. ~ ~I~ \~"~\)j/2~~ \ cJl .. \~~~~v

ELECTION TO THE HOUSE OF THE PEOPLESTRIKE OFF PART I OR PART" BELOW WHICHEVER IS NOT APPLICABLE

FORM-2A(See Rule 4)

NOMINATION PAPER

PART·I(To be used by candidate set up by recognized Political Party)

I nominate as a candidate for election to the House of the People from the PUOUCHERRY

ParliamentaryConstituency.

Candidate's Name....... .. .

Father's I Mother's I Husband's Name .

His/Her postal address ..

His/her name is entered t S.No........... in Part No of the electoral roll for

....................................................................*(Assembly Constituency comprised within) Puducherry

ParliamentaryConstituency.

My name is and it is entered at S.No .

in Part No............. of the electoral rolls for *(Assembly Constituency

comprised within) Puduc rry Parliamentary Constituency.

Oate . Signature of proposer

* Score out the words "a~embIY constituency comprised within" in case of Jammu & Kashmir, Andaman & Nicobar Islands,Chandigarfl, Dadra & Nagar Haveli, Daman & Diu and Lakshadweep.

. ----~-------------------------------------

2

PART· II(To be used by candidate NOT set up by recognized Political Party)

We hereby nominate as candidate for election to the House of the People from the

Puducherry Parliamentary Constituency.

Candidate's Name D!.1: t\:..A.:..b..:.!?..U.B.RA ..uB.N'.f\.N /.Father's / MetAeFs/ Husband's Name M..:.f.\.: ..b..H.f'..N.MU.l.st8M/

His/Her postal address ..~9.:.~.?..I 2?~ Cr.M!>..1. /. ..

.........1~ M.~ Rro.d ..r VOJDx.\ ~.~m(

...........~~.?~ ( .f.~m.~'D.':J..~.b.Q5. 0~

.............................................7- / .HisJl.lernarntered at S.No.J~.'h in Part No lb. of the electoralroll for

.......\.l.-:-: ..K.~.h..f\?.~.'I *(Assembly Constituency comprised within) Puducherry

Parliamentary Constituency.

We declare that we are electors of the above Parliamentary Constituency and our names

are entered in the electoral roll for that Parliamentary Constituency as indicated below and we append our

signatures below in token of subscribing to this nomination:-

Particulars of the ro osers and their si natures.

SI.No. Date

Electoral Roll No. ofro oserName of component

AssemblyConstituency

SignatureFull NamePart No.of S.No.Electoral in that

Roll Part

(1)

1.2.3.4.5.6.7.8.9.10.N.B.:- There should be ten electors of the Constituency as proposers.

* Score out the words "assembly constituency comprised within" in case of Jammu & Kashmir, Andaman & Nicobar Islands,Chandigam, Dadra & Nagar Haveli, Daman & Diu and Lakshadweep.

3

PART·III

I, the candidate mentioned in ~I/Part II (strike out which is not applicable) assent tothis nomination and hereby declare -

61(a) that I am a citizen of India and have not acquired not acquired the citizenship of any foreign State orCountry.

(b) that t havecompteted .1,Z, ~ age.

••,r-

(STRIKEOUT c(i) or (ii) BELOWWHICHEVERISNOTAPPLICABLE).

(C) (i) that I am set up at this election b party, which is recognizedNational Party/State Party in . tate and that the symbol reserved for the above party beallotted to me.

. . (~R~I(K1'tL N¬ G"OItI MA I1\1'\ /(ii) that I am set up at this election by the party, which IS a reqistered-

unrecognized political party / tRat I am contestiflg this electie)fi as an independent eandidate

(strike out which is not applicable) and that the symbols I have chosen, in order of preference,

are:- i31\icre42... '1 /(.)} ()Re.. H-: . . (") ("')I : ..; ..:...' II III .

