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13
I @ero go kirm{r TELANGANA tsltLl2otS Rs.So/- Sold M BHAVANI W Io,HANMANTH REDDY R/o. Hyd For Whom: SELF P.KAVITHA LICENCED STAMP VBNDOR L.No.:15-21-002/2013 Ren.No. I 5-2 l-039 12016 H.No.5-28-251, Plot No.l3l, Shiridi Sai Baba nagar l.D.A, Jeedimetla, Quthbullapur, M.M.District Cell No.9908088744 to H 281i09 sl. FORM 26 (See Rule 4A) AFFIDAVIT o\ by Filed by the candidate along with nomination paper before the returning officer for election LBGISLATIVE ASSEMBLY OF TELANGANA STATE fTom 33-SIDDIPET conStitUCNCY. ' PART-A I, BHAVANI MARIKANTI WifE Of HANMANTH REDDY MARIKANTI, AgCd 40 YEATS' TCSidENt Of plot 9, Apurupa II, Near Dhyanahitha High School, Pragathi Nagar, Bachupally, Medchal - Malkajgiri - 500090, a candidate at the above election, do hereby solemnly affirm and state on oath as under:- (1) I am a candidate set up by TBLANGANA JANA SAMITHI PARTY AT-TESTE D \\ I I I I I i I I I I emw INDIA W I l M.A., LL. M Page I of 13 2D 16

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Page 1: INDIA - siddipet.telangana.gov.insiddipet.telangana.gov.in/wp-content/uploads/2018/11/14-MARIKANTI-BHAVANI-TJS... · FORM 26 (See Rule 4A) AFFIDAVIT o\ by Filed by the candidate along

I

@ero go kirm{r TELANGANA

tsltLl2otS Rs.So/-

Sold M BHAVANI

W Io,HANMANTH REDDY R/o. Hyd

For Whom: SELF

P.KAVITHALICENCED STAMP VBNDOR

L.No.:15-21-002/2013Ren.No. I 5-2 l-039 12016

H.No.5-28-251, Plot No.l3l, Shiridi Sai Baba nagarl.D.A, Jeedimetla, Quthbullapur, M.M.District

Cell No.9908088744

to

H 281i09sl.

FORM 26(See Rule 4A)

AFFIDAVIT o\by

Filed by the candidate along with nomination paper before the returning officer for election

LBGISLATIVE ASSEMBLY OF TELANGANA STATE fTom 33-SIDDIPET conStitUCNCY.

' PART-AI, BHAVANI MARIKANTI WifE Of HANMANTH REDDY MARIKANTI, AgCd 40 YEATS' TCSidENt Of

plot 9, Apurupa II, Near Dhyanahitha High School, Pragathi Nagar, Bachupally, Medchal - Malkajgiri -

500090, a candidate at the above election, do hereby solemnly affirm and state on oath as under:-

(1) I am a candidate set up by TBLANGANA JANA SAMITHI PARTY

AT-TESTE D \\

I

I

I

I

Ii

I

I

I

I

emw

INDIAW

Il

M.A., LL.M

Page I of 13

2D 16

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I

@elo r; eo futrrmr TELANGANA

,6H-.,^te. 1 3 / t r r 2o'a Rs.so/ -

To: M BHAVANI

sl. NSold

ATTES ED .\\

.M LU

H 281910P.I(AVITHA

LICENCED STAMP VENDORL.No.:15-21-00212013Ren.No.l 5-2 I -039 /2016

H,No.5-28-251, Plot No.l3l, Shiridi Sai Baba nagarI.D.A, Jeedimetla, Quthbullapur, M.M.District

Cell No.9908088744

W I o.l$rrualrrH REDDY R/o. Hyd

For Whom SELF

(2) MV name is enrolled in 45 - QUTHBULLAPUR ASSEMBLY CONSTITUENCY in

Telangana State, at Serial No 819 in Part No 93 - ZPHS VASAVI LAYOUT PRAGATHI

NAGAR and EPIC No. NVT2I13959.

(3) My contact telephone number(s) is / are +91 8897648012 and my email id is

[email protected] and my social media account(s) is/are (i) Facebook

account - Bhavani Reddy (ii) Facebook Page - Bhavani Reddy for Alternative Politics (iii)

Twitter - @BhavanireddyT and Whatsapp number is +91 8897648012.

