FORM 26

(See rule 4A) ~=============-

S.~.hi~(l\S. :r{;r~NARA'(;t.\NAl icenSc,j ~".::"'!~ l.ie n d~r

. LJ,ln r: . -':""'~i;':O(l1F'-, ~: .:. :" . , ,,~ 2014

Ii 8 1·6U. "::,, ,~., ,~: .>, n;:i."x,Uear "r;;)~:,:' :,,;:,i· .,,1RoadBHADRJ,CrlJ;Lt,ii/: 'iO'111

Cell 98b5156519

Affidavit to 'be filed by the candidate along with nomination paper before the returning officer forelection to tv'lLCfrom Graduates constuancy of Warangal, Khamrnarn, Nalgonda.

,;' (Name of the House)MLC from.Graduates Constituency (Name of the Constituency) Warangal, Khammam, Nalgonda.

" PART- AI, BUSIREDDYSHANKAR REDDYS/o. SITHA RAMI REDDYAged 53 years, resident of H.No.13-1,.9!3,Revenue CQlony, Bridge Road, Bhadrachalam - 507 l11(mention full postal address) a candidateat the abov~ election, do hereby solemnly affirm and state on oath as under:

(1) I am a ~'andidate set up by NIL (Name of the Political party)/ am contesting asJY1(C...anlndependentCandidate (Strike out whichever is not applicable) l' .,l~ '"

(2) My ame is enrolledIn BHADRACHALAM ASSEMBLY NO.119, K~AIVIMAM DISTRICT"TELAN~ANA. (Name of the Constituency and the State), at Serial No.16ii~·,Part No.140.

,~, ; "r(3) My contact telephone number are 09848105900 and my e-mall Id (if any) is

Shank~rreddy3150@gmail.com .~,.":'; .':\

".

(4) Details of Penn anent Account Number (PAN) and status offiling of Income Tax return.

The financial year for Total Income

SI.No.which the last Income shown in Income

Name PANTax return has been Tax return (In

filed Rupees)

1 Self "80.--Pi3 \ 1-l.f5B... .20 J 2- - \ S G t g':j ,ruoL·-2 Spouse

/IJ I L N\l NIL

3 Dependent-l NIL NIL NiL

4 Dependent - 2 N'L f\..1 , l NIL

5 Dependent-3 NIL NIL {\ItL

(5) I am not accused of any offence (s) punishable with imprisonment for two years or more in a pendingcase (s) in which a charge (s) has/have been framed by the court (s) of competent jurisdiction.

If the deponent is accused of any such offence (s) he shall furnish the following information:

)I~

'.

(i) The following case (s) is/are pending against me in which charges have been framed by the courtfor an offence punishable with imprisonment for two years or more>

(a) Case/First Information ReportNo.lNos. together with completedetails of concerned Police NI lStation/District/State.

(b) Section(s) of the concerned Act(s)and short description of the offence(s) NlLfor whichcharged

(c)- -.-~

Name of the Court, Ca:se No. and date'of order taking cognizance: , N\l --- ..• .. '.-

(d)' ~~)~1(~)..~~.fc~Ini~~_~t~~_~ha~g~(s) _---...._ .. " ..... ~..,-- ...-.- .......~ ... .. ..-._." .....

NI\-",:': ..',,,.- .

"(~) Datets) on which the chargets)was/were framed (\l'\.---. ... ... ..

.-.. ... . ...- .... _,(f)' Whether all or any of the

.proceedings(s) have been stayed by Nll1t!}Y.f~YI1{s).of cOp1p"~t~!!tjurisdiction'7.7"';' .- .... -.

(ii) The following casefs) is/are pending against me in which cognizance has been taken by the court[other than the cases mentioned in item (i) abovejr-

(a) Name ofth~Co~rt~C~e~f~~ancf- dateof order taking coznizance: '.- __ .. -.~._ ..=...:..:0 .._=:...__ --.:.._.:.- ...-'-'-_.:..:_- .... _ NlL

'(bY The 'deiaifs"ofcases~'~h~;ethe court.has taken cognizance, sectionts) of the'Aci(s} and description of the offerice(slfor which cogri izance taken

(c) Details of App_ecU(~)/ApI5iicat1on(~ifor revision (if any) filed against the;~~b.QY~O,fget .S: NU-