(d) that my name and my father's/mother's/husban/ame have been correctly spelt out above in

~.N.lf.l.~\.$..\i......(name of the language);

(e) that to the best of my knowledge and belief, I am qualified and not also disqualified for being chosen

to fill the seat in the House of the People

*1 further declare that I am a mem~ the **Caste/tribe which is a

scheduled **caste/tribe of the State Of ~ in relation to (area) in that State.

I also declare that I have not been, and shall not be nominated as a candidate at the

than two Parliamentary Constituencies.

O .2-1, 03· 201C1 -:ate............................. /'

••

Inserted vide Notification No.S.O1133(E)dated 7.4.2017of Ministry of Law & JusticeScore out this paragraph, if not applicable.Score out the words not applicableA "recognized political party" means a political party recognized by the Election Commission under theElection Symbols (Reservation and Allotment) Order, 1968in the State concerned.

N.B.:-

4

cepART IIIA(To be filled by the candidate)

(1) Whether the candidate -(i) has been convicted -

a) of any offence(s) under sub-section (1); orb) for contravention of any law specified in sub­

section(2) of section 8 of the Representationofthe PeopleAct, 1951 (43 of 1951);or

(ii) has been convicted for any other offence(s) for which hehas been sentenced to imprisonment for two years ormore

If the answer is "Yes", the candidate shall furnish the following information:(i) Case/First Information Report No./Nos:-, Ntst a..wli ~tt_

'¥es-/ No V

(ii) Police Station(s):- ~ot ~JJ e,o._}JtL_

District(s):- N~ ~pAi c.Qbh-

State(s):- N~ ~U~Q_(iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has

been convicted:- N~ Cl.({J"t( c_o._btQ_

(iv) Date(s) of conviction(s):-, ~ (.l(l>MtO...kJLL

(v) ~L1- n 11'1"'11.' CJl.,b.U_Court(s) which convicted the candidate:- \\D \ '"" '\ y>J\

(vi) Punishment(s) imposed [indicate period of imprisonment(s) and / or quantum of fine(s)]:- ~ arrhG-hb(vii) Date(s) of release from prison-

(viii) Was/were any appeal(s)/revision(s) filed against above conviction(s) : ¥eslNo~(ix) Date and particulars of appeal(s)/application(s) for revision filed- NJ- ~ co...bU-

(x) Name of the Court(s) before which the appeal(s)/application(s) for revision filed.- N~ Of{1ltca.bLL(xi) Whether the said appeal(s)/application(s) for revision has/have been disposed of or is/are

pending:- ti'* ~~(xii) If the said appeal(s)/application(s) for revision has/have been disposed ot-

a) Date(s) of disposat-

b) Nature of order(s) passed-

(2) Whether the candidate is holding any office of profit under the Government ofIndia or State Government?If Yes, details of the office held-

(3) Whether the candidate has been declared insolvent by any Court ?If Yes, has he been discharged from insolvency:-

Yes/NoV

¥es/N~

5

(4) Whether the candidate is under allegiance or adherence to any foreign country?If Yes, give details:-

(5)' '. 'Whether the candidate has been disqualified under Section 8A of the said Act byan order of the President?If Yes, the period for which disqualified:: "

;. _,.... ~

(6)I -) •

.... '-' .. ; j'

Whether the candidate was dismissed for corriJp'ti'onor for disloyalty while holdingoffice under the Government onRdia or the)Sovemment of any State? .'If Yes.fhe date of such dismissal:- ~<;.......:.'" .• t.....~ ,- , f •

-, '01 , • ,

(7)t-:"...-e,

Whether the candidate has any subsisting contractts) with the Government eitherin individual capacity or by trust or partnership in which the candidate has a sharefor supply of any goods to that Governmentor forexecunon of works undertakenby that Government?If yes, with which Government and details of subsisting contract(s):-

(8) Whether the candidate is managing agent or manager or Secretary of anycompany or Corporation (other than a cooperative society) in the capital of whichthe Central Government or State Government has not less than twenty-fivepercent share?If Yes, with which Government and the details thereof:-