I

I

I

I

I

I

I

$

etre

INDIA

PINNAM.4., LI.M.

Page 2 of 13

I

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SI

No.

Names PAN The financial year

for which the last

Income-tax return

has been filed

Total income

shown in

Income-tax

return (in

Rupees)

I Self - Bhavani Marikanti BRUPM6827P 2017-r8 Rs.4,78,692

2. Spouse - HanmanthReddy Marikanti

AYVPM4349M 2017-t8 Rs. I1,78,443

J Dependent-l - SreeMithra Reddy Marikanti(Son)

NIL NIL NIL

4. Dependent-2 - SreekrithiReddy Marikanti(Daughter)

NIL NIL NIL

(4) Details of Permanent Account Number (PAN) and status of filing of Income Tax return:

(5) Pending criminal cases

(D I declare that there is no pending criminal case against me. Et

OR(ii) The following criminal cases are pending against me: NOT APPLICABLE

Cases of conviction

I declare that I have not been convicted for any criminal offence. El

OR

I have been convicted for the offences mentioned below: NOT APPLICABLE

(6A) I have given full and up-to-date information to my political party about all pendingcriminal cases against me and about all cases of conviction as given in paragraphs (5)and (6).

NOTAPPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6 (i), above

(7) That I give herein below the details of the assets (movable and immovable etc.) of myselfmy 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 deposit/Investment, the details including Serial Number, Amount, date of

deposit, the scheme, Name of the Bankflnstitution and Branch are to be given page 3 of 13

E\\

(6)

(t)

(ii)

UM.A., LL.M.

ADVOCATE & NOTAP.YSIDDIPET-5 02 I03

OITI; $IDDIPEI. TEI.ANGAIIAEsll:ge+:32142-2

ATTE

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Note: 3. Value of Bonds/Share Debentures as per current market value in Stock exchange inrespect of listed companies and as per books in case of non-listed companies should begiven.

Note: 4. 'Dependent' means parents, son(s), daughter(s) of the candidate or spouse and any otherperson related to the candidate whether by blood or marriage, who have no separatemeans 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

Sl.No. Description Self Spouse Dependent-l

Dependenta

(D Cash in hand 45,000/- 3s,000/- NIL NIL(ii) Details of deposit in

Bank accounts (FDRs,Term Deposits and allother types of depositsincluding savingaccounts), Deposits

SB Account (A/c No501 0025 I 459b00) Bulancewith HDFC Bank, Pragathi

[.,lagar Branch is Rs.5,35,6651-

SB Account A/C No.4496101003814 withCanara Bank Siddipetbranch is Rs.965l (ForLegislative Assembly ofTelangana State Election201 8 purpose)

SB Account (A/c No.62341464180) Balance withSBI, Pragathi Nagar Branchls 26,11,101/-

SB Account (A/c No.(4411368330) Balance

[with Standard Charteredpank, Jubilee Hillspranch is l,l5,l 86/-

SB Account (A/c No.5762609552) Balancewith CitiBank,Begumpet Branch is7,27,069/-

SB Account (A/c No.631201117645) Balancewith ICICI Bank, KPHBBranch is25,7351-

T Account (A/c No.22350252) Balance withBOQ, NWBP, SydneyBranch is AUD $44l-

SB Account (A/c No.22350255) Balance withBOQ, NWBP, SydneyBranch is AUD $119/-

T Account (A/c No.461 126864) Balance withCiti Bank, Sydney Branchis AUD $490/-

SB Account (A/c No.461 12687 2) Balance withCiti Bank, Sydney Branchis AUD S11,540/-

NIL NIL

Page 4 of l3

TES

PINNM.A., [.]-'i'r

ADVOCATE & NOTA'*7SIDDIPET-502 183

DISI: SIDIIIPET. TTU,{64?I&Cell:984932r'422

%

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with FinancialInstitutions, Non-Banking FinancialCompanies andCooperative societiesand the amount ineach such deposit.

(iiD Details of investmentin Bonds,debentures/shares andunits incompanies/Mutualfunds and others andthe amount.

