Total)
1Highesteducational qualification
Master ofiaw - 1993-95- Madras University.

TARY
PUB DEPONENT

ATORE
OvT
 VERIFICATION
tha
and declare
named, do hereby verify
above
the deponent, to the best of my

aflidavit are truc and

correct
the contents of this and nothing material has
been
belief, no part of it is false
knowledge and
declare that
concealed there from I further
thosc
me other than
or pend1ng case against
Ihere 1s o case ol convIction
(a)
mentioned in items 5 and 6 of Part A and B above:
have any asset or liabillty
my dependent do
not 9 and
or
A and items8,
my spouse,
(b) of Part
mcntioned in itcms 7 and 8
other than thosc
10 of Part B above

at Coimbatore this the 18h day of March 2021

Verified
7allk

DEPONENTT

BA
020 LIC H0hMel3/bo
A. PRABHU, B.A., B.L.,
ADVOCATE &NOTARY PUBLIC
22023/2020
GOVT. OF INDIA, REG. No:
Complex,Ground Floor,
MOTARUALsNOTARIAL 25-A, Gayathri Coimbatore 641 018.
Huzur Road,
Cell: 99946 22110

OF

Volome nu, D
Pge o 12
Seval ,51
Dale 83 2

Page 15 of 15