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NOMINAT10N PAPER
Election to the Legislative Assembly ofTELANGA A siate.
d a'
STRIKE OFF PARTIOR PART I BELOW WHICHEVERIS NOT APPLIC___
PART I
(To be used by candidate set up by recognized political partltl
I nominate as a candidate for Election to the Legislative Assembly from the 46-
Nagar, l{ear NMDC,Masab Tank Hyderaba4 TETANGANA. Pln' 500028. Her name
is entered at S.No. ..710.. ln Part No 48 of the electoral roll for 63' AMPALLY
Assembly constituency.
215 in Part No 334 of the electoral roll for the 45- Kukatpally Assembly
Constltuency.
Date:‐ 1711.2018
b+:,
Signature of Proposer
1s+<rt sttounQ)
PARr-r
/
(To be used by candldate NOT iet up by recognized polltic.l party) /
We hereby nominate as candidate for eledion to the Legislative Assgrhbly from
Constituency.
the........................................... Assembly
/
Candidate's Name........................... ...........tathe/s/Mof e/s/husbandt
name...............-.----.. W Postal
Address....................... ..........1i/ name entered at
S1.No............................. in Part no........... of /tfre electoral roll for
.......... Assembly Constituency. ,/
/
We declare that we a.e electors of this Assembly ConstitueD(y and our names are entered
/
in the electoral roll for this Assembly Constituency a)ir{dicated below and we append our
t●
2
1 /2. 4 6.
■ 2 3 4
,
6 7 3 9.1
0
(c) (i) I am set up at this election by the TEIU6UOESAM PARW which is reco8nized State Party
in this state and that the symbolreserved forthe above party be allotted to me.
OR
(ii) I am set up at this election by the....../.................... Party, which is a registered
(strike out which is not app )and that the symbols I have chosen, in order of
prefetence, are:-
(d) My name and my fathe/s/mothe/s/husband's name have been correctly spelt out above ln
(e) That to the best of my knowledge and belief, lam qualified and not also disqualified for
I also declare that I have not been, and shall not be nominated as a candldate at the present General
Election/the bye-€lections b€iry held slmultaneously, to the Letislative Aisembly of TELAt{GAt{A
State from more than two Assembly C.nstituencies.
(iiD S€ction(s) of the concemed Act(s) and brief description of the offence(s) for which he
(viii) war/were any app€al{s}/revi5ion{s) fi led against above convict,on(s) ...... l{i|....
(x) Name of the coun(s) before which the appeal(s)/application5(s) for revlslon
fi|ed.........................................................N11............
(xi) whether the said appeal(s)/applications(t) for revision has/have b€en disposed of or
islare pendin9.....................,,,,,,.,,....................,...Ni1..........................................................
(3) whether the aandldat€ has been dedared insolvent byanycoun?.... .. O...,..
-lfyes, has he been dlscharged from insolvency............I{OT APPUCABU.............
(4) Whetherthe aandidate is under allegiance or adher€nceto any foreign country...... O.........
Whetherthe candidate has been dlsqualifled under section 8A ot the said act by an order of
president?......lto.....
-if yes, the period for which dlsqualiffed......... l{Ot APPUCAALE .................
(6) Whether the candidate was dismiii€d for corruption or for disloyalty while holdinS office under
(フ ) Whether the c.ndldate has any subsisting contract(s) with thecovernment elther ln lndivldual
(apacity or by t.ust or partnership in which the candidate has a share for supply of any goods to
-if yes, with which Government and details of subsistint contract(s) OT APPUCABLE
Corporation (other than a aooperative society) ln the Gpitalof which the Centrel Government or
State Govehment has not less than twenty-five percent share? .......t{O.,...
lf yes, with which Government and the details thereof.................. IOT AppUCASt E .............
PlaceiXukatpally
PART V
I have examined this nomination paper in accordance with section 36 of the Representation oI the
0ate:.............,,................................
Returning Ofti€er
PART VI
● ′
SRll)HARJASTI
Age: 39
G€nder: Malc
lll]田 田: ROV371尉
1:‖
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il"€A KiAIFII TELANGANA ,l9g_ u 30s775
B.MARY
{0......}-qffi€..orh...
Lqltilt"n r t nr... f p.o ( _ 中 ロ Licenced stamp vendOr
。1`│′ lol'016
t'Cit6■ 7001′ 2013,Ren‖
9‐ 22/11/104,Hll Tぃ ぅf、 1 11′ .