30% Share holder in ShreeRam Constructions. Currentcapital balance as perbalance sheet dated 3 l-03-2018 is Pis.35,76,769/-

Share holder in VummadiFamily superannuationFund Account balanceAUD 73,852/-

20Yo Share holder inShree Ram Constructions.Current capital balance as

per balance sheet dated3l-03-2018 is Rs.33,96,432/-

Share holder in VummadiFamily superannuationfund. Account balanceAUD 79,483t-

lnvestments in 130 sharesof Tata Motors is Rs.

23,400 I - (current value)

Investments in 500 sharesof SBI isRs.1,37,2251-(current value)

Investments in 100 sharesof Suven Lifesciences isRs. 25,250/- (currentvalue)

lnvestments in Reliancemulticap mutual fund is1,98,8911 - (current value)

Investments in Axis I

Equity Advantage mutualfund is 2,17,4911- (currentvalue)

NIL NIL

(iv) Details of investmentin NSS, Postal Saving,Insurance policies andinvestment in anyFinancial instrumentsin Post office orInsurance Companyand the amount.

Policy No. 645891975 ofLIC of India -Pis.78,7521-premium paid

Policy No. 648925668 ofLIC of India - Rs.2,16,125 I - premium paid

Policy No. 1K049994705of SBI Life - Rs.3,00,000/- premium paid

NIL NIL

Page 5 of 13

\\\

M.A., LL.MADvocArE &"ti'6il'ii

SIDDIPET-502 103OISI: SIDOIPET. TELAT{GAT{ACell:9849321422

ATTES\

EED

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( ) Personal loans/advance given to anyperson or entityincluding firm,company, Trust etc.,and other receivablesfrom debtors and theamount.

Loan and advanes Rs.

5,00,000/- given to MPanduranga Reddy

NIL NIL NIL

(VI) Motor Vehicles/Aircraft sAiachts/Ships(Details of Make,registration numberetc. year of purchaseand amount)

Nissan Terrano XVPREMIUM DCI BSIV:Registration No.TS07ER8329 purchased in2015: current IDV valueRs 8,47,945/-

NIL NIL NIL

(vii) Jewellery, bullion andvaluable thing(s) (givedetails of weight andvalue)

650 gramsRs. 19,50,000i-

40 gramsRs.1,20,000/-

25gramsRs.

75,000

150grams

Rs.4,5

0,000/-

(viii) Any other assets suchas value ofclaims/interest

NIL NIL NIL NIL

(ix) Gross TotalValue Rs. 1,01,45,2321-&

LUD 73,852t-

Rs. 55,37,804/-&

LIJD 9t,6761-

Rs.75,000t-

Rs.4150,0

D0/-

B. Details of Immovable Assets:

Note: L Properties in joint ownership indicating the extent ofjoint ownership will alsohave to be indicated.

Note: 2. Each land or building or apartment should be mentioned separately in thisformat

S.

No.Description Self Spouse Depen

dent-1

Dependent-2

(i) Agricultural LandLocation(s)Survey number(s)

NIL NIL NIL NIL

Area (totalmeasurement in acres)

NIL NIL NIL NIL

Whether inheritedproperty (Yes or No)

NIL NIL NIL NIL

Date of purchase incase of self-acquiredpropefi

NIL NIL NIL NIL

Cost of Land (in case

ofpurchase) at thetime of purchase

NIL NIL NIL NIL

Page 6 of 13

a

ATTESTE D

PIADVOCATE & NOTARY

SIDDIPET.5O2 103DIST: SIDOIPET. TEIANGANACetl:9849327-427

l\\\r

LL.M.

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Any investment on theland by way ofdevelopment,construction etc.

NIL NIL NIL NIL

Approximate NILmarket value

NIL NIL NIL NIL

(ii) Non-AgriculturalLand:Location(s)Survey number(s)

NIL 1) 43.75o/o share inopen Plot No 10

(Part) at PragathiNagar, Sy No.133&135

2) 43.75% share in openPlot Nos: l l and l0(part) at PragathiNagar, Sy No.133&,135

3) 50% share in openplot F-l I atSimhapuri Layout,Bowrampet, Sy.No.540

NIL NIL

Area (totalmeasurement in sq.ft.)