(9) Whether the candidate has been disqualified by the Commission under Section10A of the said Act?If Yes, the date of disqualification:-

¥es/No ~

'fe5/No ~

~/No~

¥as/Nov-

¥¬ ssINo~

~s/No~

Place: PVOJc...8Ee(C 'iDate: ).. 1-. 0 ~ .1J) \ ~

6

PART IV(To be filled by the Returning Officer)

Serial No. of Nomination paper ...Qlt... 9. ". I . Jj JM1 11M ~R ..oJ1

ThISnomlnetion was delivered to me at my office at ')~':""""""I.(hour) on (date) by

7 2 MAR 2019Oate .

* Score out the words not applicable

PARTV

DECISION OF RETURNING OFFICER ACCEPTING OR REJECTING THE NOMINATION PAPER

I have examined this nomination paper in accordance with section 36 of the Representation of the

PeopleAct, 1951 and decide as follows:-

Oate .. Returning Officer

INDIA NON JUDICIAL

Government of Puducherry

e-Stamp

. Certificate No.Certificate Issued DateAccount ReferenceUnique Doc. ReferencePurchased byDescription of DocumentProperty DescriptionConsideration Price (Rs.)

IN-PY3104129I341783R21'-Maf-201'9~~5flPM" .IMPACC (SH)/ pyshimp17/ PUDUCHERRY/ PY·PUSUBIN·PYPYSHIMP1750961683905133RDr MAS SUBRAMANIANArticle 4 AffidavitAFFIDAVITo(Zero)Dr MAS SUBRAMANIANRO ELECTION COMMISSION OF INDIADr MAS SUBRAMANIAN20(Twenty only)

First PartySecond PartyStamp Duty Paid ByStamp Duty Amount(Rs.)

. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ••••••• -. - •- ... Pleasewrite or type below this line- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --

0001421725

Statutory Alert:1 The authentICity 01 this Stamp Certificate shOuld be ver fied al "wv1W.shcilestamp.com" Any discrepancy in the details on this Certificate and as

available on the website renders H Invalid.2 Th.. nn", of c~eckin9 lhe leQltimacy is on the users of the certificate.3 In case of any discreoancy please Inform the Competent Aulhonty

FORM- 26(See rule 4A)

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH NOMINATION PAPER

BEFORETHE RETURNING OFFICER FOR ELECTION TO THE PARLIAMENTARY

HOUSEFROM PUDUCHERRYCONSTITUENCY

PART-A

I, Dr. M.A.S. SUBRAMANIAN, S/o M.A. Shanmugam, aged 72 years, resident of

No.83, 3rd Cross, 2nd Main Road, Vasan Nagar, Lawspet, Puducherry - 605 008, a

candidate at the above election, do hereby solemnly affirm and state on oath as

under:-

1. I am a candidate set up by MAKKAL NEEDHIMAlAM

2. My Name in enrolled in 12-KALAPET, PUDUCHERRY,at serial No.342 in

Part No.22.

3. My contact telephone number(s} is 9443380111, and my e-mail ID is

dr.mas123@gmail.com and my social media accounts are

(i)

(i i)

Mas Subrmanian (Face book account)

9443380111 (whatsApp)

/

2

4. Details of Permanent Account Number (PAN) and Status of filing of Income

Tax return:-

51. Name PAN The financial Total Income shown in

No. year for which Income - Tax return

the last Income (in Rupees) for the last

Tax return has five Financial Years

been filed completed (as on 31stMarch)

