Soorres AeA TELANGANA { u Boor | rent zotssstee Dat GeNOV 22) 9 Parana HEMALATH LON DoTLLOAU subaRsHANA cHARY ‘io UPPARPALLY,RATENDRANAOAR, RR DST sau SIRES t Form 26 (See rule 4) ' ' 5 oT AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION PAPER | BEFORE THE RETURNING OFFICER FOR ELECTIONS ‘10 TELANGANA STATE ASSEMBLY (NAME OF THE HOUSE) FROM RAJENDRANAGAR-SI CONSTITUENCY (NAME OF THE CONSTITUENCY) PART A | HEMALATHA JILLOJU, Dio. JILLOJU SUDARSHANA CHARY, Aged 36 yeas, resident of HLNo, 2-4-72/1/A, 1" Floor, Paramareddy Hills Colony, Upparpally, Near Pilla: £ No.200, Rajendranagar, Ranga Reddy District ~ 500048, Telangana, a canidate at the aboon election, do hereby solemnlyaffim and state on oath as under: 414584(1) 1am candidate contesting as an INDEPENDENT candidate (@) My name is enrolled in RAJENDRANAGAR-S1, TELANGANA (Name of the ccnstitueney and the State, at Serial No. 214 in Part No. 195. (G) My contact telephone number (3) are 9600021668 & 7981224859 and my e-mail id (it any) is hemalatha2286@jgmail.com and my social media account(s) are (Facebook Account: emajiloju gmail.com (ii) Whatsap No: 9600021668 (4) Details of Permanent Account Number (PAN) and status of filing of Income tax return: ST [Names PAN “The vandal year] Teal income Farwhich the lat | Shown in Income tax return (i Ineome-taxretum | Rupees) for the last five | as boon fled Financial years eomploted (as on 31 March) or [Ser ALHPIB43Q | 202021 2021-21 (HEMALATHA (€8s.8,09,000/-) JILLOJU) a NIL a NIL iw) NIL NIL WIL NiL NIL NIL | Nit NIC NIL Ni NIL NIL NiL NIL Ni Nic @ NIL | Spouse NI wi (CR ILAYARAJA) 0 [ HuPUrCandiaaeis | NIL ML Kartal Copareener) [oR | Dependant «YE Nic[08] Dependanra NL NIL ON Nic (iy NIL Wy NIC @ NIC () Pending criminal cases () I declare that there is no pending criminal case against me. (Tiek this alternative if there is no criminal ease pending against the Candidate and write NOT APPLICABLE against alternative (i) below) oR (Gi) The following criminal cases are pending against me: (Uf there are pending criminal cases agninst the eandidate, then tick this alternative nd score off alternative (i) above, and give det ls of all pending cases in the Table below) Table @)) FIRNo, with name and NOT NOT NOT address of Police Station | APPLICABLE | APPLICABLE | APPLICABLE concerned ()] CaseNo. with Name of NOT NOT NOT the Court APPLICABLE | APPLICABLE | APPLICABLE. (| Section(s) of concerned NOT NOT NOT Acts/Codes involved | APPLICABLE | APPLICABLE | APPLICABLE (eive no. of the Seetion, 4, Section wm OF PC, te). (| Brief description of NOT NOT NOT offence APPLICABLE. | APPLICABLE | APPLICABLE (| Whether charges have NO. NO NOT been framed (mention APPLICABLE - YES or NO) HK answer against (@)| NOT NOT NOT |abdye is YES, then give) APPLICABLE | APPLICABLE | APPLICABLE e:\\date on which were framed[(@] Whether amy Arps 7] NOT Application for revision | APPLICAI has been filed against the proceedings (Mention NOT BLE | APPLICABLE NOT APPLICABLE YES or NO) (©) Cases of conviction ()_Tdeclare that I have not been convicted for any eriminal offence, (Tick this alternative, ifthe candidate has not been convi APPLICABLE against alternative (i) oR (i) Thave been convicted for the offences below) ‘mentioned below: jeted and write NOT .en convicted, then tick this alternative and score off (Uf the candidate has be Stternative () above, and give details in the Table below) Table [ap | Case No. NOT APPLICABLE NOT NOT | APPLICABLE. | _ APPLICABLE. (| Name of the NOT APPLICABLE NOT NOT Court APPLICABLE | APPLICABLE TH] Seaiontsyorthe | NOT APPLICABLE ‘NOT NOT. ‘ActsiCodes APPLICABLE | APPLICABLE | invotved (give no. of the Section, eg. Section |_| of Cet. te {a | Brief deseription | NOT APPLICABLE NOT NOT of offence for APPLICABLE | APPLICABLE which convicted TH | Dates of orders of | NOT APPLICABLE NOT NOT ‘conviction APPLICABLE | _ APPLICABLE ® | Punishment NOT APPLICABLE NOT NOT fesse APPLICABLE | _ APPLICABLE Tl Whether any | NOT APPLICABLE ‘NOT. ‘NOT “Appeal has been APPLICABLE | APPLICABLE filed against conviction order (Mention YES or NO), ul Transwerto(e) | NOT APPLICABLE NOT “NoT ove is YES, APPLIC. APPLICABLE Je details and prbsent status of pheal p— 4 .