NIL 1) 126.875 Sq. Yds outof 290 Sq. Yds Plot.i.e 1141.875 sft

2) 135.625 Sq. Yds outof 310 Sq. Yds Plot.i,e 1220.625 sft

3) 200 Sq. Yds out of400 Sq. Yds Plot i.e.1800 sft

NIL NIL

Whether inheritedproperty (Yes or No)

NIL l) No2) No3) No

NIL NIL

Date of purchase incase of self-acquiredproperty

NIL r) 07-08-20182) 07-08-20183) 06-02-2016

NIL NIL

Cost of Land (in caseofpurchase) at thetime of purchase

NIL l) Rs. 12,68,750/-2) Rs. 13,62,5001-3) Rs. 6,00,000/-

NIL NIL

Any investment on theland by way ofdevelopment,construction etc.

NIL 1) NrL2) NrL3) NrL

NIL NIL

Approximatemarket value

NIL l) Rs. 13,50,000/-2) Rs. 14,43,0001-3) Rs. 9,00,000/-

NIL NIL

(iii) Commercial Buildings(including apartments)-Location(s)-Survey number(s)

NIL Ntt- NIL NIL

Page 7 of 13

\\

M.A., LL.MADvocArE & N'6iAii

SIDDIPET.5O2 103DIST: SIDDIPET. TELANGAI{ACell:984932L422

TA ET Ts E

MU \r

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(iv)

Area (total NIL NIL NIL NILmeasurement in sq.ft.) NIL NIL NIL NILBuilfup Area (totalmeasurement in sq.ft.)

NIL NIL NIL NIL

Whether inheritedproperty (Yes or No)

NIL NIL NIL NIL

Date of purchase incase of self-acquiredproperty

NIL NIL NIL NIL

Cost of property (incase ofpurchase) atthe time of purchase

NIL NIL NIL NIL

Any investment on theproperty by way ofdevelopment,construction etc.

NIL NIL NIL

Approximate currentmarket value

NIL NIL NIL NIL

Residential Buildings(includingapartments):-Location(s)-Survey number(s)

Properties Jointly owned(50% share in 1 to 4 and25% share in 5):

l) In Plot No. Plot 9,Apurupa 2,PragathiNagar

2) In Plot 3645, 8-28,Sri SaikrishnaLayout, PragathiNagar

3) In Plot 1250-12655-l0s/s9Pragathi Nagar

4) In Plot 34 & 35Nizampet

5) At 6 Newton Rd,Blacktown, Sydney

lPropenies Jointly owned

l{sox in share I to 3 and

l25Yo share in 4):

I tl In Plot No. Plot 9,Apurupa 2, PrugathiNagar

2) ln Plot 3645, 8-28,Sri SaikrishnaLayout, PragathiNagar

3) In Plot 1250-12655-10s/s9Pragathi Nagar

4) At 6 Newton Rd,Blacktown, Sydney

Area(totalmeasurement in sq.ft.)

r)2)3)4)s)

266.67 Sq. Yds240 Sq. Ydsl5 Sq. Yds (USL)108 Sq. Yds (USL)753 Sq. Mtrs

t) 266.67 Sq. Yds2) 240 Sq. Yds3) 15 Sq. Yds (USL)4) 753 Sq. Mtrs

NIL NIL

Built up area(Total

measurement in sq.ft.)

r) 3800 sft2) 5100 Sft3) 7ee sft4) 2800 Sft5) 3000 sft

r) 3800 sft2) 7300 Sft3) 7ee sft4) 3000 sft

NIL NIL

Whether inheritedproperty (Yes or No)

No No NIL NIL

Page 8 of l3

luPI

M.A., LL.MADVOCATE

SIDDIPET& NOTARY-502 103

AISTI SIDDI PEI TEI.AT{GAI{ACell:9849 321422

\E

NIL

TTE

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Date of purchase incase ofself-acquiredproperty

l) 06-0r-20152) 04-09-20143) 23-07-20124) 26-09-20145) July 2015

l) 06-01-20152) 04-09-20143) 23-07-20124) July 2015

NIL NIL

Cost of property (incase ofpurchase) atthe time of purchase

Rs. 16,00,000/-Rs. 14,78,000/-Rs. 17,26,000/-Rs.31,88,000/-AUD 9,50,000/-

l)2)3)4)s)

r)2)3)4)

Rs. 16,00,000/-Rs. 14,78,000/-Rs. 17,26,000/-AUD 9,50,000/-

NIL NIL

Any investment on theland by way ofdevelopment,construction etc.