Adarshnagar,Hyderaba3,0_、
`5‐ ,:こ
Ph No.984983806●
︰
1
FORM‐ 26
1
′
Ytaに Resdent oF H.No.■ 0‐ 3-310/A/2 Humavun,lagar7 Near NMDC′ Masab Tank
dO hereby
derabad′ TELANGANA,日 n‐ 500028a Canddate at the above dediOn′
町
afnrm and state on oath as under:-
嶋
′
●
1
0 助
lled
Nandamuri Venkata
Rs 12′ 00,000/‐
Chundru Venkata Sn
Harsha(Student
Dependent &!
α 塑ヽ゛
カ
ヽ ;tr
│ン
_ル
1ラ
FIR No.With name NOT APPLICABLE
and address Of
PoliCe Statlon
concerned
NOT APPLICABLE
Case No. with
Name of the Coud
NOT APPLECABLE
NOT APPLICABLE
Section(s) 。f
@ncerned
Acis/Codes
inuolY€d (give no,
of the Secnion, e.g'
Section......"of IPC
etc.).
響1選I(1.if讐縄
charges Were
u6i aPPLrclalr noi aFPLrcABLe
器 醐 辟 報
been ■led against
the
proceedlngs( rlrerti
面 PHCABLE
=f ansWer
above tO(9)
is YES, give
details and
present status of
(6)Cases of Conviction
for any criminal offenccs'
(i)I declare ttrat I have been convicted
writo NOT
if the Gandidate has not been Gonvicted and
(flck this altsrnative,
against atternatlve (ii) b€low)
%
OR
nViCted fbr the ofFences ment10ned be10W:
(11) l have been∞
●onViCted′ then tlCk thiS aiternatlVe and
(lf the candidate has been
S in the detal:sin the table be:oW)
scOreofr a:temauve(1)abOVer and giVe deta‖
NOT
Case No. NOT APpLECABLE NOT APPLICABLE
(a) APPLICABLE
NOT
Name of the NOT APPLICABLE NOT APPLECABLE
(b) ApPLECABLE
Court
NOT NOT
sections of fr-orlppLrclgLe AP'LECABLE
(Cl APPHCABLE
ACお ノCOdes
lnvolved(giVe
no.of the
sdion′ e.9,
s“ ion,¨ ,..Of
IPc,etCニ NOT ‖OT
oiiE-'retd.sctiPtion
NOT APPL■ CA● LE APPLECABLE
(d) AppLECABLE
of offence for
which convicted
NOT
Punishment NOT APPLICABLE NOT
▲ppLICABLE ApP口 cABLE
(う
imDosed- NOT NOT
any NOT APPLユ LA● LE APPLICABLE
(9) APPLICABLE
App€als has been
-Whether
tiled against
conviction
order(Mention
I Yes or No)- NOT APruLADLE ‖OT NOT
APPLECABLE APPLECABLE
口“5
癬
蘊 嘲
(6A) have given full and up-to-date information
t to my political party about all
Notel
enfutd clarry aod legibry in EoLD letats
7, oetails should be
cas€ under differcnt @lumns
2, Debits tu b giYen seryrably for each
3,Detasshoutdbegi4enlnreve$echrcnologicalotder'l'e'thelah'tase
dabs for the other
b E mentiond first and bckwads in the otdet of
ag.
