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FORM 2 A(See rule 4)

NOMINATION PAPER

Election to the House of the People.

STRIKE OFF PART I OR PART II BELOW WHICHEVER IS NOT APPLICABLE

I iI PART-II

(To be used by candidate set. up by recognized political party)I •

~I

. (Signature of Proposer)

( ";( )

I ,II i iDate ..!. •.•.•......•..•....•... " !' i

! I! !

.:1 I i PART II

l' (To' b~ Js~dlb~ candidate,~o~ set up by recognized political part~)

We herebyn~rin;te ,;, C:;~~idllat, forelectiJ,nt~ ~~ House of the People fro~ the ..~.~.~~.~~1:~~!.?.j: :1 I ! I :! .

.......... j' "i"r'" ·i..··..· , j ; .. 'j' ; ; Parliamentary Constituency.

Candidate's Name ,;....13.HI';/.if ..e.ty ;..~~.r1.(~¢t.~..l!. , : k.~..~1.f.~ .

Failioc's I Mrer'S' I Hiand'si t+(-t~11fti'§I1"",!£),{"":.,(,/~~mmm

ms I ~ Postal AddresSI.i~irto;:():::7Z1('ri,'.!(""~~{;(}?(}~,)'·~{''''''.i'I''.'tI~~.m

.·t1/!.·~~~·~·~·..····(~~·!?.;···!!····f·t··1l!..~1..1J..·;~f·~·~·p···~r··r#··~·ti .

His / ~r name is entered at ~r.~o /.~J'~!..L in Part No /.'1..f? of the electoral roll

for the !!!!..{.~~.~1.~.!.fP.i !.(..(.£(!(r..~.1".f;I! !.~.? (Assembly Constituency comprised

within) ~::~1~.~.~.1..~..1.~~ !.~ Parliamentary Constituency .

,1

I nominate as a candidate for 'election to the House' of the People from the :-\'I :: .

..... ~ ' Parliamentary Constituency . ,\~. ~

Candidate' s Name ~ L J \

i . ~ l'.. j 1

Father's / Mother's ./ Husband's Name t .1 \" 1-··;

i j II I r!His / Her Postal Address 1•••••••••••••••••••••••••••• ...<. •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••.••••••••••• , \

.. ~.. '/ ~mm ..m ! m m m.•.......m.C}i./lVt:. ..m : :.. m m m ................•......................m m m:\ <, \

His / Her name is e,ntered at Sr.. No. : ~.t1- · Part No : of the electoral rollt· '\

f"'mm't\fu~~mm*(ASSemblY C;n;tituency compriSoIf\Wiilii:y:=~;Sr·~;~,:::::H=e::~t ~~n:~::::c:t~\. '. i

Sc No mm m.m :mm m.)d"P'rt No m..mm.m..m.mmm.m.. of ilie e1ectom(roll for : :.:.';m:..mm..m m m.:.:ik~.................................Z, *(Assembly Constituency' comprised within) 4 , '.".•. 1 .•• 4!

..................................•... j ,.............................................................•... p.,arhamentary Constituency. !,,-a,•....

i • ' . ' : ~ .!\ . 4 _i i

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We declare that we are electors of the above Parliamentary Constituency and our names are entered in theroll for that Parliamentary Constituency as indicated below and we "[pend our signatures b~low in token of subslto this nomination :-

Particulars of the proposers and their signatures.

Electoral Roll Number of proposer

SerialNo.

Name of

componentAssembly

Constituency

Part No.of

Electoral Roll

SerialNo. in

that Part

Full Name Signature Date

(3) (7)(6)

~

~f-

~ Ij~f-o

J4~ 7-7-&,....... , ......--

7--7- ~

(5)

{AHl/i.KI{/VArrt

~IV.(J~ £'•..

.s,yt(Z .D~.4~tr'iNA PA-71( A-O

SA L.. VI:

A.7-EE rk."S,l-fZN/f r~c;:..eIJ~M

.2JftAN ~/V.J A Y.su I<. YA BijA/'IVALJMA~£

MAyA,...s:.cP.L) h'''.( r~

·fA-NA.<.e

(4)

3'//.