l) Rs.46,00,000/-2) Rs.75,00,000/-3) NrL4) Rs.35,00,000/-5) NIL

6) Rs.46,00,000/-7) Rs.75,00,000/-8) NrL9) NrL

NIL NIL

Approximate currentmarket value

l) Rs. 1,14,00,000/-2) Rs. 1,50,00,000/-3) Rs. 26,20,000/-4) Rs.90,00,000/-5) AUD 12,50,000/-

6) Rs. 1,14,00,000/-7) Rs. 1,50,00,000/-8) Rs.26,20,000/-9) AUD 12,50,000/-

NIL NIL

(v) Others (suchinterest in property)

AS NO NO NIL NIL

(vi) Total of current marketvalue of(i) to (v) above

Rs. 1,90,10,000/- which is 50%of Rs. 3,80,20,000/- jointly heldproperties

&AUD 3,12,500/- which is25ohof AUD 12,50,000/-

Rs. 1,82,03,000 (Rs.36,93,000from Non agriculture Land +Rs.1,45,10,000/- which is 50%of Rs. 2,90,20,000/- jointly heldproperties)

&AUD 3,12,500/- which is25o/oof AUD 12,50,000/-

NIL NIL

(D

(8) I give herein below the details of liabilities/dues to public financial institutions and

government:-

Loan or dues to anyotherindividuals/entity

M.A., LL.M.ADVOCATE & NOTARY

SIDDIPET.SO2 103DTSII SIDOIPEI. TETAIIGAITA

Celt:98r*932,-422

Page 9 of 13

S.

NoDescription Self Spouse Depen

dent-lDependenta

Loan or dues toBank/financialinstitution(s)Name of the Bank orfinancial Institution,Amount outstanding,Nature of Loan

Joint Housing Loans (50%):Rs. 38,61,288/- andRs. 27,68,8721- fromIndiabulls Housing FinanceLimited A/c Nos.HHLKUK00286895 andHHLKUKOO399163respectively

Joint Housing Loan (25%):AUD 7,13,0161-

Joint Housing Loans (50%):Rs. 38,61,288/- andRs. 27,68,8721- fromIndiabulls Housing FinanceLimited A/c Nos.HHLKUK00286895 andHHLKUKOO399I63respectively

Joint Housing Loan (25%):AUD 7,13,016/-

NIL NIL

Loan from Sri SomeshwarReddy received

NIL NIL NIL

l\\

t

ATTE

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other than mentionedaboveName(s), Amountoutstanding, nature ofloan

5,24,0001- into A/c100251459800 HDFC

PragathiNagar

from Indrajeeth Reddy:Rs. 50,000/- into

50100251459800 HDFC

Any other liability NILINIL NIL NIL

Grand totalliabilities

of Rs. 38,89,080/-&

AUD 1,78,2541-

F$ 33'

lcIAUD r

15,080/-

,78,254/-(ii) Govemment dues:

Dues to Departmentsdealing withGovemmentaccommodation

(A)Has the Deponent been in occupation ofaccommodation provided by the Government atany time during the last ten years before the date ofnotification of the current election?

(B) If answer to (A) above is YES, the followingdeclaration may be fumished namely: -

NOT APPLICABLE

NO

M.A., LL.M.ADVOCATE & NOTARY

StDDIPET.502 103DISI: SID0IPEI. IELANGII{ACell:984932L422

l\\r

Page 10 of l3

a

AT-TES

PINNA

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(iii) Dues to departmentdealing withGovernment transport(including aircraftsand helicopters)

NIL

(iv) Income tax dues NIL

Self Spouse Dependent-1

Dependent-2

(v) GST Dues NIL NIL NIL NIL(vi) Municipal/Property

tax dues

NIL NIL NIL NIL

(vii) Any other dues NIL NIL NIL NIL(viii) Grand total of all

Government duesNIL NIL NIL NIL

(ix) Whether any otherliabilities are indispute, if so, mentionthe amount involvedand the authoritybefore which it ispending.