4, Additional shfr,t may & addd if tquired'
alt information in @mPliance of
5, @ndidab is ,esPonsibte for supplying
tlon'bte Su4eme Coa'ts iudgnent in w'P(
C)No' 536 of 20"'
immo\rable etc") of
(7)That I give herein below fie details of the asseB (Movable and
イ
son(S)′ daughte(s)Ofthe canddate Or spOuse and
Note:4` Dependenr means parenrs′
ЫOOd Or mamage′ who haVe no
any other persOn related tO the Canddate whether by
h00d
separate means ofincome and whO are dependent on the candidate for theirllVe‖
Chundruvenkata Sri
DescriPtion HarshaDePendent(Son)
灘馨 槻 獅騨
i帯‖
Insttulons′ Non‐
J
A/C
l『 怖′
Bankng Finandal No 145115500004
companlesand 1760
c00perauve socieues Balance in the
and the amountin above AccOunts
each such depOSit Rs 20319/‐
GtaG of investment m
TOtal amount:
Rs 3,24′ 000/‐
N‖ Rs l′ 00′ 00,000/‐
N‖
(V)
∬冊 脚 鳳
mm電
綿 in上 N‖
Nl
(Vl) Totor
vehicles
/Ai rcraft s/Yachats/Shi
淵謂帽 駐′
ps(details of make, lyear/
2018)
reqistration number
Value
etc., year of Purchase n_1′ 0`'ln
and amoud- ヽ0■ ■ フ′ 望
N‖
N‖
bullion and a)Gold:2222GramS
いう Jeweller.,
│
worht
valuable things (Give
Rs.71,03,456/‐
deBils of weight and
value) b)Predous&
stones
Rs.30′ 00,0007‐
釧
°I需 躍 N‖
Nl
Nl
(輌 1) AnyotherattSuch
dalms/interest RS l′ ●2′ 00,υ υV′
КS■ ′
D`′
・
′o● ′_
ヽフ●′ rs;z,oo,ooo1-
Gross TOtaШ
│ユ ′
(lx)
岬胃
鵬招 Ⅵ‖age′
U Kothapa‖ e
survey Number(S) Mandaし East
Godavan Dist′
sy.No 1052
四
Nl Ac 3 20 cents Nl
AreaCfotal
measurement in
Acres) Nl
N‖ No
whether inherited
prope‖ 呼(Yes Or
No) __ Nl
N‖ Year o1 196Z
Date of PUrchase
in case of self-
acouired DroPerty N‖
N‖ Rs 20,000/‐
of Land
(incase of
-cost
purchase) at the
time of Purchase N‖
N‖ N‖
Any Investment
on he land bY
way of
development,
ヽ
J」 ll)tl
N‖ N‖
N‖
Approximate
current market
value
N‖ N Manda Pe● ToWn′ Ea史
Agriculture GodavaH Dist
-Non
land: Location (s) Sy No l10/1&110/3
Survey.Numbe(s)
N‖ N‖ 2455 sq.Yards.
Area(tOtal
measurementin
sOuare Yard主 NO
N0 NO
WtGther inherited
property (Yes or
tto) 21-07-2018
N‖ N‖
Date of Purchase
in case of self
acouired oroDertv
N‖ N‖ Rs^88"3S,000/-
Cost Ofland
OnCaSe Of
purchase)at the
Jme of ourchase N‖
N‖ N‖
Any investment on
fie land bY way of
develoPment
construdion gEl Rs 88′ 38′ 000/‐
N‖ N‖
Approximate
current market
value
cOmmercial N‖
N‖ N‖
buildings
(InCluding
ap● ‖
unents
脚 :‰
釦
Area(total NI N‖ N‖
measurement in
So.Ft)
N‖ N‖
Buiに up area(total N‖
measurement in
sq feet)
Whether inherited No No No
property(Yes or
No)
Date of Purchas€ N‖ N‖ NI
in C3se of self-
acouired Drooertv
N‖ N‖
Cost of prope町 N‖
(InCaSe of
purchase)at the
time of ourchase
N‖ N‖ N‖
Any Investment
on the land by
way of
development,
construdion etc,,
N‖ N‖
Approximate N‖
cunent market
value
N‖ N‖
Residential H No.8‐ 2‐ 293/82/F/4′
(iV)
buildings PIot No:4′ F‖ im Nagar′
(including ShalkpetHyderabad
apartsnents)locatio
n(s)-
survev.Numbe(s)
N‖
Area Cfotal 450Sq Yards N‖
measurement in
qn ft\
N‖
BJに up area(tOtal 750 Sq.Feet. N‖
measurementin
Sa Ftヽ
whether inherited No N‖ N‖
propertY(Yes or
No)
Date of Purchase 23061993 Nl N‖
in case of self
,.r1l,irpd droDertv
Cost of Property Rs l,9o000ノ ‐ N‖ N‖
(Incas€ of
Purchase) at $e
time of purchase
\慟
N‖ N‖
Any Investment N‖
¨
′
Rs.430,00,000/-
other (such as
interest in
Rs.4,30,007000′ ‐
Rs 88,38,000/‐
Total of current
market value of
劇 httmms md
msttut OnS′ enUw Or
government(Note:Rease g∼ e separate detals of name of ban、
individuat and amount b€fore each item)
Chundruvenkata
Nandamuri Venkata
Sri Harsha(Son)
Suhasini(Sel0
Loan or dues to
any other
individuals/
entity other
than
mentioned
above name(g
Rs l′ 46′ 287246ノ
‐
Government
dues, Dues to 暇呻 試
慨 扁 酬 鳳 酵‖
departments
deallng with
government
accommodation The AddL…
`.
