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ANNEXURE - I

AFFIDAVIT

I...

EFORE THE RETURNING OFFICER FOR ELECTION TO THE ANDHRA PRADESH

ASSEMBLY FROM 015 YELLAREDDY CONSTITUENCY

I, TUDUM RAM KISTAIAH son of DURGAIAH, aged 30 years, Residing of Resident

o Wariguntham, Mandai Kulcharam, Dist. Medak, candidate at the above election, do

ttrebY solemnly affirm and state on oath as under;

lTTESTEO1 ( · J:-: L~ ~\\,

K. SHIVA CHARANM.A; LL.M.

ADVOCt. TE & NOTARYSIDD1PET.5021 03, (A.P.)

Phone: 222275.Cell' 9849341518

Contd. 2nd

2.

Page 2

the following cases are pending against me in which congnzance taken

i. Section of the Act & description of the offence for

which congnizance taken Nill

ii.

iii.

iv.

The Court which has taken congnizance Nill

Case No. Nill

Date of Order of the Court taking congnizance Nill

Detail of appeal(s)japplication(s) for revision, etc., if any filed

against above order taking congnizance. Nill

v.

That I give herein below the details of the assets (immovable, movable bank

balance, etc.,) of spouse my deponents and my self.

4, T~ESTEn(,....-- ~\N\'

K SHIVA CHARAtIv • M.A: LL M.ADVOC.c. TE & OT ARY

SIDOIPF:1·S()2 103, (~p.)PnGne' 222275.

(".:11' qR..J9~41518

Contd. page 3...

,

Page 3

A. DETAILS OF MOVABLE ASSETS(Assets in joint name indicating the extent of joint ownership will also have to be

given)

S.Description Self Spouse Name

Dependent 1 Deponent 2 Deponent 3No. Name Name etc. Name1 Cash Rs. 20,000/- - - - -

Deposits inBanks, Financial

2 Institutions and -Nil- -Nil- -Nil- -Nil- -Nil-Non BankingFinancial ..CompaniesBonds,

3 Debentures and -Nil- -Nil- -Nil- -NiI- -nu-Share inCompaniesOther financial

4 instrument NSS, -Nil- -Nil- -NiI- -NiI- -Nil-Postal Saving LIC,Policies etc.,Motor Vehicles

5 (details of make, -rcn- -nn- -Nil- -Nil- -Nil-etc.,)Jewellery (Give 20 gramsdetails of weight Gold and

6 and value) -NiI- Silver Worth -Nil- -Nil- -Nil-of

Rs.35,OOO/-Other assets,

7 such as values of -Nil- -Nil- -Nil- -Nil- -NiI-claims/interests

Note: Value of Bonds/Shares/Debentures as per the latest market value in stock Exchange inrespect of listed companies and as per books in the cases of non listed companies should begiven.

*Dependent here means and person substantially dependents on the income of the candidate.

Contd. Page 4rd ...

iJl A, LL.~•.

C~'T,~ & QTARYL) ,~- AP)CYJ1,-·-T.5 2103. ( ..

• I Pncne 222275,CeIL 9 49341518.

•.

Page 4

B. DETAILS OF IMMOVABLE ASSETS(Note: Properties in joint ownership indicating the extent of joint ownership will also have to be

indicated)

S.Description Self Spouse Dependent 1 Deponent 2 Deponent 3

No. Name Name Name etc. Name1 Agricultural land - Sy.No.121/42,

location - survey 425 extent ofnumber - extent AC.2-00(Total situated at -uu- -NiI- -Nil- -nn-measurement) WarigunthamCurrent Market village ofValue Kulcharam

Mandai2 Non-Agricultural

Land - LocationSurvey Number -Extent (Total -Nil- -nu- -NiI- -Nil- -Nil-Measurement) -Current MarketValue

3 Buildings(Commercial andresidentialLocation(s) -Survey/Door -Nil- -NiI- -nu- -nu- -NiI-Number(s) Extent(TotalMeasurement) -Current MarketValue

4 Houses/apartment,etc., location(s) -Survey/DoorNumber(s) -

-Nil- -Nil- -Nil- -Nil- -nn-extent (TotalMeasurement) -Current MarketValue

5 Others (such asinterest in -Nil- -Nil- -Nil- -Nil- -Nil-property)

lATTESTF.n!~ S',..'~c~l~N, . tv1.A; LL.M.

i\OVOCATE & NOTARYSIDDIPET-5021 03, (A.P.)

Phone: 222275.Cell: 9849341518.

Contd. Page S'd ...

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Page 5

3. I give herein below the details of my liabilities/overdue to public financial institutionsand Government dues.

(Note: Please give separate details for each item)

s. Name and Address ofAmount outstandingDescription Bank/FinancialNo.

institution( s)/Depa rtment( s)as on 30.03.2010

1 (i) Loans from Bank -nu- -Nil-(ii) Loans from Financial -Nil- -nn-Institutions

•..