NIL NN NIL NIL

(9) Details of profession or occupation:

(a) Self - Business - Engineering

(b) Spouse - Self Employed

(9A) Details of sources of income:(a) Self - Business / Rents

(b) Spouse - Business / Employment

(c) Source of income, if any, of dependents: NIL

(9B) 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:NIL

(c) details of contracts entered into by dependents: NIL

(d) details of contracts entered into by Hindu Undivided Family or trust in

which the candidate or spouse or dependents have interest: NIL

(e) details of contracts, entered into by Partnership Firms in which

candidate or spouse or dependents are partners: NIL

({) Details of contracts entered into by private companies in which candidate or

spouse or dependents have share: NIL

(10) My educational qualification is as under:-

Bachelor of Engineering (Mechanical)

from University College of Engineering,

Osmania University, Hyderabad during 1998 -ATTE T ED

PIl\

M.A.,ULULL.M.

ADVOCATESIDDIPET

& NOTARY-502 I03

DIST: SIDDIPET. TETANGAIIA

I

Ce ll:984e 3214221l of13

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PART.B

(11) ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART.A:

ATT

ADVOCATSIDDIPET -502 103

DISTI SIDDIPFT. rrtIUE[UNiellr9S4$3Z1-4?z

%-

1 Name of the candidate Smt. BHAVANI MARIKANTI2 Full postal address II, Near Dhyanahitha High School,

Pragathi Nagar, Bachupally, Medchal - Malkajgiri -500090

Plot 9, Apurupa

J Number and name of the constituencyand State

, TELANGANA STATE33-SIDDIPET

4 political party which set upthe candidate'Independent')

(otherwise writeName of the GANA JANA SAMITHI PARTYTELAN

5 Total number of pending criminal cases NIL

6 Total number of cases in whichconvicted

NIL

PAN of Year for which lastincome Tax returnfiled

Total income shown

(a) Candidate BRUPM6827P 2017-2018 Fls.4,78,692(b) Spouse AYVPM4349M 2017-2018 Rs. I1,78,443

7

8

nt-ISpouse

Details of Assets and Liabilities inSelfDescription Depe

ndent-II

A. Moveable Assets(Total value)

Pis. 1,01,45,2321-&

{UD73,8521-

Rs. 55,02,804/-&

AUD 91,676/-

NIL NIL

B. Immovable Assets NIL NILI. Purchase Price of

self-acquiredimmovableproperty

Rs.39,96,000/-&

LUD 2,37,5001-

Rs.56,33,250/-&,

AUD 2,37,5001-

NIL NIL

II. Development/construction costof immovableproperty afterpurchase (ifapplicable)

Rs.78,00,000/- 60,50,000/-

['NIL

ru ApproximateCurrent marketprice-(a) self-acquiredassets (TotalValue)(b) inheritedassets (TotalValue)

Rs. 1,90,10,000/- which

,20,000/- jointly

3,12,5001- which is% of AUD 12,50,000/

50% ofRs.

&.1,45,10,000/- which is

0% of Rs. 2,90,20,0001-held properties)

3,12,500A which isofAUD 12,50,0001-

1,82,03,000from Non

Land +

&

NIL

9 Liabilities(i) Government dues

(Total)NIL NIL

(ii)

T E DII-\btiJLUII.1.M. lll'aov lll

M.A.,

38,89,090/-

I,78,254/-(Total)

&and

Loans from Bank,inancial

Rs.33,15,080/-&

AUD 1,79,2541-

NIL

Page 12 of13

(c) Dependents NIL NIL

Depende

NIL NIL

Page 13: INDIA - siddipet.telangana.gov.insiddipet.telangana.gov.in/wp-content/uploads/2018/11/14-MARIKANTI-BHAVANI-TJS... · FORM 26 (See Rule 4A) AFFIDAVIT o\ by Filed by the candidate along

are underLiabilities(i) Govemment dues

otal

10.

(ii)

others otal

Loans from Bank,FinancialInstitutions and

ll

Bachelor of Engineering (Mechanical)from University College of Engineering,

Osmania University Hyderabad during lggg -2002

Highest educational qualification:

VERIFICATION

I, the deponent, above named, do hereby verifr and declare that the contents of this affrdavit 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 initems 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 l0 of part B above.

verified "t...Si.d,d;.Pq* .....this trr" L-6.lHl\?..day or.

I

DEPONENT

#iffiffff#iffiEntered in NotariarRegister Sl. No ,\\ b\Date'il o iloy ?olg

DVOCATE &SIDDIPET.5

DIST:

ET-r sA

NNAPIN A YA

20 1SIDOIPE'

4 229a49Cel

Page 13 of13