(6A) Thave given full and up-to-date information to my political party about all pending criminal cases against me and about all cases of conviction as given in paragraphs (5) and ©. [candidates to whom this Item is not applicable should clearly wri APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), abovel Nor Note: 1, Details should be entered clearly and legibly in BOLD letters. 2. Details to be given separately for each case under different columns against each item, 3._ Details should be given in reverse chronological order, ic, the latest ease to be mentioned first and backwards in the order of dates for the other eases. 4, Additional sheet may be added if required. 5, Candidate is responsible for supplying all information in compliance of Hon'ble Supreme Court's judgment in W. P (C) No, 536 of 2011. 6. That I give herein below the details of the assets (movable and immovable ete.) of ‘myself, my spouse and all dependents: Note: 1. Assets in joint name indicating the extent of given, it ownership will also have to be Note: 2. In ease of deposivinvestment, the details ineluding Serial Number, Amount, date of deposit the scheme, Name of Bank/Insttution and Branch are to be given, Note: 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 ease of non-listed companies should be given. Note: 4, ‘Dependent’ means parents, son(s), daughter(s) of the eandidate or spouse and any ‘ther person related to the candidate whether by blood or marriage, who have no separate means of income and who are dependent on the candidate for their livelihood, Note; 5, Details including amount isto be given separately in respect of each investment. Ac: 6. Details should include te interest in or ownership of offshore assets, Explanation — Z ean Forte puro of tis Form, the expression fs ast includes, deals of [Seas leposts or investments in foreign it an any other body oF insitt fr E \broad, and details of all assets and liabilities oun eee foreign countries, » ante LOCKS ‘aimDescription Sar Spouse ent Dependents Tach Rand 1,00;900 NIL NIL [NIL WE Details of deposit ir Bank accounts (FDRS, ‘Term Deposits and all ther types of deposits including saving aezount 's)Depesis with financial instvtons, Non-banking » Finacial Companies, ‘and cooperative societies and the amount i each such deposit RS5,000= Ave No. 126417700000 5070, Karor ‘Vysya Bank, Valaaravaa 1, Cheer Branch 12,0001. Ale.No. 218501309982 ICICI Bank, Valesravaa sm, Chena Branch Rs. 2,500 Ale. (1250010206 6501 Kernataka Bank, Upparpally Branch Nic WI [aw ‘Deals of vestments Tm ‘Bonds, Debentures Shares and units in CCompanieyMutual Funds and thers and the mount NIL Nil LN NL ww ‘elas of Investments im NSS, Postal Saving, Insurance Policies. and Investments in ay Financial instruments in Post Office or Insurance Company andthe Te Paley Nos 516855378 is 50,00,001 Wil Wi | NIC Nit o pions Feria Ton vanes fren oy pason of ty ning conpany Tat tier ees fot sss dhe noun Wit Wit a om ML Motor Vehicles! iY achts/Shipa( lis of Make, ion umber a i purchase and Renald Diner Mose: 2020, TNDAHH6 Rs 12,00,000%- NC NL [NIT NU )(Gi) [Heveieny ulin and] 100 GRWS, —] NTE iE] NIE Nit alae thing (6) (give | RS. $30,001 details of weigh and val) (Wid | Any objer assets suchas | NIL iL NE [NIL NL value of claimnterest (i) [Gross Tol Value |, 68;5002 [NIL [NIE NIE B. DETAILS OF IMMOVABLE: Note: 1. Properties in joint ownership indicating the extent of joint owner ship will also having to be indicated. ‘Note: . Each land or building of apartment should be mentioned separately in this format. ‘Note: 3. Details should include the interest in or ownership of offshore assets Destipion Sar Spomse Depend] Dependent- | Dependents 2 Agrieaiarat | NTC WL WIE Nic WIC Las WIL NE Wi NIE NE res) ] Whether toheried | NIL NL NL WL Nit property (Ves or No) Date of parshase | NIL Ni NIL NL Wil case of self - acquired property Cost of Land Gin | NIL Wil NI Ni Wil ‘ase of purchase) atthetineof purchase “Any iavesiment on | NI Wil Wil Wi IC the and by way of| development sonsiruton ‘Approximate | NIL (Coren market vale TT | Now-Agricaitaral| Nil Ni Land Locations) Survey Not) ‘Area (ual NIL Wil NC Ni NI ‘measurement in 54.81) WIC NL Wil Wi Wit Nil NL Whetier Ti Wit Ni Nic Nil == fuhrited property or Nr wr NiCost of Land Ga ‘ase of purchase) atthetime of purchase WL Nil Nil NIL Nil ‘Ay investnent on the land by way of evelopment construction ee, We WL WL Wit Wir ‘Approximate ‘current market Value Wil Nic Nil Nil ‘Commercial Buildings (oeluding sparen) Locatins(s)— ‘Survey numbers) NL Nit WE Nit “Area (tal ‘measurement (in sa.) NE WE iL Wi Nil Built wp area (otal measurement In Saf). Wi WL TE Nil TL Whether ahead property (Yes or No) WL Ni Ni NE Nit Date of parse Te case of al? squire prope NL NL NE NC Cost of propery (neaseof purchase) atthe time of purchase Nit Nil Nil Nc Nit ‘Any investment on the property by way of development, Consiucion ete, NIL Ti Wit Nit Nit ‘Approximate current market Wil Wi Wi Ni Nt ‘Residential Buildings (including paiments): Location(s) ~ ‘Survey numbers) Peds Nagar, Sy, NosIs HINo, 4-18 Nil Nit NIC Nic 218 a Yards 2000 Si Wit Nil Nit Nil“t ‘Where inheried [NIT Ni NI WI ropery ey cea | REROT —TAT Ni a purchase the ime of purchase Tay ivesiment on | NIL NI NIL wi she propery by way of ‘evelopment ontction ee, ‘Approximate | NIL NIE WC NE] ecient market ‘alte V— [Otter cha | NIL NE WI 3 ineren in rope) Wi [Total of eament | ReSOpHORI | NIL NL La tarkt val of wopabove (8) I give herein below the details of labiltes/dues to public financial institutions and govermment- (Note: Pease give separate details of name of bank, institution, entity or individual and amount before each item) SIND | Desipon ‘SELF [SPOUSE [HUF Dependent | Depeniene | Dope T | Laan erduesio Carbo — [NI [NIL Nt XI NIL Bank nancial | ICICI Book, instintons) | Re Name ofthe Bank | 6,000 of toaca insite, Personal ‘sou Loan oustanding, ICICI Ban, Naweoflow, | Rs.00000/ Tan or does to ay x PE wr NE teria Jey eer mentioned above Name (),Ansun outstanding nate ‘foan =a MI pa — ar Mi Ni 707 [Nit] NIE NIL NIL A) Ths the deponent Been in occupation in accommodation provided by the Government at any time during the last. s ten years before the date of notification of the current | SPR# pe‘Goverment election? Seems (B) Ifanswerto (A) above is YES, the following declaration may be furnished namely:- () Theadéress of the Government ecommodation: (i) There isno dues paysble in respect of above Government accommodation towards: NO (a) Rent (&) Electricity charges (© Water charges (@ Telephone charges a8 0M sone (date) ‘(the date should be the last date ‘of the third ‘month prior to the month in which the election is notified or any date thereafter). Note: No Dues Certificate from the agencies in respect of rent, electricity charges, telephone charges, water charges for the above Government Accommodation should be _ submitted. —_ Ty | Basso depres [RIE MM NE [RI Nic NE desling with Government transport icing diets and telco cc ‘Income tax dues: ‘Nil. ‘Nit. Nie NIL NIL NIL W)_| Gst des NIL. NL [NIL Ni iL (Pee | NT nil. NIb NIL NIL | oip [Any ot does [I NE Nic Nic Gilly [Granda ofl—_| NI a NIL ii Goverment dss TH] Whiter any oer PTE RP we NI Habis een opi, tention he aout involved andthe thoy before ing Self: Movie Producer & Distributor etails of profession or occupation:~ @ (b) Spouse: NIL, (9A) Details of source(s) of income (@) Self: Movie Distribution, Botique (b) Spouse: Nit (©). Source of incom iny, of dependents, NIL, (B) Contracts with appropriate Goverment and any public company ot companies (2) details of contracts entered by the candidate NIL (b) details of contracts entered into by spouse NIL. (©) details of contracts entered into by dependents NIL. (@) details