Affidavit 1699946177

Form 26 r-
(See rule 4.4')

fa Ia
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NARSAPUR
B NOv Z0?3
AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION

PAPER BEFORE THE RETURNING OFFICER FOR ELECTION
TO TELANGANA STATE LEGISLATIVE ASSEMBLY - 2023 (NAME OF THE HOUSE)
FROM 037-NARSAPUR CONSTITUENCY (NAME OF THE CONSTITUENCY)
PART A
I, VAKITI SLTNITHA, wife of Late V. Laxma Reddy, aged 55 years, resident of H.No.
2-16, Gomaram (Village), Shivampet (Mandal), Medak (District), 502313, a candidate at the
above election, do hereby solemnly affirm and state on oath as under:-
(l) I am a candidate set up by BHARAT RASHTRA SAMITHI (**name of the political

parry) / ** (**strike out whichever is not
applicable)
(2) My name is enrolled in 037 - Narsapur Constituency, Telangana State at Serial No 460
in Part No 299.
(3) My contact telephone number(s) islare 9849218752,9848218752 and my e-mail id (if
any) is vakitisunithareddy3(a),gmail.com, donthisrinath@yahoo.com and my Social
Media account(s) (if any) is/are
(i) Facebook -Sunitha Laxma Reddy
(ii) Twitter- Vakiti Sunitha Laxma Reddy
(iii) Instagram - Vakiti Sunitha Laxma Reddy
Details of Permanent Account Number and status of

of Income tax retum
The Financial Total income shown in Income
Year for which Tax Return(in Rupees) for the
sl. the last Income- last five Financial Years
Names PAN
No.
Tax Return has completed (as on 31't March,
been filed 2023)
I Self: ADUPV564IH (i) 2022-23 (i) Rs.40,71,680/-
VAKITI STINITHA (ii) 2021-22 (ii) Rs. 1,33,9101-
(lii) 2020-2r (iii ) Rs.4,51,280/-
(iv) 2019-20 (iv) Rs. 5,05,880/-
(v) 2018-19 (v) Rs.5,22,190/-
F ATTES ED
to \\\>J,
Page I of 13
2 Spouse NOT NOT APPLICABLE (i) NOT APPLICABLE
APPLICABLE (ii) NOT APPLICABLE
(iii) NOT APPLICABLE
(iv) NOT APPLICABLE
(v) NOT APPLICABLE
a
J HUF (If Candidate is NOT NOT APPLICABLE (i) NOT APPLICABLE
Karta/ Coparcener) APPLICABLE (ii) NOT APPLICABLE
(iv) NOT APPLICABLE
(") NOT APPLICABLE
4 Dependent I NOT NOT APPLICABLE (i) NOT APPLICABLE
(iv) NOT APPLICABLE
(v) NOT APPLICABLE
5 Dependent 2 NOT NOT APPLICABLE (i) NOT APPLICABLE
(iv) NOT APPLICABLE
(v) NOT APPLICABLE
6. Dependent 3 NOT NOT APPLICABLE (i) NOT APPLICABLE
(iv) NOT APPLICABLE
(v) NOT APPLICABLE
Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should be
clearly stated "No PAN allotted".
(5) Pending criminal cases

