rend ssngausaseut SEEM an whe cae PT Bec DAMODAR RAZANaRsiMna F $3:228034 mating smzana Form 26 Prsosnasion (See rule 4A) AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION 6 VELANGANA STATE LEGISLATIVE ASSEMBLY (NAME OF THE HOUSE) FROM 36 - ANDOLE (SC) CONSTITUENCY (NAME OF THE CONSTITUENCY) PART A |. Trisha Cilarapu, **sendaughter/wife of Cilarapu Damodar Rajanarsimha, Aged 28 years, resident of H.No.8-90, Jogipet Village, Andole Mandal, Sangareddy District, Telangana State (mention full postal address), a candidate at the above election, do hereby solemnly affirm and state on oath as under-~ \\ we wr HAttested//(1) am a candidate set up by @4name of the political party}/ **am contesting as an Independent candidate. (**strike out whichever is not applicable) (2) My name is enrolled in 36 ~Andole (SC), Telangana (Name of the constituency and the State), at Serial No.1217 in Part No. 196 (3) My contact telephone number(s) is/are 9908408070 and my e-mail id (if any) is trishadamodar@gmail.com and my social media account(s) (if any) is/are (i) Facebook Account: C Trisha Rajanarsimha ii) NIL iii) NIL i NOTARY ADVOCATI Sangareddy Town & Mist. (. pal: 440707474 : \we [/Attested//(4) Details of Permanent Account Number (PAN) and status of filing of Income ‘Names PAN [The financial {Total income shown in Incom rear for which [Tax Return (in Rupees) for th the last Income-jast five Financial Year ax return has Completed aa as on 31° March 2019-2023) i) RS(13.87538-) 018-2019 jLoss on shares Trading ! po19-2020 2,50,000/- ilarapu Trisha (Self) ATQPC7533B bo79.2921 i) [Rs4,60,000- 021-2022 IRs. 14.36.150- 022-2023, IRs 12,23,610 fot Applicable fot Applicable b Spouse Not Applicable] Not Applicable jot Applicable jot Applicable jot Applicable UF jot Applicable Not Applicable fot Applicable If Candidate is 5 (eatin ii) Not Applicable ) Not Applicable iv) Not Applicable (v)_Not Applicable . [Dependent I jot Applicable Not Applicable [(i) i ‘Applicable fot Applicable (ot Applicable 5. Dependent 2 jot Applicable Not Applicable (ot Applicable fot Applicable jot Applicable {ot Applicable fot Applicable [Dependent 3 fot Applicable Not Applicable fot Applicable jot Applicable iot Applicable fot Applicable (ot Applicable \ 8 //attested//‘Note: Itis mandatory for PAN holder to mention PAN and in case of no PAN. it should be clearly stated “No PAN allotted” (6) (5) Pending criminal cases (1 declare that there is no pending criminal case against me. (Tick this alternative if there is no crit NOT APPLI lal case pending against the Candidate and write “ABLE against alternative (ii) below) OR in-the-Fable-below) Table (a) FIR No. JNot Applicable Not Applicable JNot Applicable ‘lice Station concerned (b) (Case No. with Name of the Court jot Applicable Not Applicable Not Applicable (c) Section(s) of concerned Acts/Codes ‘ot Applicable [Not Applicable Not Applicable. involved (give no.of the Section, eg. Section.......of IPC, ete.) (d) Brief description of offence (ot Applicable Not Applicable ot Rppcbl (c) Whether charges have been framed ‘ot Applicable Not Applicable Not Applicabl (mention YES or NO) (0) Hfanswer against (e) above is YES, then Not Applicable Not ‘Applicable Not Apaieabe| ive the date on which charges were | Feamea | | (8) Whether any Appeal/Application for [Not Applicable Not Applicable” ot Applicable ‘evision has been filed against the proceedings Cases of conviction ( I declare that I have not been convicted for any criminal offence, (Tick this alternative, if the candidate has not been convicted and write NOT 0 ye Hattested// APPLICABLE against alternative (ii) below)(a) | Case No. ‘ot Applicable [Not Applicable Not Applicable () | Name of the Court ‘ot Applicable Not Applicable Not Applicable (©) Sections of Acts/Codes involved (give no. [Not Applicable Not Applicable |Not Applicable f the Section, e.g, Sectio of IPC, te). (@) [Brief description of offence for which Not Applicable Not Applicable Not Applicable convicted {e) [Dates of orders of conviction ‘ot Applicable [Not Applicable Not Applicable | (f)_ [Punishment imposed jot Applicable [Not Applicable Not Applicable (g) Whether any Appeal has been filed ‘ot Applicable [Not Applicable |Not Applicable wgainst conviction order (Mention YES or No) (h) [if answer to (g) above is YES, give ‘ot Applicable Not Applicable [Not Applicable Hetails and present status of appeal (6A) Ihave 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 (6)- NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above (This clause shall not applicable to me since I don’t have any pending cases on me) [candidates to whom this Item is not applicable should clearly write NOT APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above] Note: 1, Details should be entered clearly and legibly in BOLD letters. 