'160

7

//6

/06

/f~H.eN .z>~A/~.rM-BAX

ZJ~N&-A~ .E

-SUtM'JM~AOV""~~N~-'lO

!/(A~tB~(}..T

£~9: i AI'v:"/j~A V. I 'l(A-7ijA LV/l,IJ-NT

: 7(/PA.SA-I'1IN'h1~

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(2)

7.

6. / () 7 / .Lt,t

~v'¥lll/f-""AA!) UNT~,oJL.I!

/0 7 /,y~ iI,

5. 107 /1'.!..

.J} P/!ANf-Jl/tMIJ C,fqrtf.;J t...

4.

A(J"'I1NG-/jj§~ C-ENT~A'-

3. I 0 ~ J.2 7IJ(JMlVtTrl~/J/) CeNT;:~,!-

2.

Jt lJ",4Jt/ 6-1f~{) ~TI(4'l--

A vl(;JIII~.If!)/tJ> CGvr~L.

/0 7 /"t~ :8.

1/v~~IVH9&41>C~~ll..

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A-V/{A/V;'MA/) C-.f/v/ML

fa ~ J,yo10. !

-4(l,f~N6-I1dltJ) GENi~lL

1. lor; ~()I

AU"~N(h4~Ab C~/VTI(I1'-

(1)

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

, i i i ( 't )Iiij ! :

--= - -~~~~-~~----._--_..

--- I

I

(c)

PART III

I, the candidate mentioned in Part I/Part II (Strike out which is not applicable) assent to this nominatiori ami

declare- "'; .(a) that I have completed 1. years (

[ STRIKE OUT b(i) or b(ii) BELOW WlllCHEVER IS NOT APPLICABLE]

OR

(b)(ii)thot IE. se~: : :':;;'iOO by the {1!~C1.~~'?.'!'Y1..~!.:(q(!~f>'.'!-!..,ij...................~ party h' h .. d ................................................................... , W IC IS a registere -unrecogl1lsed polItical p

that I am conteSkHg t!;lis @l@ctioflas an i~d@fJeRdefttGafldidatc. (Strike out which is not applicable) andthe symbols I have chosen, in order of preference, are :-

. IlAIL w~y ,(~/V&-ZN.t .. cS£W.rNG- /1~CH..£NE ... TEL E V.rSJoN(i) L ; (11) (11 i) .

that my name and my father's / IR~r's / R\lg9:HH!'S name have been correctly spelt out above in &.~.(Name of the language).

(d) that to the best of my knowledge and belief, I am qualified a::d not also disqualified for being chosen tothe seat in the House of the People.

*1 further declare that I am a member of the lj'!!..~-!i..~,••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• 60 ••••••••••••••••••••••••••••• ,;1

** Caste/.tI:ibe which is a scheduled ** caste/ti'ffie of the State of IY../t.!.t.4. ..I1.1:...f...-Y.r.6.1. :.

III relation to !J..'!.1.'.~N..~1.(f.-1:R (area) in that Stat;

I also declare that I have not been, and shall not be, nominated as a candidate at the present general election/:,.~~cctioltS being held simultaneously, to the House of the People from more than two Parliamentary Constituencie§1

Date:

* Score out this paragraph, if not applicable.

** Score out the words not applicable.

N.B.- A "recognized political party" ~eans a political party recognized by the Election Commission under the Election Symbols (ReServati~*'and Allotment) Order, 1968 in the State concerned ...

!

~~) ~ <t>~U'-jI\1 31~ (~) (\Cfff ~ (~) / ~ ~ mEYIT <t>1q,U'-jI\1 ~ (3iTfIT) 311t

. (~) fcf>crr <f (ill) ~ ~ (~) fcf>crr ~

,(onn) \rR ~ <t>~U'-jI\1 ~ (~) (\Cfff ~ (311fu;f) / ~ ~ Rcnrffi <t>1q,U'-jI\1 ~ (31Tffi-)

~cYf w-

I IIif:~I

•••

tit

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..", (~)

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:-----,d-~--·-------- .. '0 -. t ..---.,...--,--....---.~--..-.,...II II i I