(6) Ih~ bFnlhave not been convicted of an offencets) [other than any offel)ce(s) referred to 1n sub-section (1) or sUh-se.ctibil (2), of cover«d in sub~.se~ti.bn(3), 9f~e:cil:QD8 ot the Representation ofthe Peop'le :A'ot, 1951 (43 of 195.1)J and sentenced to imprisonment for one year or more-

If the deponent is convicted and punished as aforesa-id, he shall furnish the following information,

In the following cases, r have been convicted and sentenced to imprisonment by a· court 'of law:

(.'d')' ,; :.,,";: ..:-:,;= --"':'~ ..:::~~:;~'::':::;-=-'~~~~:::;;oo;"';~:"::~..::-'_"-. . Whether any appeal was/has been

, filed against theconviction, order. If so, details and the present. ?~B!~~I?of!h(!~pp..ea]: .

N..tL_ ....

" no.: The de.ta'ils of cases, S:ecti:oti(s) 0 .". ; the cop cern eo Act{sl and:

. de.s~riptign oJ ili~ Qffc!1ce..(s)'.~.=-=-~.:fQr~w.bjy.h.QPQyJ:~t~d_..~=."'"_".=~..., ..~~~.J....._co ....

NlL. '-Om N~hi'e''''orthe Courtis), Case No;";.", ..,,:'jp(Ldate..~~{)f oroer:(~.:.. :

N\L".

==-

(7) That I give herein below the details of the assets (movable and immovable etc.) of myself, myspouse and all dependents:

A. Details of movable assets:

Note: I.Assets in joint name indicating the extent of joint 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 Bank/Institution and Branch are to be givenNote: 3. Value of Bonds/Share Debentures as per 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 here has the same meaning as assigned in Explanation (v) under section 75 A of

the Representation of the People Act, 1951.Note: .5. Details including amount is to be given separately in respect of each investment

Spouse Dependent-I ;Pe,~dent-2'1 Dependent-S'Self

en)] ~~~ts;£R~~f~:f~e~osj::~~

. f :~l~~:~l~~~{'~~QO~~!~~~~:~j FiriaJiCial Institutions, Non-Banking.Financial Companies Mi:J;Cooperative societies and the

__' ~oullLio ~~lCQS1.l¥h. ~~PQ~_it _,

N\t-

(til): Details ofinvesuftertt -in -Bonds,.: peQeililireS/shaies and units in

1" .. ',: :;; ,'"'- tual:fUh'd's,.'an~'oth~~ N\L

NU-

f\1tL

NtL1:

,..~ __ , - .. ;.;. '_,_H .~:

f\..\\k

N\L

NlL

i

T\..\\L N..\.L N\\'--

N\\-...- \"'t \ \-.- Nt\.-. MtL

lS· ~r lo..~ N\\.-- N.t~ N\\-..

'.

'(yil5! f~weITeii--~'b~mon--a~~d'~a:1~abl~';i Jhing(s) (give details of weight and':,value)

·(vi-ii)Arty other assets 's~ch as vallIe) t\lU- -.'of claims/interest

B. Details or immovable Assets:

Note: l. Properties in joint ownership indicating the extent of joint ownership will also have to beindicated

Note: 2. Each land or building or apartment should be mentioned separately in this formatr-::-r------~----__,_----r_---._---_.---,--_:r_-·--· ..-··..··--·-S.No. Description Self Spouse

N.\ l

Dependent-I Dependent-Z: Dependent-S

.Area (total measurement in acres) q ALl

(i) Agricultural Land:Location(s) .Survey numberjs)

3J\RA?A kA , t<.\ AMMA-Ml)\~-h;(t) S'(·r {) ·\ql K,.-l9.2-

N. \1.- ,,\\ "'- NI..\,-. N\\....-

NtL Nt\r- N.tL•....•...•..•.•• ·.•·.0· .• ·.···- •.•.. co •. •.·.• •• • •.•.•. ·••.•.• ~.... • • .

. Date of purchase in case of self-..acgujr~.d..ProRerty ~A;.•Cost of Land (in case of purchase). aithe time .of purchase NA N\L N\L Nt.L

. : Any investment on the land by way'.of development, construction etc. NJ1 N\L NJL

N.\L N.\.\ ....

N.\ L NtL N\L

N\L

\,,\\L

N\L NtL.