2. Details to be given separately for each case under different colu against each item, 3. Details should be given in reverse chronological order, i.e., the latest case to be mentioned first and backwards in the order of dates for the other cases. Ad Candidate is responsible for supplying all information in compliance of Hon'ble Supreme Court's judgment in W. P (C) No. 536 of 2011. ns jonal sheet may be added if required. rs HAttested//6. That I give herein below the details of the assets (movable and immovable ete.) 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/Investment, the details including Serial Number, Amount, date of deposit, the scheme, Name of Bank/Institution 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 case of non- listed companies should be given. Note: 4, Dependent’ means parents, son(s), daughter(s) of the candidate or spouse and any other 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 is to be given separately in respect of each investment Note: 6 Details should include the interest in or ownership of offshore assets Explanation,- For the purpose of this Form, the expression “offshore assets” includes, details of all deposits or investments in Foreign banks and any other body or institution abroad, and details of all assets and liabilities in foreign countries’; NOTARY ADVOCATE ‘Sangareddy Town & Dist. (TS) AANTO7ATA \ee : J/attested//SL. Description Cilarapu Trisha] Spouse JHUF | Dependent-1 ],, |, o. (Self) 2 2 Ss is & g g | a (4 alien ea ka 51550 aa R__ oa franc fren ii) | Details of deposit in Bank . Fised Deposits Frm anf Frstate abe accounts (FDRs, Term Deposits 8" and all other types of deposits |B. Balancesin including saving accounts), ‘Saving Bank : [Accou Deposits with Financial Institutions, Non-Banking | HDFC Bank re i Limited, nancial Companies ani siilecklls Cooperative societies and the Branch, amount in each such deposit hace “ide Account ( SO100051711417 5. 1,085.60 16.10.2023) HDFC Bank imited. ubilecills ranch, vderabad, [Telangana Vide Account (0. SO100436076040 ance 511,130.97 27.10.2023) ili) | Details of investment in Bonds, fivestments in Nocampicans fa Nat pate Ke ae Debentures/Shares and units in [sila Home Care companies /Mutual Funds and "5% others and the amount aiveaitacks [Abhishii Lite Sciences Put Lid. Rs. 12.50.0001 ‘Sangareddy Town & Dist. (7.8) Cell: 9440707474 LJartested//iv) | Details of investment in NSS, [Adiga Birla Sun Po Arptahis fox Rar pha Rte sta Postal Saving, Insurance ife Insurance. “i =e Policies and investment in any Policy Financial instruments in Post ° DUS TOTES, office or Insurance Company iS 102-728 including GST) and the amount cree kets insurance, Policy (0. 190067937, fs247275- Policy Date 30.11.2022) Sy 1 Personal Toanvadvance given to Advan to Tama Not Gn Not Applicable | .Nahain any person or entity including HomeCare Pv. Applicable td, RS.22.92,900/- firm, company, Trust ete. and ff 0822-500" other receivables from debtors Roady Re 3.74.000/- and the amount vance to anikanta 56.34,230/- her Advances 5 20,42.280/- (vi) | Motor Vehicles/Aircrafts/ Pisin Tew jot NS caweNNot Applicable fe Yachts/Ships (Details of Make, [{S09"72555. Applicable |” meee fm registration number. ete. year of [sous purchase and amount ) ” 524 49,082 und 10 TS09FUSI9, ear of Purchase 202, oes lle 380 © TSOSFSS284 Hear of Purchase 2021, Rs.,75,000 vil] Jewellery, bullion and valuable (Gold 380 Grams Not NS, Not Applicable RPS, thing(s) (give details of weight [Approximate value {Applicable [™ pats Prpesetis and value) sive ‘Any other assets such as value of Nil Not srucane/NOt Applicable Fo cane claims/interest [Applicable ix) | Gross Total value FRGaS Not Sean Not Applicable FS Sa, plicable. /fartested//Note: 1, Properties in joint ownership indicating the extent of joint