(i) I deelare that there is ne pending erinrinnl eose against me, (Tiek this alternative
if there is ne eriminal ease pending against the €andidate and write NeT
OR
(ii) / rnefollowing criminal cases are pending against me:
OR
ATTESTFi:I
j-T<. t $
Page 2 of 13
(If there are pending criminal cases against the candidate, then tick this alternative and
score off alternative (i) above, and give details of all pending cases in the Table below)
Table
(a) FIR No. with name I.FIR No: 2.FIR No: 3.FIR No: 4.FIR No: 5.FIR No:
and address of Police 92120t8,P5 1 15/2018, PS 141/2018, PS 36/2018, PS 24U2018,P5
Station concerned Kowdipally, Kowdipally, Narsapur, Veldurthy, Narsapur,
Medak District Medak District Medak District Medak District Medak District
(b) Case No. with Name STC No: CC No: CC No: CC No: STC No:
of the Court 82t2021 2st2023 270t2020 s212020 27812020
JFCM Court, Spl. JFCM for JFCM Court, Spl. Mobile JFCM Court,
Narsapur Excise Narsapur Court, Medak Narsapur
Magistrate,
Hyderabad
( c) Section(s) of n/s 171(E) u/s 341, 188, u/s 341, 353, uls 341,290 u/s 188 IPC
concerned Acts/ IPC, Section 504, 506 IPC IPC IPC
Codes involved (give 123(1) RP Act
no. ofthe Section,
e.g. Section _ of
IPC, etc.)..
(d) Brief description of Allegations of Allegations of Allegations of Allegations of Allegations of
offence Bribery & wrongful wrongful wrongful Disobedience
comrpt restraint, restraint & restraint & to order duly
practices disobedience, assault on public promulgated
insult to public nuisance by public
provoke servants by servant
breach of several
peace & persons
criminal
intimidation
( e) Whether charges NO NO YES YES NO
have been framed
(mention YES or
NO)
(0 If answer against (e) NOT NOT 15-09-2023 30-01-2023 NOT
APPLICABLE APPLICABLE APPLICABLE
above is YES, then
give the date on
which charges were
framed
(g) Whether any AppeaU NO NO NO NO NO
Application for
revision has been
filed against the
proceedings
(tvtrrrieGt&S or NO)
r
Page 3
ATTESTED
of 13
\o rl\2-J
(6) Cases of conviction
(i) / | declare that I for any criminal offence. (Tick this
have not been convicted
alternative, if the candidate has not been convicted and write NOT
APPLICABLE against alternative (ii) below)
OR
NOT APPLICABLE
(If the candidate has been convicted, then tick this alternative and score off alternative
(i) above, and give details in the Table below)
Table
(a) Case No. NOT NOT NOT
(b) Name of the Court NOT NOT NOT
(c) Sections of Acts/Codes involved NOT NOT NOT
APPLICABLE APPLICABLE
(give no. ofthe Section, e.g. APPLICABLE
Section of IPC, etc.).
(d ) Brief description of offence for NOT NOT NOT
which convicted APPLICABLE APPLlCABLE APPLICABLE
(e) Dates of orders of conviction NOT NOT NOT

(f) Punishment imposed NOT NOT NOT
(g) Whether any Appeal has been NOT NOT NOT
APPLICABLE APPLICABLE
filedagainst conviction order APPLICABLE
(Mention YES or No)
(h) If answer to (g) above is YES, NOT NOT NOT
give details and present status of APPLICABLE APPLICABLE APPLICABLE
appeal
I
have given full and up-to-date information to my political party about all
(6A)
pending criminal cases against me and about all cases of conviction as given in
paragraphs (5) and (6).
[Candidates to whom this Item is not applicable should clearly write NOT APPLICABLE
IN VIEW OF ENTRIES IN 5(i) and 6(i), abovel
Note:
l. 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, i.e., the latest case to be
and backwards in the order of dates for the other cases.
ATTESTED
:K. \\\1-3
Page 4 of 13
4. Additional sheet may be added if required.
5. Candidate is responsible for supplying all information in compliance of Hon'trle
Supreme Court's judgment in W. P (C) No. 536 of 2011.
(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 ofjoint ownership will also have to be given.
Note: 2 In case of depositilnvestment, 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
S Depende Depende Depende
Description Self Spouse HUF
No. nt-1 nt-2 nt-3
(i) Cash in hand Rs. 2,00,000/- NOT NOT NOT NOT NOT
APPLICABTE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
(i i) Details of deposit in Bank l.Rs. 64,54,7841- NOT NOT NOT NOT NOT
APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
accounts (FDRs, Term SBI, Secretariat
Deposits and all other types Branch, A/C No:
of deposits including saving s2088496453
accounts), Deposits with
Financial Institutions, Non- 2.Rs. 1,11,618/-
Banking Financial Union Bank,
Companies and Cooperative Chikadpally
societies and the amount in Branch. A"/c No:
each such deposit 00761001 t371992
3. Rs.40,00,000/-
HDFC Bank Ltd.,
Narsapur Branch
A/c.No.
zffi 50200088372216
ATT ESTE!}
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Page 5 of 13
(ii i) Details of investment in NIL NOT NOT NOT NOT NOT
Bonds, Debentures/Shares
and units in companies/
Mutual Funds and others and
the amount.
(i ) Details of investment in SBI Life NOT NOT NOT NOT NOT
NSS, Postal Saving, Insurance -
Insurance Policies and Rs. 199,800/-
investment in any financial
instruments in Post office or Shriram Life
Insurance Company and the Insurance -
amount Rs. 2,04,600/-
( ) Personal loans/advance given NIL NOT NOT NOT NOT NOT
to any person or entity
including firm, company,
Trust etc. and other
receivables from debtors and
the amount.
(vi) Motor Vehicles/Aircrafts/ l.Toyota NOT NOT NOT NOT NOT
Yachts/Ships (Details of Fortuner: TS09
Make, registration number. FS 9099/ 202r -
etc. year ofpurchase and Rs. 39,50,000/-
amount ) 2.Mahindra XUV
700: TS35 G
09091 2021
Rs. 21,59,000/-
(vii) Jewellery, bullion and 25 Tulas NOT NOT NOT NOT NOT
valuable thing(s) (give Rs. 15,00,000/-
details of weight and value)
(viii) Any other assets such as NIL NOT NOT NOT NOT NOT
APPLICABTE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
value of claims/interest
(ix) Gross Total value Rs.1,87,79,802/-
t ATTESTED
to\tt\!3 u9!
Page 6 of 13
B. Details of Immovable assets:
Note: I Properties in joint ownership indicating the extent ofjoint 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.
Depende Depende Depende