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';~)~\1fdf-i-cfuq ~, ~~~~ un ~ ~~ 3f1BR" -m ~ -i11·1f-i~~1-i4::1~ ~ ~ f.::ruf<r (91~I~W'IIUI

Affidavit to be furnished by the candidate before the

•• 2

(Nameof House)

•• FeRI>:! 26 ••

(Seel Rule 4A)

..-oath as under

Returning officer for

El ect'i on to •..tf.1 : .'!~/!1:''! .

at the above elect ion, do hereby sol ernn ly affirm/state on

i

/} {)A~Wr;/J~AIJ ...from•••••• --I ••• / •••••••••••••• (Name0 f Const J.tuency) Const J.tu

I. #:~f!'1.S.'i~;.1?~.6.t::~:.{~~~.(:fon/d:lUgbter/WifO o1:~~~;/d.VY!4JI. It/l1Y84.E ~.s- . AJ ;;,••••••••• p .\ ••••••• aged about ••~A•••••• YE'ars,residen t ofFtJr..••.I I

!~Ju:~~~1'f:..~o.LjyY..•-1.4!fJ:'!1~.1~·.~ff.iJ.~':~~1:~~~~~f~I

........

I'

r

.• 3

•• •••••• • " •••••• ej •••• ' •••••••••••••••

•~\ ••••• e • en ••••• e .••••••••••••••••• '~' ••••••••

liar If II L:£C-A,!{-e-.......... :.....- ...............•.........

I

./

I I!

stayed by any court(s) of c~rnpetent jurisdiction ••••

(vi) Whether all or any of the proceeding (s) have been

.... ..: ;/ ;' .•••••••••••••••••••••••••••••••••••••••••••••••••••

I

If thE::!deponent is accused <hfany such offence(s)he

de!scription of the offence(s) for which candidate has

. 10>r AIlJlL£CNJ L- 67 .bE~en changed •••••••••• ,••• e ••••••••••••••••••••••••••

Court(s) of competent jurisdicticn.

case(s) "lhich a charge(s) has/have been framed by the

with L~risonrnent for b10 years or more in a pending

....---••••••• Q.States •••••• ~~.e •••••• ~ ••••••••

: 2 :

~ /\~r I;tft/'LPAB J,~(iv) Court(s) ,\-lhich framed the charge(s) I.::' ~~.~ ~! ' .

(i) Date (s) on 'l-lhichthe charge (s) was/were framed ••••••

!y~!:...~':~!-.f.~/}tBLe

(iii) section(s) of the concerned Act(~) and short

shall furnish the following infoJ:mation :-

~r. A~;LcCA4Le(i) ca&e.l~t In~ormation Report No./Nos ••••••••••••••••••

. .. ' ~r AII.LZCAbL.lY _(ii) PoU.ce st:3.t:Lsn(s) •••••••••••••••••• IDistrict (s) •••••••••

1. I aflV'amnot accused of any offence(s) punishable

2•. I ha~eefl/have not b~1 convicted of an offence{s)

Sign~~onent

court (s) of competent jurisd:ic t ion•••••••••••• / •••••

N,r A//LrC-A-LJ~~- Z -.••••••••••••••••••••••••••••••••••••••••••• ••••••••• e

••••••••••••••••• !••••••••••••••••••••••••••••••••••••iI

~lace: AurangabadII

~te: / / I

~/1fg11II!

whether the sentence(s' has / have· been stayed by any

Date(s) wn which 'che sentence(s) was/were pronounced•• '.~~"

~~r /}/Jtf/ L£UTB-t.f••••••• 0 ••••••••••••••••••••••••••

: 3 :

of the ()ffence (s) for \'lhich the candidate has ever been

charged~•••••••••••••••~••••••••••••••••••••••••••••••~

•••••• u •••• jY!.t: .. ;fJ.(f. ~Bft.'!f.~..Zoo ....:."-'. ;"'-""~" -, ....• ,"'-'" 7~'_' •...- t_;:·~· "~"

••••• · •• ~ •••••••••• ·•••••• ·6 ••••••••••••••••••••••••••• _.