ownership will also have to be indicated Note: 2. Each land or building or apartment should be mentioned separately in this format Note: 3. Details should include the interest in or ownership of offshore assets, Description Spouse |HUF | Dependent-1 |Z 2 \Cilarapu Trisha| = = (Self) 2 |z z UE a | A ral SNo1S3Ro and Not Peet Applicable Pate fertile Sy.No.195Ru. Applicable “pn Location(s) Survey camels (Since Un number(s} anchayat, Kani uumber(s) andl, Prakashany AE istrict, {Andhra Pradesh Area 5 Cents ie Acers Not Not Applicable [= Buon, (total measurement in acres) and 30Guntas {Applicable viens pass Whether inherited jot Applicable Not ane] Not Applicable [ne property IApplicable ™ " (Yes or No) No Date of purchase in case of self )2.06.2022 [Not Rtcane| PPE Pate Repti ~ acquired property {Applicable Cost of Land (in case of fRs1.65850 fot FS ac) Not Applicable [fa purchase) at the time of [Applicable {| =“ purchase ‘Any Investment on the land by Not Applicable Not ricaie]| NOt Applicable Pe wie fipicabe way of _ development, IApplicable construction ete ‘Approximate Current Bs.00,000 ot K=_,,| Not Applicable F,_., Fan market value [Applicable [| veness pirnics ji) | No [Annexure No.1 Qprrrrani 2] [iptcasc pant [Enclosed 2 2 Location(s) Survey 4 = number(s) =| 5) =I Zz Area (Annexure No.1 late FPrptnnic pte (total measurement in sq. ft.) Fascloped < = = \ Ze — Wwe SANGI 2 NOTARY ADVOCATE ‘Sangareddy Town & Diet. (.5) [fattested//e Whether inherited N tae Rattle piste property ad (Yes or No) Date of purchase in case of self [Annexure No.1 rica liable Appiabe - acquired property Enclosed Cost of Land (in case of [Annexure No.1 lai frptate ptiatie purchase) at the time of [Enclosed purchase ‘Any Investment on the land by [Annexure No.1 aa Peas fesse way of development, Enclosed a onl construction etc Approximate current ¢-50,00,000, frre nia enti Retest pete market value " iii) | Commercial Bi S lrestanl pte] apr Nil Not jot Applicable (including apartments) |Applicable -Location(s) -Survey number(s) ‘Area jot Applicable Not lca NOt Applicable Ps Pate (total measurement in sq. ft.) [Applicable ~ ~ Built-up Area jot Applicable Not Nicane Not Applicable ee eae (total measurement in sq.ft.) {Applicable . Whether inherited fot Applicable Not FS Not Applicable FS Sans property [Applicable ™ me (Yes or No) Date of purchase in case of self [Not Applicable Not Msicabie NOt Applicable Ppicable a lee acquired property fPplicable ‘Cost of property (in case of ot Applicable Not I isticatte NOt Applicable a purchase) at the time of lApplicable purchase ‘Any Investment on the Land by Not Applicable Not =a Not Applicable [SK way of development, construction Applicable " ™ ete Approximate current jot Applicable Not Fe cae Not Applicable SR, market value [Applicable ['"""" ™ poe iv) | Residential Buildin Plot No.6 & 7. ey frmeniefVOt Applicable Po cie fora (including apartments) py No Aall ir 4/ED/1, 94Aa/2 Location (s) & OWED) Bi -Survey number(s) Sangareddy, = sangareddy istrict < ‘Area 1895.50 Sq Fis SB} FinieasefNot Applicable Fe. Riese (Total measurement in sq.ft) (321.72 Zl : Yards) 10 P \) a ‘le Yer ‘ADVOCATE ‘Sangareddy Town & Diet. (T-S) Cell: 9440707474 Jattested//Built up Area eo Rican Not Applicable PS. B&scane (Total measurement in sq. fi.) _ P1525 S4Fs ™ cara oe Whether inherited io Sau Not Applicable [Sac heucae property (Yes or No) Date of purchase in case of self’ 3.06 2020 Fc Not Applicable fs, BS Acatired SrOpeny rotate pe Cost of property (in case of —_[Rs.6.82,860/- T_, Not Applicable Sn, hom, purchase) at the time of purchase ‘Any Investment on the land by _[Rs.44,13,186. Rerrtcarie NOt Applicable Pe [ipicae way of development, construction ete. ‘Approximate current 5 50,96.045 amine Pesucatie NOt Applicable Pca fiche market value f v) | Others (such as interest in NIL Not aac Not Applicable fo Wane property) Applicable (iy | Total of current market value RS 10496006 [wine fis Nanos Sm Moms of (i) to (v) above (8) I give herein below the details of liabilities/dues to public financial institutions and government:- (Note: Please give separate details of name of bank, institution, entity or individual and amount before each item) = |e S.No. Deseri (Cilarapu Trisha] Spouse HUF| Dependentt |= |= ce zg |Z a 1s i) | Loan or dues to Bank’ (CarLountrom — Not Applicable f,_,,, Not Applicable hn. bosom Financial Institution(s) DFC Bank, Vide vote be joan Account Name of Bank abe or Financial Institution, [119378609 Amount outstanding, rere Nature of loan RL 8880.18 Loan or dues to any an from Not T, [Not Applicable Pyac ame other individuals/ adminiof | pplicable entity other than 5.35.16,000/- mentioned above. For Construction Building) ‘oan from Srideep| teddy 5. 