S. No Description Self Spouse HUF
nt-l nt-Z nt-3
(i) Agricultural Land l.Gomaram (V) NOT NOT NOT NOT NOT
Location(s) Survey Sy.No.l3lerl
number(s)
2.Pedda
Gottirnukla (V)
Sy.No. 109 to
126(ln parts)
Area (total measurement in l.Acres00.l6 NOT NOT NOT NOT NOT
acres) Guntas
2.Acres 19. l5
Whether inherited property I.YES NOT NOT NOT NOT NOT
(Yes or No) 2.YES
Date of purchase in case of \OT APPLICABLE NOT NOT NOT NOT NOT
self - acquired property
Cost of Land (in case of NOT APPLICABLE NOT NOT NOT NOT NOT
purchase) at the time of
purchase
Any Investment on the land NIL NOT NOT NOT NOT NOT
by way of development,
construction etc.
Approximate Current r) NOT NOT NOT NOT NOT
market value Rs.3,20,000/-
2)
Rs.1,55,00,000/-
(ii) Non-Agricultural Land Sy.No.21, NOT NOT NOT NOT NOT
APPLICABLE APPI-ICABLE APPLICABLE APPLICABLE APPLICABLE
Location(s) Survey Gopannapalli
number(s) Village,
Serilingampally
Mandal, RR
Dist. Joint
Ownership
Area (total measurement in Joint ownership NOT NOT NOT NOT NOT
sq.ft.) share to an
extent of 1422
-ffit. sft
ATTESTED
5 r0 \r,\!l Ury!
Page 7 of 13
NOT NOT
Whether inherited property YES NOT NOT NOT
(Yes or No)
Date of purchase in case of NOT NOT NOT NOT NOT NOT
self - acquired property APPLICABLE APPLICABLE APPLlCABLE APPLICABLE APPLICABLE APPLICABLE
Cost of Land (in case of NOT NOT NOT NOT NOT NOT
purchase) at the time of APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
purchase
Any Investment on the land NIL NOT NOT NOT NOT NOT
by way of development,
construction etc.
NOT NOT NOT NOT NOT
Approximate current market Rs.49,77,000/-
value
(iii) Commercial Buildings H.No 6-ll7, NOT NOT NOT NOT NOT
APPLICABLE APPLICABLE APPLiCABLE APPLICABLE APPLICABLE
(including apartments) Nizampet (V),
-Location(s) Medchal
-Survey number(s) Malkajgiri(D)
G+3 Floors
Area (total measurement in 2274.39 sq.ft NOT NOT NOT NOT NOT
sq. ft.)
Built-up Area (total 48OO SFT NOT NOT NOT NOT NOT
measurement in sq.ft.)
Whether inherited property No NOT NOT NOT NOT NOT
(Yes or No)
Date of purchase in case of 29.03.2007 NOT NOT NOT NOT NOT
self - acquired property
Cost of property (in case of Rs.10,11,000/- NOT NOT NOT NOT NOT
purchase) at the time of
purchase
NOT NOT NOT NOT
Any Investment on the Rs.24,00,000/- NOT
property by way of develop-
ment, construction etc.
NOT NOT NOT NOT
Approximate current market Rs.50,00,000/- NOT
value
(iv) l)H.No.2-16, NOT NOT NOT NOT
Residential Buildings NOT
(including apartments) Gomaram (V),
-Location (s) Shivampet (M) -
-Survey number(s) Inherited
2)H.No.19-4214,
Narsapur (v&m)
self acquired
Area (Total measurement in l) 1800 Sq.ft NOT NOT NOT NOT NOT
sq.ft) 2) 1854 Sq ft
Built up Area (Total NOT NOT NOT
I )2000 sq.ft NOT NOT
measurerpgffif{.) 2\4209 sqft
N
G0.l,l.S
No:354
It2
F ATTE TED
\o \\ v
Page 8 of 13
Whether inherited property 1)Yes - NOT NOT NOT NOT NOT
(Yes or No) Gomaram (V)
Property
2) Self Acquired
Date of purchase in case of 1) NOT NOT NOT NOT NOT NOT
self - acquired property APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPI,ICABI-E APPLICABLE