1 Dr.M.A.S.Subramanian AAVPS4913K 2017-2018 2013-2014 l,17J4,433(Self)

2014-2015 1,39,09,107

2015-2016 95,44,193

2016-2017 45,06,015

2017-2018 25,01,769

2 S.Santhi (Spouse) AURPS5504N 2017-2018 2013-2014 18,30,829

2014-2015 64,297

2015-2016 -NIL

3,20,4112016-2017

2017-2018 -NIL-

3 S.Suresh AZSPS4366A 2017-2018 2013-2014 3,06,293

(Dependent)2014-2015 5,31,929

2015-2016 8712

2016-2017 759

2017-2018 932

S. Pending Criminal Cases~ I declare that there is no pending criminal case against me. /

~~ J.:.)ff. '. (Tick this alternative if there is no criminal case pending against the

~

., C'~Y.~C)0.~ \l~candidateand write NOTAPPLICABLEagainst alternative (ii) below)v ~ ""'\ it:7; 00' \ ("5:2 (OR),~<;'o . --4Y The following criminal c~es are pending against me Not ltPp,(J CD.h{.a__~1~~~~;_~'(If there are pending cJrll'rnal cases against the candidate, then tick

this alternative andr: off alternative (i) above, and give details of

all pending cases1h.::theTable belO~ . ".

~

3

Table

(a)FIRNo. with name and address of Police Station Not Applicableconcerned

(b) CaseNo. with Name of the Court Not Applicable

Section(s} of concerned Acts/Codes involved(c) (give no. of the Section, e.g., Section .......of IPC, Not Applicable

etc.)

(d) Brief description of offence Not Applicable

(e) Whether charges have been framed (mentionYESor NO)

Not Applicable

(f) If answer against (e) above is YES,then give thedate on which charges were framed

Not Applicable

Whether any Appeal/Application for revision(g) has been filed against the proceeding (Mention Not Applicable

YESof NO)

6. Casesof Conviction ~(i) I declare that I have"beenconvicted for any criminal offence

(Tick this alternative, if the candidate has not been convicted and write NOTAPPLICABLEagainst alternative (ii) below)

(il) I have been convicted for the offences mentioned below: No{ a.pp.lL~(If the candidate has been convicted, then tick this alternative and score offalternative (i) above, and give details in the Table below \

~,

4

Table

(a) CaseNo. Not Applicable

(b) Name of the Court Not Applicable

Section(s)of Acts/Codes involved (give no. of theNot Applicable(c) Section, e.g., Section.......of IPC,etc.)

(d) Brief description of offence for which convicted Not Applicable

(e) Datesof orders of conviction Not Applicable

(f) Punishment imposed Not Applicable

(g) Whether any Appeal has been filed against convictionNot Applicableorder (Mention YESof NO)

If answer to (g) above is YES,give details and presentNot Applicable(h) status of appeal

(6A) I have given full and up-to-date information to my political party about all pending criminalcasesagainstme and about all casesof conviction asgiven in paragraphs (5) and (6)

1. Candidate is responsible for supplying all information in compliance of compliance ofHon'ble SupremeCourt's judgment in W.P (C) No.536 of 2011

7. That I give herein below the details of the assets. (m,0rKe and immovab~eetc.) of

myself, my spouse and all dependents: ~,~~ I

~

;

5

A. Details of Movable Assets:

PuducherryCancer Trust

Rs.97,1O,OOO/-

Dependent51.No. Description Self Spouse

Rs.4S000/-

Details of deposit in l)Puduvai l)Union Bank of 1) Axis Bank

Bank accounts (FDRs), Bharathiar Grama India Rs.1860/- Rs.40000/-

Term Deposits and all Bank Rs.8,200/- 2)Punjabother types of deposits National Bankincluding Saving 2)Union Bank of Rs.9267/-Accounts Deposits with