(43 of 1951) and sentenced to imprisonment for one year

Section (s) of the concerned Act (s) and short description

(other than any offence(s) referred to in sub-section

If deponent is convicted and punished as aforesaid; he

or more~

.... ~-=- .... state (s) •••••••••.•••••••••••••

ssction 8 of the Representation of the people Act; 1951

(1) or Sub-Section(2) or covered in Sub-Section(3) of

(vi)

(v)

i)

ii)

p,.,f)the. ~............ /) /J(1A1fA~APVerified at ••• i this

. ~rRL'(' .- 00 Qof, •••• f 0 •••••• • 2 ~ •••••••• 0 •••••••••

l,the deponent above named~dohereby verify and

i

VERIFICATION

: 4 :

day

concec~ledtherefrom.

no part of it is false and nothing material has been

and correct to the best of myknowledgeand belief:

declare that the contents of th:i.s Affidavit are true

H:lcNTIFiED & DRAFTEDBY Mr. :-

/\f~~· ~or/~~s .(~'

1.

NOHINATION PAPER

AFFIDAVIT TO BE FURNISHED BY CANDIDATE ALONGv.fITH

I :

and state on p~th as under :_

Before the Returning Officer

, . Lat rSA tSl-//f .for election ~o ----~---------------------(Name of the

! 4()/{4/1/tA/.!.ADHouse), from ----------------~------- Constituency

I. ~~I..r!t-!S;:~.~1~"!t1;.{"'.'7:t:;div)!JRtgr/w 1ie oi: ~~~1:,,!I(.. ~\

iBf/V"JZ,. kA/16",e d~.s- 'd lior,1lv,-J#, ··.···:.\~.· ••• i•••••• age ••/.'~••••• years, resJ. ent of ••.•••••• Ia ML;.t;~«~11.....l'?fff.'-Y. ; . .<"~M~Af1..if."1f .• Ii.{"f ."."!f.U.11 •• ]

IJlJ~"Nj/J6-1J), I ,i \§ candidate at tl~ above election, do hereby solemnly affiDm

II

Depen­dent-3etcName :

-.-

i "j Self 1'spouse(s) Depen Depen­,: Name(s)'dent-l dent-2

Name: Name:. ! j

! I

That I giveh@rein below the details of the assets

Desdript ion

,Cash 11~cnro,I

Depos!ts in BanlQs

Financial Institrtionsand Non-BankingFinan'cial comppnlies.

I .

BondS,~ebentur1sl andshares, in compi3-n~es., I: Ii

(A) Details of moveable assets :

cmnership will also have to be given).

(Assets in joint name indicating the e~ent of joint1 ' , .

E;rtl"' ; f any, fi' ed aOainst abo.•.•.~ order -±ak.'Lng

c~zance: v0.,-

(iv) ~:e of erder O:E the COUft taking eegni~ances:

v0r 4//L-LCA-/],(,c:- ,(v) Dat'aiJs gf QPpeal(s)/applioation(~ for ravioion

(i) SGation of the Aat ~nd description of the offense

my spouse and dependents *

(immovable,movable, bank balance etc) of myself,

w~ oognizance h::1cbeen taken by ~he Court :-

: 2 :

(iii) Caa-e-Uo :

£UL which coga;lsaAao tak~. 4/I'L.7X-'!/.JLC

(ii) The Court which h::1:;taken cognisance : /Yt>r A/JllLClflJLE.

(ii i)

(i)

,----~-.--~-,------•..•..•.•'

S.No.

-

\

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I

\

t

\

\

\

\

\

\

••4

.6~ cruv/-

'~nJx;""f/.u~

4'1? 1~/I1~/Vf4t-. '$ (/T,f(A

I 3 :

Jwellery (give details ofweight and value).

. ~ ... ~..-.~,

-rvs ~l/zu)t..J:

Motor vehicles(~etails MH-20 -A I<.

of make etc.) 9'()J 6

other ?inancial'Instru­ments, NSS ,postal Sav­ings,LIC policies etc.

market value in stode exchange in respe~t of listed

'it Dependent here means a person substantially

companies and as per books in the case of non-listed

.-

(B) Details o£ 1mmovableAssets :I ..

dependents on the Income of the candidate.

con~anies should be given.