9.50,000/- ke ——« ws u M (NOTARY ADVOCATE ‘Town & Dist. (T.S) ‘Cell: 9440707474 UfAttesteas/Name(s), Amount outstanding, nature of loan From Kishore ‘umar Reddy s.47.34,800/- 10,00,000/- {LMI Infra rojects 5 8,20,000/- ‘Any other liability Mher Loans f= ‘Applicable [Not Applicable P= fm 13,78,6700~ ical olcble ppabe Grand total of liabilities f*19015501%- Ss ee cena pe ete he cere eee ‘Government Dues: (A)Has the Deponent been in occupation of YES/NO) oe accommodation provided by the Government at any {Pl dealing with time during the last ten years before the date of fick Government notification of the current election ? he accommodation rr (B)If answer to (A) above is YES, the following |iate declaration may be furnished namely:-—Not. Applicable latter (i) The address of the Government accommodation: ~ hive Not Applicable (ii) There is no dues payable in respect of above Government accommodation, towards- (a) Rent — (b) electricity charges - NIL. (©) water charges - NIL and (d) telephone charges. as on (date) - NIL. [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 concemed in respect of rent, electricity charges, water charges and telephone charges for the above Government accommodation should be submitted Not. Applisabl staying. dati rovided by the Government, iii) [Dues to department dealing ith Government transport NIL Whiners |e anf including aircrafts and licopters) MAttested//0 e Gilarapu Trisha HUF [Derendenct]er |p (Self) Spouse oe el 3 3 z (F Beale iS 1d iv) [Income Tax dues NIL Not Applicable |” Not Not fot Rt Applicable | Applicable obs [smc (vy) | GST dues NIL Not Applicable | Not ‘Not at Applicable | Applicable + Repcabe (vi) | Municipal/Property tax NIL Not Applicable [Not Not fe Ra dues “Applicable | Applicable tbl pate (vii) | Any other dues NIL Not Applicable | Not Not foe Ree Applicable | Applicable [S#etssbe [Aptcsbe Grand total of all NIL Not Applicable [Not a a Government dues Applicable | Applicable femtabt prtinabe Whether any other No, There isno Not Applicable Not fot ct Net ix) | liabilities are in dispute, if pther liabilities are [Applicable [Applicable ['?P"'sable plicable so, mention the amount jn dispute involved and the authority before which it is pending (9) Det Is of profession or occupation: (a) Self (Cilarapu Trisha (b) Spouse: Not Applicable (9A) Details of source(s) of income: (a) Self (Cilarapu Trisha ): By (b) Spouse : Not Applicable. (c) Source of income, if any, of dependents Not Applicable (9B) Contracts with appropriate Government and any public company or companies: (a) Details of contracts entered by the candidate: Not Applisable, since N Gov Company.or Companies, (b) Details of contracts entered into by spouse Government and Public Company or Compani plicable, si (6) Details of contracts entered into by dependents: Government.and Public. Company, or Not. Api ble,_ since No. Contracts entered. (d) Details of contracts entered into by Hindu Undivided Family or trust in which the candidate or spouse or dependents have interest : Not Applicable, since No Contracts entered with Government and Public Company or Companies. ae isd Mee HAttested//(e)_ Details of contracts, entered into by Partnership Firms in which candidate or spouse or dependents are partners : Not Applicable, since No Contracts entered with Government and Public Company or Companies. (8) Details of contracts, entered into by private companies in which candidate or spouse or dependents have share: Not Applicable, since No Contracts entered with Government and Public Company or Companies. (10) My educational qualification is as under: > Masters in Mass Communication from St. Franeis College for women in the Year 2019 (Give details of highest School / University education mentioning the full form of the certificate! diploma/ degree course, name of the School /College/ University and the year in which the course was completed.) 