India Rs.4,167/-

Financial Institutions, 3) Indian Bank (4Non-Banking Financial Accounts)Companies and Co- Rs.1,18,048/-operative Societies andthe amount in each 4) Union Bank (FDR)

such deposit Rs.2,SO,OO,OOO/-

Details of Investment in 1) Pixie Dust Puducherry Puducherry

Bonds, Partnership Medical Services Medical Services

debentures/shares and Investment LLPRs.lO,OOO/- LLPRs.10,OOO/-

units in Companies / Rs.7,00,00,000/- share share

Mutual funds and other 2) Religareand the amount Commodity Ltd

Rs.S2,980/-3) PuducherryMedical Services LLPRs.10,000/- share

Rs.48000/-

Geetha Pharma Puducherry Puducherry1,20,00,000/- Cancer Trust Cancer TrustSwapna Rs.1,00,000/- Rs,tOO,OOO/-MathivananRs.1,00,00,000/-

(i) Cash in hand

(ii)

(iii)

(iv) Details of investment in

NSS, Postal Saving,Insurance Policies andInvestment in anyFinancial instruments

in Post Office orInsurance Company and

the amount

(v) Personal loans / 1)advance given to anyperson or entity 2)including firm,company, trust etc.,and other receivables 3)from debtors and theamount

-NIL- -NIL-

LlC Insurance

PolicyRs.10,00,000/-

6

(vi) Motor Vehicles / Aircrafts / Yachts Honda City Car Honda Amaze

/ Ships. (Details of Make, (2015) PY-01-CG (2013), PY-01-registration number etc., year of

-NIL-1596, BY-6321,-

purchase and amount) Rs.ll,98,OOO/- Rs.6,04,460/-

(vii) Jewellery, bullion and valuable 80grms Rs.2,OO,OOO/-96grms 40grmsthing(s) (Give details of weight and Rs.1,92,OOO/- Rs.1,OO,OOO/-value)

(viii) Any other assets such as value of -NIL- -NIL- -NIL-claims/interest

(ix) . Gross Total value Rs.12,72,28,,395/- Rs.15,59,127/- Rs.18,99,460/-

A. Details of Immovable Assets:SI.No Description Self Spouse Dependent

(i) Agricultural Land:Uppuvellore -NIL -NIL-

Location(s) & Survey numbers77/2,77/3

Area (Total measurement in acres) -NIL -NIL-2 acre 60 cent

Whether inherited property? (Yesor No.) -NIL -NIL-No

Date of purchase, in case of self-acquired -NIL -NIL-property 08-06-2015

03-08-2015

Cost of land (in case of purchase) at the Rs.7,36,710/- -NIL -NIL-time of purchase Rs.97,200/-

Any investment on the land by way ofdevelopment, construction etc.,

-NIL -NIL- -NIL-

Approximate current market value -NIL- -NIL-Rs.9,OO,OOO/-

~,~ow~V@LO~J) ~ W" ~

7

(ii) Non-agricultural land:

(a) Location(s) & Survey numbers Kumarapettai Thavalakuppam -NIL-Cuddalore Puducherry146/6, 145/8, 146/4, 8/4146/5,37/2

Area (Total measurement in acres) 2 Acre 64 cent 17856Sq.ft -NIL-

Whether inherited property? (Yes or No No -NIL-No.)

Date of purchase, in case of self-acquired 25-09-2000 02-09-2011 -NIL-property 29-08-2001

Cost of land (in case of [purchase) at the 71,522/- 9,97,142 -NIL -time of purchase

Any investment on the land by way of No No Nodevelopment, construction etc.,

Approximate current market value 20,00,000 22,00,000 -NIL-

SI.No Description Self Spouse Dependent.(b) Location(s) & Survey Numbers Thazhamboor, Thavalakuppam -NIL-

Chenna! Puducherry116/180

8/4, 7/2, 17/2/2/2

Area (Total measurement in acres) 28 cent 100730Sq.ft -NIL-

Whether inherited property? (Yes or No No -NIL-No.)

Date of purchase, in case of self-acquired 05-03-2012 02-09-2011 -NIL-property

Cost of land (in case of [purchase) at the 66,53,570 52,11,250 -NIL-time of purchase

Any investment on the land by way of No Nodevelopment, construction etc.,

-NIL-

Approximate current market value 2,24,00,000 60,00,000 -NIL-

1>-

. ~,~Jv®Jaw' ,, , I. ' .~~~~~4

8

(c) Location(s) & Survey Numbers Anumanthai Village Thavalakuppam -NIL-Marakkanam TK, PuducherryVizhupuram Dist.