of contracts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have interest NIL () details of contracts, entered into by Partnership Firms in which candidate or spouse or dependents are partners NIL (© gels of conta, eed ito by private companies n which candidate or spouse or dependenis have share (10) My educational qualification is as under: 1. SSC- Vignans Residential School, Peddanagaram, Mahabubabad istrict ~2001 2 Intermediate Govt, Girls Junior College, Mahabubabad 2001-2003 4. BA. Politieal Science ~ IPL. Degree College, Ambedkar University ~ 2016-2019 B.A, Journalism ~ AP Degree College, RTC X Road, RIC X Road, Hyderabad, Hyderabad, AU- 2016-2019 ersity education mentioning the full form of the P diploma degree course, name of the School ‘College’ University and the year the course was completed.) nPARTB (11) ABSTRACT OF THE DETAILS GIVEN IN (1)T0 (10) OF PART A: T, | Name ofthe candidate | HEMALATHA JILLOJU | Full postal address HiNe. 24-7071, 1" Floor, Paramareddy Hills Colony, Upparpally, Nea Pilla No.200, Rajendranagar, Ranga Reddy District 500048, Telangana. 3. Number and name ofthe | RAJENDRANAGAR-S1, TELANGANA constituency and state | Name ofthe political party | INDEPENDENT ‘which set up the eandidate erie write Independent”) 3] Total number of pending [NIL Crivinal Cases % | Total number of easesin | NIL which convicted 7 PANOF ‘Year Tor which last] Total income shown income tax return filed (candidate ALAPIT43Q NIL 2020-21 (Bs.8,09,000/-) Pispowse__| NIL NI NIL. (HUF NIL. NIL Nil (q)Dependents_| NIL NIL NIL [Details of Assets and abilities fo Rupees Description [Self Spouse | HUF | Dependent- | Dependent-2 J Dependent 1 3 oT Moabie | Rs68,.500 [NIL [NIL | NIL NIC NIL Assets : (Total Value) B. | mmovable | NIL wi [NIL [NIC NIL NIE Assets T Purchase price | Rs2,00,000- [NIL | NIL [NIL Nil Nt of sell acquired immovable property IT | Developmentie | NIL- NIL) NIL | NIL NIL Nit onstruction J 2 ygsisbe 1H) Approximate] Rs-SO00000/ [NIE [NIL PIL NIL Ni ‘urrent market | = price (@) Self acquired assets (Total Value) (b) Inherited assets (Total value) 9. Liabilities (| Government | NIL NIL NIL [NIL Wil NIL dues (Total Gi | Loans from | Rs.7,00,000 | NIL NIL [NIL NIL NIL Bank,Financial | /- ‘thers (Total) TO. Liabilities that are under dispute @ | Government | NIL NIL NIL [NIC [Ne NIL ues (Total GH | Loans from | NIL NIL NIL [NIL NIL NIL ‘Bank, Financial Institutions and thers (Total ) z TiC] Highest duce onal gales BA. Poel Science & Journalism Ambedkar Uaiversty-2019 {Give details of highest school/university education mentioning the full form ofthe certificate ‘iploma/degree course ,name of the schoolschool/college/university and the year in which the |__| course was completed.) ii CATION VER I, the deponent above named do by hereby verily and declare thatthe contents of this affidavit are rue and correct to the best of my knowledge and belie? and no part of it is false and nothing material has been eoncealed there from. I further declare tha: (a) there is no case of conviction or pending case against me other than those mentioned in items and 6 part A and B above: (6) 1, my spouse oF my dependents do not have any asset or liability, other than those ‘mentioned in item 7 and 8 and of part A and items 8, 9 and 10 of part B above. gr EPONENTNote: 1 Affidavit shouldbe filled latest by 3.00 pm on the last day of illing Nominations rote: 2. Affidavit shouldbe sworn before an oth commissioner oF magistrate of he First class ‘or before a notary Public. Note: 3: All column shouldbe filled up and no column oe et blank, If there is no Tnformation to furish in respect of any item, ether “Nil” or “Not applicable” 0s the ease may be, should be mentioned, Note: 4. The Affidavit should be either typed or written Ieiby and neatly. ote: 5: Each Page ofthe AMidavit shouldbe signed bythe deponent and the Alfidavit should bear on each page the stamp ofthe notary or Oath Commissioner or Magistrate efore whom the Affidavit is sworn, ry