(Ill) Government Dues -nn- -nu-a) Dues to departments

dealing with -NiI- -Nil-governmentaccommodation

b) dues to departments -NiI- -nu-dealinq with waterc) Dues to departments

dealing with supply of -nn- -nu-water

d) Dues to departments -nu- -NiI-dealinq with telephonee) Dues to departments

dealing withgovernment transport -NiI- -nu-(including aircraftsand helicopters

f) Other dues, if any -nu- -Nil-(b) (i) Income Tax including

Surcharges (alsoindicate theassessment year upto -nu- -uu-which Income taxReturn filed. Give alsopermanent AccountNumber (PAN)

(ii) Wealth Tax (alsoincluding theassessment -nu- -NiI-year upto whichIncome Tax returnfiled)

(iii) Sales Tax (only incase of proprietary -NiI- -nu-Business)

(iv) Property Tax -Nil- -Nil--TEDT1'1-flv

I . SH!V:\ <..>" .1/1/1 '. r

r,DVOCJlTE & NO I AI~Y.SIDDIPET ·502103. (A.P.)

Phone: 222275,Cell: 984934151

Contd. Page 6rd...

-'.l\~

Page 6

4. My education qualifications are as under

(GIVE DETAILS OF SCHOOLAND UNIVERSITY EDUCATION)

1. SSC ZPHS Rangampet, Kulcharam MandaI.

(Name of School/University and the year in which the Course was completed

should also be given)

,.~Ji~DEPONENT

VERIFICATIONS

I, the above named deponent, do hereby verify and declare that the contents of

this affidavit are true and correct to the best of my knowledge and belief, no part of it is

false and nothing material has been concealed there from.

Verified at Siddipet this the 6th day of June, 2010.

'\.

DEPONENT

"

•.

C!.OO~L"'~~ 3ffil~ ANDHRA PRADESH~. No ~?~.UQ1ee ..~.~--. ~.~~~~ ~V th @~ ~,7~Yrf (LJ C(\. ~ f V"'') - USold To ..., ·.f· •••.••••••••••••••.

ANNEXURE - I

~ I, TUDUM RAM KISTAIAH son of DURGAIAH, aged 30 years, Resident ofWariguntham, Mandai Kulcharam, Dist. Medak, I candidate at the above election, dohtreby solemnly affirm and state on oath as under;

li I am not the accused of any offences purnishable with imprisonment for a periodof two years or more than in a pending case in which a charge has not been framed byt~e court of competent jurisdiction.

If the deponent is accused of any such offence he shall furnish the followinginformation.

Case/FIR No. -- N.A.Police Station -- N.A.Sections of the concerned act and short description of the offence

~

. for which the candidate has been charged~ T T EST..4· Court which framed the Charge -- N.A.

l r. - ~: Date(s) on which the charges (s) -- N.A.C. "(I""-"'""L~hr\t'" Whether all or any or the proceedings (s) have been stayed by any

K. SHIVA c«~~~~.ADVOCATE & ~TARY

SIDDIPET-5021f:3. (A.P.)Plone:222275,

Cell' 98493~ 51 B.

1~.

~:

Contd. 2nd

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,

~OL~~ c3~s. No .....•• ~.26(~r.',

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31isT ~ ANDHRA PRADESH 33AA 319147b~('6"" /~ \."" '-(,1:> i .>: vi<tv.~~..........1: v ~ ()~';~) ~ {) .I

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1;0' ho. Page 2

~ Court(s) of Compentent Jurisdiction .... N.A.2. I have been/have not been convicted of an offences (other than any offences)teferred to in sub-section (2) or convered in sub-sectionm (3) of section 8 of therepresentation of People Act, 1951 (43 of 1951) and sentenced to imprisonment for~ne year or more. .If the deponent is convicted and punished as aforesaid, he shall furnish the followingnformation.

l.

f·3.f·

Case/FIR No. .. ..N.A.Court(s) which punished N.A.Police Station. . N.A.Sections of the concerned act and short description of theoffence for which the candidate has been charged N.A.On which the sentences was pronounced N.A.Whether the sentence have been stayed by anycourt(s) of competent Jurisdiction .... N.A.

lTTE.~Tpn('rf-- ~l?{hl

K. SHIVA CHA~ANADVOCATE 8. ~tf.~~.~.

SIDDJPET-S02103, (A.P.)Phone: 222275

Cell: 9849341518.

~..a~The Deponent: 06.07.2010

,

VERIFICATION

I, the above named deponent, do hereby verify and declare that the contents ofthis affidavit are true and correct to the best of my knowledge and belief, no part of it isfalse and nothing material has been concealed there from.

Verified at Siddipet this the ih day of July 2010

TE ED

le?-l \K. SHIV~ ~~RAN

M A; LL.M.ADVOC/-ITE & NOTARY

SIDDIPET-502103, (A.P.)Phone: 222275,

Cell 9849341518.

T.l~DEPONENT

,