N.\l < •••••. ~\.l N\L

; Cost ofLand (in case of purchase)':::~.J_th~!iri2e ofpurch~~~ . .. ~\ ~ : . __..~\L N\l N.lL

N,\\.... N,\\.....H ••••••••••• • _N •• _......... •• _

{ii) ..Non-Agricultural Land},Location(s)Survey number(s) M\L

: Date of purehasein case olseIJ'-····;.~5?"9u.ir~9prQP-StJ..Y -t • .~.\~ ••

.. J\l\L

N\L

ftJNt( IoN' l<i;LLKO'THA-fE'T-t\ Csel..+:

fNI L N\.L. .1'~,",.!\.t\.L__. ;

Cost of property (in case of'purchase) at the time of purchase . NA

NlL

Ntk..:.-.,.~.. -.. - .._-_ .., ,.....

.l'\.t\\.,...~-. --:~ ' - ~.'

: (ll}) CorrYrnerCialBuildings: .. ~(including apartments) A N~~ PtJ RNi'

! -Location/s) -:It q -'. - O::S ["- ,J •.Survey nurnberts) N \.L

Date ofpurchase in case of self- '. \. d t'l.1\L ':, "t~Lacqu.lre property \ 'I. 1'1..\

\'\.t \. L

\~\'L'.Any investment on the property by .way of development, construction 2.0 iLo....\~etc. .._.... .. - .~-~~,~ -.-------ApprOXJIllate current markct~ I."~ .Q:'i'( N,\L. N\\ NtU~~~:~~;:f~r()j

~ ~ ~' ~~, TTESTEO ~~O~~~Regd~51J/~~ J~/; ~

~ II; 'O)'I~:;U Y ( p /.J~~~=======-~-~-~/-----

N \.L.

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

NIL

I 3 - \ - '1 I?> , Rev e () L{ e <'-0 \ 0 \')\f I

f.3(j; 0- e ~ oo.q, B hR ~(). h.ol.o ('f) •

"'IlL

NiL

, '--~OO,S 'T ..NI L.,. ,IL

NIL"-IlL

N\LN \L,"- ....,.....,.. .."'.

ofNIL

Nt L. NIL

(S~tglv~~:rt!.jn'b::elqW;th~!J.~~itsQfl@plJl!iesldues to public financfal institutions and governmentr-

(NQte,;. please giye separate details of name of bank, institution, -entity or individual and amountbefore each item), .

;;7~.--~-=-~~-:?-=,-_.....~,~,~ .'= ..::.~-:.-- . ~ ~ ,...•.;'O:::::..=.-~- .• --~""--......-'1=---. ~- ------:--.--------:"':.-----il . r ,l.~l:~ .,,~..~~~~R~.i~n~.- S~lf ,~_~~~~S~__'.~~:l~:lJ~~~~~~~~~~.~perlaent-3'n (!~~ ;oj"i,dues"to Brotktfmaneiil 'A~ 1&00.",~A<l Lt30{t) r ...,, f •.:i!.','l""~=...,- . -. . ~ ..J

;'l' ,;:;;;t;:" 0\ e\. too." ~~ 01 A. Lon ~i.'ll mnt' '.~. ,i Nt L! : - ..~-- . ~ -1-

:, i .. ,¢,SO tG. f ~~,S'() l!lIi I",",: . -;~ ...: ' ~f I ._J:':l.'U~.:1_, ,_ ... ~ .'I, ' " \leo n'~...._,

NILNIL

... - r-r-:' --. - - .~-, •••. "i' '

j

Nil " NIL.

!Dues !l'a !d.epaifment dealing wi ') •i~ROC~W~~r __ . _~~ .~J ~. t. N' L .N..!..~__

·· .. 1

NIL NILDues. to dc-partment :d~anngw-!Ul' -

,,t go.vemmen t~spoa (ino11l1311lg N, L L !

i l"~

--lncome {ax dues Ntl NtL t--\ \ L \~\L Nt\.-

Wealth tax dues NtL N\L "\.1\ l N\L f'...\\L

Service tax dues NtL NtL f'.\\k N\L N\L--.'. -.-

Municipal/Property Tax dues N..\L N\ t- !\.\\t- N\L NtLSales Tax dues \\\\L N.\\..... NIL Ntk Ntl_.-

- Any other dues N\L N\ "- N\l N\L "'",I.. -.-. - .-

(iii) .Grand total of all Government dues \\ltL N\~ C\t\k N.\tr- N\L.- ":"_- ", - -i (iv). -. --- .. ,.-'.~ ~.-... -' -

Whether any other liabilities are indispute, if so, 'mention the amount N\L-' ~\L N\"'-. \L-- Nth....