山
認
●
り 置常I濯 璧霊HL賛誦魚 │
喬
:掘 滉モ:■百 「
品htLccOmmOdatiOn′
tOwardS‐
nぶ 珈
∞ :珈 野Ⅲ堪ξ
輩
淋 :
Dues to
department
dealing with
Government
Transport
including
alrcraftS and
Municipal/ProPerty
Grand total of dl
whether any
other liabilities are
in dispute, if so
mention the
amount involved
and the authority
before which it is
躍糊1淵 :誦Ⅷ∬
鶏ec Rend
(b)SpOuse:Through Bugness ‐ ニ ユ
/
2ヽ
2感 ィ
悌
Interest from personal loan
(c) source of income, if any, of dependent
(e)Detallsofcontracts,enteredintobyPartnershipFirmsinwhichcandidateorspouseor
t"'
iJilna.ns.t" Nil "
paitners "p'l'ii" " ' or
or spouse
Companies in which candidate
Jy
(f) Details of contracts
"ntt'* 'n-
dependenE have sha16 " " Nil " '
under
(10). My Educational qualification is as
Bacheloroflavr(LlB),studledatPendekandtawCollege'Hyderabadaffiliadto
ttre vear 1999'
ili"J unr"tittv ind Goursc comPleted ln
PART‐ B
GIVEN IN O) TO G
11. ABSTMCT OF THE DETAIE Snrt.Nandamuri
Name ofthe Canddate
赫 3‐ 310/A/2
蠍 #聯駄
A
63 Nampa‖
Number and name of the conSttuency and State :A湘 ]‖gana
iisenat no.zro in Part t'to
48.
onMcted
Year for Total Income
PAN of
which last shown
income
― tax return
filed
AHWPN9516H 2018-19 E:o,ss,:oo
(a Nandamuri Venkata
c hntinirCandidate) N‖ Nl
N‖
(b)Chunl‖
1』 inkata Rs 12.00′ 00U′
三[= N‖
AKUPC8582H
lb‖ ]へ uPヽ
8 Details of AsseB ano uaotttue
Cn
肥
DescriPtion
¬ andamul Sri Ha6ha
venkata SuhaSini -hundruvenkata
(DePendent)
CSelう (Son)-
Uυ υ
RS 7′ Uυ ′ ′ ilpz,eo,ooo/-
A ]●vaЫ e AsSets lTOtal
Value)
Immnvable ASSetS -crl.s4qt,qsll- Rs.38′ 38′ υυu′
B Rs.20,000/・
Rs,1,90,000/‐
癬
f
珈
I
―■
^‐ ‐ハ ′ N‖
N‖
N‖
辟灘Tttl器:『
躙瑕
吻 a)1く S■ ′ ′ υ
υυ′
^ハ
n′
Vυ ′ 脚 ,0001‐ 詢
b)N‖
8′ 000/
`υ b)N‖
b).Ni‖
9 tes
uaЫ ‖ N‖
N‖
N‖
GoVernment
」 ^_rTAl● N‖
Nl
1ヽ
uuじ b、
Rs.1,46′ 28,246/‐
聰湘盤識n md
othe―
10 uabi‖ Oes that are
,lndρ r disOute N‖
Nl Nl
1)6oVemmentう ues
COtaり
k ハ
ス 恥
N‖
Nl
颯
ヽ 4孫ツ
ノ
2)Loans from banK,
蝠
′1
nnandalinsutuuons and
OtherJOtaり
‖ated
にge′ HYderabad a価
Baぬ dOr″ LW(LLり ,SwJ里 空
苫 Fi里 魁舌
二I罰常嘉 99'
讐雷思雷t諾∬キ:W品
撃
h 睡
tte で r■ 999・
rear■
y“
amdavit are uue and COreCt tO the beSt Of my knowledge and belief and no part Ofit iS
false and ndhing matelal has been conCealed there from.I futter deClare that,
On or pendlng caSe aganst me Other man thoSe
a)there L no Case Of COnvl“
Deponent
rrlt カお /チ
tl.:,´ 1::^
nominations'
Note:3.Allcolumnshouldbefilledupannocolumntobeleftblank.Ifthereisno
as the case may
respect of any item' either'1''lil" or "Not applicable"
informadon to fumishin
Note:4.TheAffidavitshouldbeeithertyPedorwrittenlegiblyandneady.
¨
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o● ,‐
縫喝 :,5-ゝ
`、“
(Signature of
authorised person)
Name Designation and
Seal
(Signature of
authorised person)
oate ...,.,.,.,.,...,.............. Name, 0esignation andSeal