354/5,7,8,9,10,11 7/2

356/1, 1, 273/21,277/14,15

Area (Total measurement in acres) 7.50 ~ acre 12100 Sq.ft -NIL-

Whether inherited property?(Yes or No.) -NIL No -NIL-

Date of purchase, in case of self-acquired 22.11.2016 16-07-2012 -NIL-property 29.11.2016

12.07.201812.10.2018

Cost of land (in case of [purchase) at the 1,29,00,375 7,03,697 -NIL-time of purchase 26,25,935

15,54,3601,66,700

Any investment on the land by way of -NIL- Nodevelopment, construction etc.,

-NIL-

Approximate current market value 1,75,00,000 10,00,000 -NIL-

Location(s) & Survey No.(s) Golden Avenue, Vasan Nagar, -NIL-Neyambakkam village, Lawspet, PuducherryThiruvalluvar Taluk 78/2A/10/A/l/2

202/2 & 202/1CArea (Total measurement in acres) 2900 sq.ft 1500 Sq.ft -NIL-

Whether inherited property? (Yes or -No- Na -NIL-No.)

Date of purchase, in caseof self-acquired 22.05.1998 22-10-2012 -NIL-property

Cost of land (in case of [purchase) at the 19,695 23,63,952 -NIL-time of purchase

Any investment on the land by way of No Nodevelopment, construction etc.,

-NIL-

Approximate current market value 9,00,000 30,00,000 -NIL-

\ rtlA r\ l\.~

"OVIN./) "'"rJ-~\IV

9

SI.No Description Self Spouse Dependent

(e) location(s) & Survey No(s) -NIL- St. Theresa Street, -Nll-Puducherry - 83,84

Area (Total measurement in Sq.ft) -NIL 10478Sq.ft -Nll-

Whether inherited property? (Yesor No.) -NIL No -Nll-

Date of purchase, in case of self-acquired -NIL 29-08-2012 -Nll-property 06-02-2013

Cost of Property (in case of [purchase) at -NIL 4,18,77,620 -su-the time of purchase

Any investment on the land by way of -NIL Nodevelopment, construction etc.,

-Nll-

Approximate current market value -NIL 6,00,00,000 -sn-

(f) location(s) & Survey No(s) -su- Mission Street, -Nll-Puducherry

T.S.No.16

Area (Total measurement in acres) -Nil 1656 Sq.ft -Nll-

Whether inherited property? (Yesor No.) -NIL No -Nll-

Date of purchase, in case of self-acquired -Nil 27-01-2012 -su-property

Cost of land (in case of [purchase) at the -Nll- 69,88,577 -Nll-time of purchase

Any investment on the land by way of Nodevelopment, construction etc.,

-su- -su-

Approximate current market value -NIL 1,00,00,000 -su-

10

(iii) Commercial Buildings {Including AQQartmentsl:

(a) Location(s)& Survey No.(s) Bazar Saint Laurant Needarajappaiyar -NIL-

Street, puducherry Street, Puducherry

31 T.S.No.152, R.S.No.239

Area (Total measurement in Sq.ft) 8877Sq. Ft 3174 Sq.Ft -NIL-

Built-up area (Total measurement in Sq.ft.) Huts 3000Sq. ft. -NIL-

Whether inherited property? (Yesor No.) No No -NIL-

Date of purchase, in case of self-acquired 22-10-2007 08-11-2011 -NIL-

property

Cost of Property (in case of [purchase) at 91,81,626 2,19,88,687 -NIL-

the time of purchase

Any investment on the Property by way of 3,00,000 No

development, construction etc., -NIL-

Approximate current market value 6,50,00,000 2,50,00,000 -NIL-

(iv) Residential Buildings {Including AQQartments):

(a) Location(s)& Survey No.(s) Vasan Nagar, Puducherry Candappa Street, -NIL-Puducherrv

78/2A/10A1/1, 78/2 T.S.No.14

R.S.No.239pt

Area (Total measurement in Sq.ft) 10,500 Sq.ft 2776 Sq.ft -NIL-

Built-up area (Total measurement in 6000 sq.ft 2500Sq. ft. -NIL-

Sq.ft.)