Agricultural land ,iII

I

-surveynumber(s) II I- EXtent(Total measurements)

-Currant', Market valle• 'I' !I II : !

i j r I

- Locat ion (s)

(v)

Note : Value of Bonds/Shares/Debentures as per the latest

(vii) other assets, such asvalues of Claims/interest •

(i)

. \

(Note: Proparties in joint o~nership indicating the extent.' \

.. of j Oi:t. ~nerShiP "ill ~lS0 have to beIMi cateay-S-.-N-O-.--D-es-c-r-ip--;--t-i-o-n-self Spouse (s) Depen- Depen-~ Depen~

Name(S) dent-l . dent-2 dent-3________ .~~~-, _ .. _~~e,' '~~~:.\

. !

I

\

\

\

I

\

\

I

I

\

I

I

I

\

\

I

I

\

\

\

I

\

\

•• 5

details for each item)I, ,

sE¥PerateI i I

J ! ,-- -< -

-- I

Nameand address Amount Iof Bank/Financial outstanding

I i Inst itution (5) / as on••••• :.i. ! : __ .. _._ D~~rtme~1?'(~) , '.'. \

. I T-'- AI - TBank i VV££I ~

Financial Institutions A/, I t/V£L.IIi

I

I

I

Please give

Description

- Current Market value

- Locat ion (s)

lbuses/Apart:ments etc:

-Extent (Tot:al measurements)

- Survey/door number(s)

: 4 :

- CUrrent Hclrket value

Surveyfdoc'r numbed- Extent (Tc,tal measurements)

-CUr~ent Market value

-Survey number(s)

-Extent (Total measurements)

- Location (;s)

Non Agricultural land:

(Note :

(ii) Loans from

(a) (i) Loans from

(v) Other (such as interest in

. propert y)

(3) I give herein below tpe ,details of my liabilities/over dues toI i

public financial institUtions and Government dues :-, ;

S.No.

(iii) Building (OOIDmEcial&residential):

- Location (s)

-

~I

·~/·.~

"

·i

Ii

'I \

ii

J

!I'IiI

'I

I

I ., It!I

wealth Tax (Also indicate the assessment yearupto vlhich wealth ta:)::return filed).

_ N//Sal~s Tax only in case of property bus inoos)

_ /Y/ /Property Tax

Incc:meTax .Including surchaI:ge (Also indicatethe assessment year upto which Income TaxReturn filed give also pennanent AccountNumber (PAN). ~ /"1'/1

( GIVE DETAILS OF SCHOOL Ab1D UNIV'ERSITYEQUCATIONI

(f) otht=r clues, if any.

(b) duels to departments deal ing with supply of wat erhll(c)

d'-le:3to departments dealing with supply ofe~ectrici ty.

N/f

(d) Due:s to departments dealing \.oJithtelei?!lone~

(a.) due:s to departments dealing with GovernmentACCoDmmodation. .M/

(e) dues to departments dealing with GovernmentTransport (including aircrafts and helicopters)

Nt/

: 5 :

Government dues :

My educational qualification are as under 1-

iv)

(iii)

(ii)

( 3)

(b) (i)

(Nameof ~;chool/University and the year in which the coursewas cOIT[?J.eted shduld be giVEn .)•.

;

. / '180 - HOL.y' Ct<f)$..C,£IYYi..tSI;tM.£f'" ~C~f)O'- - A(;'L."11Vf//4,IJ,O

~i ~O~~O,LfSG /9~~ - ~oYT .r71T-S_..lvc.,C;(;;W'C~ . -Au~"'f-l/)io~.1>

P-c(M.cljf-'tN'7~/'l'lfj - G'o V"j ~/VYZ~U~J:NY C.~ye D~~S·S.. ~ ·M· U .

.. . . ~

,. r __ ~ __ ~ • _ .' •• _ ~ _ •••••.I. ; il

the ~,...£)...........•• 00 :jt~.~~~u ••••• 0eo 0 200 9'..0

: 6 :

VERIFICATION

. 41~~f~AA~Verified .at ••••• o.oo •••• othis

I, the deponent above named~dohereby verify and

\

con<:Jealedtherefrom.

day of

no part of it is false. and nothing material has been \I

\

\

\

\

\

\

and correct to the best of my knowledge and belief;

declare toot the contents of this Affidavit are true