4 [/Attested//PART—B (11). ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART - A: ll. | Name of the candidate [Sh/Smt/Kum. Cilarapu Trisha b. | Full postal address ‘No.8-00, Jogipet Village, Andole Mondal, angareddy District, Telangana State Number and name of _ the constituency and State ‘6 -Andole (SC) in Telangana I. | Name of the political party which set up the findependent candidate (otherwise write ‘Independent’ 5. | Total number of pending criminal cases IL Total Number of cases in which convicted TL 7 PAN of ‘ear for which last Total Income Shown Income Tax Return led (a) Candidate [ATOPCTSS3B __po22-2023 223.610 (b) Spouse Not pliable Not Applicable ot Applica (c) HUF fiotAppiicatie Not Applicable [rot Appiicabie (d) Dependent ‘otApplicabie Not Applicable Ret Appticabie [Details of Assets and Liabilities (including offshore assets) in rupees Cilarapu Trisha iy ie Description (Sel) spome | HUF | Pomme |E 1g g |e a 8 [\. | Moveable Assets SAS G3ATSS7 Nat Applicable fot Nov Applicable f= = (Total value) plicable potable ppb B__|_| Immovable Assets Ir | Purchase Price of self= SBA8.71000 Not Applicable Not fot Applicable Pot, acquired immovable IApplicable pla ti property 1] Development JRS44.13,18600 _ NotApplicable Not fo Applicable R™__ >=, construction cost of lApplicable pote ftiae immovable property after Purchase (if applicable) we //attested//Til | Approximate Current Market Price- f-acqui oko © Seen Rs.5496,046 Not Applicable Not Not Applicable fitiass fine Value) plicable (b) Inherited assets jot Applicable fot Applicable | (Total Value) fR2-50,00,000 Kestzale pte B Liabilities (| Government dues IL Not Applicable Not jot Applicable Foca. [oan (Total) plicable Gi) Loans from Bank, 51501835018 Not Applicable Not jot Applicable Fo. [oan Financial Institutions and plicable others (Total) 10 Liabilities that are under dispute (| Government dues (Total) _ NIL fot Applicable Not Not Applicable FS, [Applicable Loans from Bank, iL jot Applicable [Not Not Applicable fS,.,,, Financial Institutions and |Applicable others (Total) [Highest educational qualification:, Masters in Mass Communication from St. Francis College for, ‘omen in the year 2019 (Give details of highest School (University education mentioning the full form of the certificate diploma/ degree course, name of the School /College/ University and the year in which the course was completed.)VERIFICATION I, the deponent, above named, 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 itis 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 aPhetre R0- this the 10" Xe day of. November 2013 jaee~ DEPONENT Note: 1. Affidavit should be filed latest by 3.00 PM on the last day of filing nominations Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public Note: 3. All columns should be filled up and no column to be left blank. If there is no information to furnish in respect of any item, either “Nil” or “Not applicable”, as the case may be, should be mentioned Note: 4, The affidavit should be either typed or written legibly and neatly Note: 5. Each page of the Affidavit should be signed by the deponent and the Affidavit should bear on each page the stamp of the Notary or Oath Commissioner or Magistrate before whom the Affidavit is sworn ae ‘Sangareddy Town & Diet. (7-5) ‘Cell: 9440707474 v ittested,Annexure No.1 B. Details of Im Assets: i) Non-Agricultural Lands of Cilarapu Trisha (Self) SINo. | Location(s) Survey ‘Area Whether | Dateof | CostofLand | Any | Approximate number(s) (Totalmeasurement | inherited | purchase in | (incase of | investment | — current inSaFt property | cascof | purchase) at | on the land | market value (Yes or self | thetimeof | by way of No) acquired | purchase | developme property nt, constructio netc 1, [Open PlotNo.1043 | 4500Sq.Fs Yes Not | Rs 98 745- No | R530,00,000 In Sy.No,124/A-8, | (500 Sq.¥ards) | 07/12/2005 | Applicable 124/A-9, 125/E and Since 125/0 In-herited Kothalaguda Village. ‘Shamshabad Mandal RR District 2. | Open Plot No.780 3600 Sq Fis Yes Not | Rs33,362- No | Rs.20.00,000 and 781 in Sy.No.72 | (400 Sq.Yards) | 18/10/2000 | Applicable in Toopranpet Since Village at In-herited CChoutuppal Mandla of Nalgonda District Total RS132,107 NiL___[ Rs 30,00,000 Jet Bet 5) Town & ‘Cell: 9440707474 //Attested//