Whether inherited property? (Yesor No.) No No -NIL-

Date of purchase, in case of self-acquired 03-09-1998 11-08-2011 -NIL-

property 05-07-199923-11-2000

Cost of Property (in case of purchase) at -NIL-

the time of purchase 40,62,2881,05,07,977

Any investment on the land by way of No 80,00,000

development, construction etc., -NIL-

Approximate current market value 2,00,00,000 1,90,00,000 -NIL-

- ~~_Ja«~~'\.~D~~o ,,~

11

(b) Location(s) & Survey No.(s) Thorapakkam, Chennal -NIL- -NIL-

109/3

Area (Total measurement in Sq.ft) 1128Sq.ft -NIL- -NIL-

Built-up area (Total measurement in 1000 sq.ft -NIL- -NIL-

Sq.ft.)

Whether inherited property? (Yes or No -NIL- -NIL-

No.)

Date of purchase, in case of self- 09-10-2012 -NIL- -NIL-

acquired property

Cost of Property (in caseof purchase) at 75,22,735 -NIL- -NIL-

the time of purchase

Any investment on the land by way of -NIL- -NIL- -NIL-

development, construction etc.,

Approximate current market value 80,00,000 -NIL- -NIL-

(v) Others (Such as interest in No No No

property

(vi) Total of current market 13,67,00,000 12,62,00,000 -NIL-

value of (i) to (v) above..

/~\~,

"

12

8. I give herein below the details of liabilities / dues to public financial institutionsand government:-

SI.No. Description Self Spouse Dependent(i) Loansor dues to Bankl Financiallnstitution(s}:-

(a) Name of the Bank / -NIL- -NIL-Financial institution(s) Indian Bank

Amount outstanding -NIL- 7,57,353 -NIL-

Nature of Loan ~NIL- Mortgage -NIL-

(b) Name of Bank / Financial -NIL- -NIL-institution(s) Union Bank

Amount outstanding -NIL- 2,80,63,477 -NIL-

Nature of Loan -NIL- Mortgage Loan -NIL-

Loanor dues to any otherindividuals / entity otherthan mentioned aboveName(s),Amount -NIL- -NIL- -NIL-outstanding, nature of loan

Any other liabilities .-NIL- -NIL- -NIL-

GrandTotal of Liabilities -NIL- 2,88,20,830 -NIL-

13

(ix)

(ii) Government dues: Dues to (A) Has the Deponent been in occupation of

Departments dealing with accommodation provided by the Government

Government at any time during the last ten years before

accommodation the date of notification of the currentelection?(8) If answer to (A) above is YES,the followingdeclaration may be furnished namely:-(i) The address of the Governmentaccommodation ......................................(ii) There is no dues payable in respect ofabove Government accommodation,towards:-

(a) Rent(b) Electricity Charges(c) Water Charges and(d) Telephone charges as date .....