. involved and the authority beforewhich it is pending.

- H'. .. .- .-... ..." :..-~.

(9) Details of profession or occupation:

(a) Self ;...t\d-~.s-0.~~~.,&- B'~(b) Spouse _. .t\:QVM..- WLEE __•

(Give details of highest School/University education mennorung the full form of thecertificate/diploma/degree course, name of the School/College/University and the year in which thecourse was completed.)

,PARTJ3

(11) ABSTRACT OF THE DETAILS GIVEN IN (I) TO (10) OF PART-A:

--.-"---~-~ 'S-i1JSmt-lKum. BWR-e.a ~'ha.n~-, __ - ...::;! ";:..= __•.•.••~_. _-;;;;:.~ __ .__ -~!7'_.- '--_ .- •. -- .-

:S:~',(O-T~~I~~~:be;dfp~~dj~-i-~a;es~h~tedh;~ges: --= "'-. ""-'"'~',C"=_,o··

;'have been framed by the Court for offences!: punishable with imprisonment for two yel:irs or; morei =.=--==:.~_ '~~~"'I...:;:-::::;-"- . - ".,-., r"-''''''''---:-~' - "-. ¥'7' - -w'- ',7 .' .••

N\L

~(Ii) Total number of, pending cases where the. courus) have taken cognizance [other than thecases mentioned in item (i) above]

- ...~-- -...----~~-. =e--..~'=6'~' -. .--...'"---0 .---~. ~."~.,~'"~.-" ---- 0",

] ': Total Number of cases in which convicted and.sentenced to imprisonment for one year or more',

1[except for offences referred to in subsections(J), (2) or (3) of section 8 of Representation 0

,the People Act, 1951]. '.

7.PAN of Year for which last Total income shown

'1income Tax return filed!

NlL,' NIl.- " Nll-'! NIL ~', NIL'~

!~~ I

N\L

L

NIL NIL

40 lo. NIL N\L NI L

N1L

~.NlL NIL

.·;..c.·.·· ....

NIL N\L

... , __ __ .._ ..r=

NIL N1L

/

VEH1FICA TlO1'l

1, the deponent, above named, do hereby verify and declare that the contents of this affidavit aretrue and correct to the best of my knowledge and belief and no part of it is false and noth ingmaterial has been concealed therefrom. Ifurther declare that:-

(a) there is no case of conviction or pending case against me other than thosementioned 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 thosementioned in items 7 and 8 of Part A and items 8, 9 and ] 0 of Part B above .

.: e : f:~:_::::~ : n:.:.. IL.. ._.. _,._. . ".".. .

Note: 1. Affidavltshould IxHlIdJ latest bY3.QO PM on theJast day offtlingilojjjjnutionsiNote: 2. AffidaVit sHould he: swom before an Oath GOffihlisslO'tfer or Magistrate Of the First

Class of beforeja''Nofary-, Public.Note: J. All coJ4mn shoul(J be filled up and no column to be left blank. 1f'there is no

jnfQ,rm?~tQ1Lto, t.JJmjsb ill,; r;:¢$pe(Jtof any item, either 'Nil" or "Not appllcable", as thecasema), be, should be mentioned,

Note; 4. The Affidavit should be either typed or-written legibly ano. neatly.",

»;

;Jf:Nti H;;llo.l'9(~)lW:i~~rtJ;:Pt:.SlfW~'fsri{~,;A~4LS-e~,·

~::S:l~.i~~~~~~~MiliWati~n;num~,;<;,j);~$. dateir t1i~16~

(I)numberS~Q;~~); ~t~d':t1\e;;8.th,May.20()7.(2)number &0. 42S{E) d~teli.~$·.a:~~.2{)lL

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. Ifurther 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

mentioned in items 7 and 8 of Part A and items 8, 9 and 10 of Part B above.

Verified at Bhadrachalam this the ...l:?l.v.A. day of February 2015 .

• j ~11.-rL~~0- {//OOAPARTHiNA~J V;))

ADVOCATE-NOTMY ,B'&'"Tatagudi Centre,

ADRACHALAM-507111J<hanun,$JJl I)jsl, (AP.),

Appointed by Govt "t Indi

Entered in the Qtary Regist8r~Page No. u~ ,")Serial No.,/!:l...Dated.: . '/

LJ ~L .~!)r-

'4