2\03-02-16
Cost of property (in case of l) Nor NOT NOT NOT NOT NOT
purchase) at the time of APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
purchase 2) Rs.6,18,000/-
Any Investment on the land 1) NrL NOT NOT NOT NOT NOT
by way of development, 2)
construction etc. Rs.25,00,000/-
Approximate current market l) Rs.18,00,000/- NOT NOT NOT NOT NOT
value Gomaram (V)
Property
2) Rs.35,00,000/-
Narsapur (V)
Property
(v) Others (such as interest in NIL NOT NOT NOT NOT NOT
propeffy) APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
(vi) Total of current market Rs.3,10,97,000/- NOT NOT NOT NOT NOT
value 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 ofbank, institution, entity or individual and amount
before each item)
S. Depende Depende Depende

No. nt-1 nt-2 nt-3
(i) Loan or dues to Bank/ 1) Crop Loan NOT NOT NOT NOT NOT
Financial Institution(s) APGVB, APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
Name of Bank or Gomaram

Branch
Financial Institution,
No.73019551445
Amount outstanding, Rs. 1,29,400/-
Nature of loan 2) Housing Loan
at SBI, Narsapur
Branch
No.62490007254
- Rs.15,50,329l-
3) ICICI vehicle
Loan:
Rs.l1,10,173l-
4) Mahindra
Vehicle Loan:
,ffi- Rs.15.80.000/-
ATT E sTtrn
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Page 9 of 13
Loan or dues to any other NIL NOT NOT NOT NOT NOT
individuals/ entity other
than mentioned above.
Name(s), Amount
outstanding, nature of loan
Any other liability NIL NOT NOT NOT NOT NOT
Grand total of liabilities Rs.43,69,9021- NOT NOT NOT NOT NOT
(iD Govemment Dues: (A)Has the Deponent been in occupation of YES / NO/
Dues to departments accommodation provided by the Govemment at (P1. tick the
dealing with Government any time during the last ten years before the date appropriate
accommodation of notification of the current election? alternative)
(B) If answer to (A) above is YES, the following
declaration may be furnished namely: -
(i) The address of the Government
accommodation:
(ii) There is no dues payable in
respect of NOT APPLICABLE
above Government accommodation,
towards-
(a) rent;
(b) electricity charges;
(c) water charges; and
(d) telephone charges as on .
(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
concerned in respect of rent, electricity charges,
water charges and telephone charges for the above
Government accommodation should be submitted.
(iii) Dues to department dealing NIL NOT NOT NOT NOT NOT
with Government transport
(including aircrafts and
helicopters)
Dependen Depende Depende
Self Spouse HUF
r-1 nt-Z nt-3
( )
1 Income Tax dues NIL NOT NOT NOT NOT NOT
(v ) GST dues NIL NOT NOT NOT NOT NOT

(vi) Municipal/Property tax NIL NOT NOT NOT NOT NOT

APPLICABLE
dues z75- APPLICABLE APPLICABLE APPLICABLE APPLICABLE
ATTEST ED
to l,\?l
Page l0 of 13
(vii ) Any other dues NIL NOT NOT NOT NOT NOT
( vu t ) Grand total of all NIL NOT NOT NOT NOT NOT

Govemment dues
(ix) Whether any other NIL NOT NOT NOT NOT NOT
liabilities are in dispute, if APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
so, mention the amount

involved and the authority
before which it is pending.
(9) Details of profession or occupation:

(a) SeIf: PUBLIC SERVICE AND AGRICULTURE
(b) Spouse: NOT APPLICABLE
(9A) Details of source(s) of income:

(a) Self: RENTAL INCOME and AGRICULTURAL INCOME
(b) Spouse: NOT APPLICABLE
(c) Source of income, if any, of dependents: NOT APPLICABLE
(98) Contracts with appropriate Government and any public company or companies
(a) details of contracts entered by the candidate: NIL
(b) details of contracts entered into by spouse: NOT APPLICABLE
(c) details of contracts entered into by dependents: NOT APPLICABLE
(d) details of contracts entered into by Hindu Undivided Family or trust in which the
candidate or spouse or dependents have interest: NOT APPLICABLE
(e) details of contracts, entered into by Partnership Firms in which candidate or spouse
or dependents are partners: NOT APPLICABLE
(f) details of contracts, entered into by private companies in which candidate or spouse
or dependents have share: NOT APPLICABLE
(10) My educational qualification is as under:
B.Sc. (BZC), Vanitha Maha Vidyalaya, 1988 , N A\"\QALLY, \-tvPECreBqD
(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.)
ATTE STED
tri
*
the
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Page 11 of 13
PART -B
11 ABSTRACT OF THE DETAILS GIVEN IN I TO OF PART. A:
I Name of the candidate Smt. VAKITI SUNITHA
2 Full postal address H.No. 2-16, Gomaram (V), Shivampet(M),
Medak District - 502313
J Number and name of the constituency 037, Narsapur Assembly Constituency,
and State Telangana
4 Name of the political party which set up BHARAT RASTHRA SAMITHI
the candidate (otherwise write
'Independent')
5 Total number of pending criminal cases 05
6. Total Number of cases in which NIL
convicted
7 PAN of Year for which last Total Income Shown
Income Tax Return filed
(a) Candidate ADUPVs64IH 2022-23 Rs.40,71,680/-
(b) Spouse NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE
(c) HUF NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE
(d) Dependent NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE
8. Details of Assets and Liabilities (including offshore assets) in rupees
Depend Depend Depend
ent-l ent-2 ent-3
A. Moveable Assets Rs.1,87,79,802/- NOT NOT NOT NOT NOT
(Total value)
B Immovable Assets NOT NOT NOT NOT NOT
A?PLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
I Purchase Price of Rs. 16,29,000/- NOT NOT NOT NOT NOT

self-acquired
immovable property
II Development/const Rs.49,00,000/- NOT NOT NOT NOT NOT
APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICAtsLE
ruction cost of
immovable property
after purchase (if
applicable)
III Approximate NOT NOT NOT NOT NOT
Current Market Price
(a) Self-acquired Rs. 85,00,000/-

assets (Total
Value)
(b) Inherited assets Rs.2,25,97,0001-
(Total Value)
B,
co
*
N
G.0.M.S.No:351/1
*
a.'
:E'
ATTESTED
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Page 12 of 13
9 Liabilities
(i) Govemment dues NIt- NOT NOT NOT NOT NOT
(Total) APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE
( ii) Loans from Bank, NOT NOT NOT NOT NOT

APPLICABLE APPLICABLE APPLICABLE APPLICABLE A}PLICABLE
Financial Institutions Rs.43,69,9021-
and others (Total)
l0 Liabilities that are under dispute
(i) Govemment dues NIL NOT NOT NOT NOT NOT
(Total)
(ii) Loans from Bank, NIL NOT NOT NOT NOT NOT
Financial Institutions
and others (Total)
ll Highest educational qualification: B.Sc.(BZC), Vanitha Maha Vidyalaya, Nampally,
Hyderabad, 1988
(Give details of highest School AJniversity education mentioning the full form of the
certificate/ diplomai degree course, name of the School lCo|legel 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 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
t mentioned in items 7 and 8 of Part A and items 8, 9 and l0 of Part B above.
Verifi ed at. .N f*Rs.fr P.v.R .. ..this the day or. . I OI. f't O.v. F-$ B.eR . 23
D
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.
ATTESTED BY
e.cor,JF'
\\ t:
@4L N OTARY
ME DAK DIST.
,9959498919
Page 13 of 13

Affidavit 1699946177

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Affidavit 1699946177

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Form 26 r-

(See rule 4.4')

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONG WITH NOMINATION

(l) I am a candidate set up by BHARAT RASHTRA SAMITHI (**name of the political

Details of Permanent Account Number and status of

(5) Pending criminal cases

(e) Dates of orders of conviction NOT NOT NOT

A. Details of movable assets :

Depende Depende Depende

self - acquired property APPLICABLE APPLICABLE APPLlCABLE APPLICABLE APPLICABLE APPLICABLE

purchase) at the time of APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE

self - acquired property APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPI,ICABI-E APPLICABLE

purchase) at the time of APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE

S. Depende Depende Depende

Financial Institution(s) APGVB, APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE

Name of Bank or Gomaram

(v ) GST dues NIL NOT NOT NOT NOT NOT

(vi) Municipal/Property tax NIL NOT NOT NOT NOT NOT

( vu t ) Grand total of all NIL NOT NOT NOT NOT NOT

liabilities are in dispute, if APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE

so, mention the amount

(9) Details of profession or occupation:

(9A) Details of source(s) of income:

I Purchase Price of Rs. 16,29,000/- NOT NOT NOT NOT NOT

(a) Self-acquired Rs. 85,00,000/-

(Total) APPLICABLE APPLICABLE APPLICABLE APPLICABLE APPLICABLE

( ii) Loans from Bank, NOT NOT NOT NOT NOT

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