[The date should be the last date of the thirdmonth prior to the month in which theelection is notifies or any date thereafter]Note- 'No Dues Certificate' from the agenciesconcerned in respect of rent, electricitycharges, water charges and telephonecharges for the above Governmentaccommodation should be submitted

(i ii) Dues to department dealingwith Government transport .- "-10 -(including aircrafts andhelicopters)

(iv) Income Tax dues

Self Spouse Dependent

-NIL- -NIL- -NIL-

-NIL- -NIL- -NIL-

-NIL- -NIL- -NIL-

-NIL- -NIL- -NIL-

-NIL- -NIL- -NIL-

(v) GSTDues

(vi) Municipal/Property Tax dues

(vii) Any other dues

(Viii) Grand Total of all Government dues

Whether any other liabilities are indispute, if so, mention the amountinvolved and the authority before whichit is pending

-NIL- -NIL- -NIL-

-NIL-

-NIL-

14

9. Details of profession or occupation(a) Self Business(b) Spouse Business

(9A). Details of Sources of Income:

(a) Self Business(b) Spouse Business(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 dependent have interest - NIL-(e) Details of contracts, entered into by partnership Firms in which candidate or

spouse or dependent are partners - NIL-(f) 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:M.B.B.S., University of Madras, 1973

PART- B

II. ABSTRACTOF THE DETAILSGIVEN IN (1) TO 10 OF PART- A:

1 Name of the Candidate Dr. M.A.S. Subramanian

2 Full Postal Address No.83, 3rd Cross, 2nd Main Road, Vasan Nagar,

Lawspet, Puducherry - 605 008.

3 Number & Name of the Constituency and Puducherry Parliamentary Constituency

State

4 Name of the Political Party which set upthe candidate (otherwise write

MAKKAL NEEDHIMAlAM"Independent")

5 Total number of pending criminal cases -NIL-

6 Total number of cases in which convicted -NIL-

'/' ~ 1\ ,

~\~D1S Ir}jf,~,~~ ~

• o

15

7 Year for whichlast income tax Total income

PAN ofreturn filed shown

(Financial Year)

(a) Candidate AAVPS4913K 2017-2018 25,01,769

(b) Spouse AURPS5504N 2017-2018 -NIL-

(c) Dependent AZSPS4366A 2017-2018 932

8 Details of Assets and Liabilities (including offshore assets) in Rupees

Description Self Spouse Dependent

A Movable Assets (Total Value) 12,72,28,395 15,59,127 18,99A60

B Immovable Assets

(i) Purchase price of self-acquired4,55,92,716 9,06,38,902 -NIL-

immovable property

(i i) Development /Construction cost ofimmovable property after purchase (if

3,00,000 80,00,000 -NIL-applicable)

(i ii) Approximate current market price -

(a)Self acquired assets (Total Value) 13,67,00,000 12,62,00,000 -NIL

(b) Inherited Assets (Total Value) -NIL- -nu- -NIL-

9 liabilities:-

(i) Government dues (Total) -NIL- -NIL- -NIL-

(ii) Loans from Bank, Financial Institutionsand other (Total)

-NIL- 2,88,20,830 -NIL-

10 liabilities that are under disgute:-

(i) Government dues (Total -NIL- -NIL- -NIL-

(ii) Loans from Bank, Financial Institutions -NIL- -NIL- -NIL-and others (Total)

Highest educational qualifications: M.B.B.S., University of Madras, 1973.

4?~D~ II'I'-Ib. 1'1 ,V ~.t.: IWt., , ' ~~~~~~ ~

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16

VERIFICATION

I, the deponent, above named, do hereby verify and declare that the contents of thisaffidavit are true and correct to the best of my knowledge and belief and no part of it isfalse and nothing material hasbeen concealed therefrom. I further declare that:-

{a} There is no case of conviction or pending case against me other that thosementioned in items 5 and 6 of Part - A and Babove.

(b) I, my spouse or my dependents do not have any asset or liability, other thanthose mentioned in items 7 and 8 of Part - A and items 8, 9 and 10 of Part - Babove.

Verified at Puducherry on this 22nd day of March 2019

~~~

~~,~

O.K. GOVINDf.,-S}Ll\iY, s.se.ru.,Advcc ato & No rary

4, Gang.3i Street I, I"tt--~ '0" J- 'or'"''"'. . I .....a., I...I.! I. ::. I

Puduche rry - GO~)004,En-f No: MS 739/84