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RECEIPT FOR ETECTION DEPOSIT

eived a sum of Rs.SOOO/-(Rupees Five Thousand only) cash

lf of

contesting in General Elections to Tamilnaciu tegislatjve Asseml)ly 2016 onThiru._........-...-_..,::!_==,..:=......-...._... a nominated candidate of 208 Tiruchuliconstituency.

U"

t108 l-ir+cSpec

APPENDIX VI C

FURNISHED IN AFFIDAVITS

(CHAPTER rrr PARA 4.s(3.1)

NO.&Name of the Constituency :208 Tiruchuli LegislaLive Assembty

: I - -\I I r(, -S\vA L\o.qK6ya.l

2 Father's Name

\l . \.,-,\l

i

-l

i

3 Age

4 Educational Qualification

.Ar . M.E.I .

Convrcted (Yes/No)If Yes, then list of sectron(s)

o-6. Cases pending (Yes/No)

If Yes, then list of section(s)

No7.

Assets: Movable

Immovable

o?.ornlNr-'

8. Liablities /overdues of PublicFinancial institutions andGovt. dues Nl0

Signa rdaLe

Name of Constjtuency

Name of the Candidate

Date and tjme of filltng nomination paper5l-No of nomjnatron paper

: 208 Tiruchuli Assembly Conjt i

st.

(aJ

(b)

JN'

:l"l'-l6. ath/af f

'.mat'on (wtrett e|. Gken)

-|

"'

j

theshould b

re yes/,,o) (if l

_l

llirrg:rIich

tY?a

Should be fijed latest by

(cJ ... ...... .-' -

(s date)

Date & Trme: e.o+. /lPlace Tiruchul

Should be Filed tatest by

e.ttndng!B lnrdruf Assenrbtv Cons

rsp€cbl o€Drrty fr{€dorWuft{ragt

FORM'A'

communication with regard to Authorised persons to intimate na9:19id$:-::t. up

_by_ r-cosnised NAiloNAL on'slaie"por iticar

"REGtSTERED un-neiocr,rrsto potitic;ip;;v.

(See paragraph 13(c), (d) and (e) of the Election Symbors

To (Reservation and Allotment) Order,1968.)

1. The Chief Electoral Officer,

ofor

..........I4A!!= NADU

The Returning Officer for the

2o6 - -rlRU c_tlvlf

Subject:- General Elections to .................t?9.1 ?C !?.t1!y:.4:?.? lIp.U.

Symbols - Authorisation ol persons to intimate names of candi

llrf,i:l*:f lapsrlq!]3 (9), (d) and (e) of the Etecrion symbots (R

111,3]:lT:T] order,. 1e68, t..hereby communicare rhar rhe ?oltowrns ,has/have been authorised by the pany, which is National part

to intimate thethe candidates proposed to be set up by the pady at the election cited abo e.

Sir,

atton(sl

Name of personauthorised to send notice

Name of office heldin the party

District(s/area(s)constituency/constituein respect ot which he

been authorised.

1. Km. Mayawati

2. xxxxxxxxx

3. xxxxxxxxx

National President

XX XXX

XXXXX

entire Tamil Nadu

XXXXXXXXX

2. T.he specimen signatures of the above mentioned person(s) sogiven below :-

2. Specimen signatures of Shri ...X?tXptpStQSXXIl9g.......

(D........lsxpspee!1r1pr........ (iD ........ ....... (iii)

Yours faithlully,

(MAYAWATI)

(iiD

Place : New Delhi

bearer shall be acceoted.

3. No lo transmitted by fax shall be accepted.

(Seat of the party)

N.B.

1. This must be delivered to the Returning Officer and the Chief Electoralnot later than g p.m. on the last date for making nominations.

Form must be signed in ink by the office bearer (s) mentioned aDo!Tacsrm e stgnature or signature by means of rubber stamp, etc., of any

National PresBahuian Samaj

Name of the Party

Notce

To

.^JiI-OTIC_E AS TO NAME OF CANDIDATE SET UP BY THE POLITICAL PATrsEE pAnAcnApts_lllgl.lc.) ANg G) AHo ig,i oi iiEiii-iii6i svr,r(REsERvATtoN Ar.ro hlr_orruerlry onoen rsosi

The Returning Otficer for the

2o 6 - 'T t Cv Cr+ ,-l r-t

constituency) in .........T411 ! !=. N APlt_........ t

setting up of candidate.

FORM'B'

In pursuance of paragraphs 13 (b), (c) and (e) and 1gA

Symbols (Reservation and Allotment) Order, 1968, I hereby

behattof ....B.A!!A44N.9AMA,!.?A.F.Ty_....(party)

Sir,

of the

give

(iD

0 that the person whose particulars are furnished in columns { io (4)

below is the approved candidate of the party above named , and

the person whose particulars are mentioned in columns (S) to (7) etow

theis the substitute candidate of the party, who will step_in

approved candidate's nomination being rejected on scrutiny or

withdrawing from the contest, if the substitute candidate is

contesting candidate,

his

ill a

the ensuing general election from this constituencyName ot theConslft.iency

Name ol th6 Falhe/s/

Husband's

candidate

FOslal

approvodcandidate

Name oJ theSubstitutecandidate whowillslep-in(i) on theapprovedcandidale'snominalion being

scrutiny,

('i) on his

FathtvlothHr/st

cand

m0s

tutelate

Postal

ol

candidate

3

2oeT'RUCF}UAA SrvA Al"4r.iko

5 6 7

2-2\ ^t R

N,1R.lk<vOl1./Ru c$!

Vra.vp Hu "r4q4qr)

F tnt - 5"rro,

3. It is certified that each of the candictates whose name is mentioned above is a mempolitical party and his name is duty borne on the rotts of members oitfris ;;- - -

Place : New Delhi

oute :..*...1.[pft.[ rb

'Score off, if not ticabte.

Yours faithfu y,

fra

(MAYAWATD(Name and signature c

Authorised person ot the

(Seal of the Pady)

N.B.1 This must be detivercdto the Retuming Officgr not laterthan 3 p.m. on the tast date for makng nomin:2- Fom must be signgd h inkbythe ofiice bearer (s) menrioned above. No tacsjmile signa,uro or srgnarumeans oI rubberstamp, etc , otany oflicB beareiahafl be accgpted.3. No fom lransmined bytax sha be acceFeo4 Para 2 of the Forn must be scored ofi, it not appticabte, or must be prcpe y fi ed, if appticabte.

of this

the

I

c.^ro-. € I )/t-.c>ccP_.2.i 5 5OO0Oo q), t/a_2ua2rp21l

ttj.rnhiilr.\t

Signature

Date

iDiUCiiiLl(in Capitat LeIer;)

1.>

.T

D

o

Gene ra I lv us-qd,atqblqybllqrsdep = Deposi(

I

I

-l

=--:----:-

SC = Short (Sl/So/SORD

S/DM/H/o=S ldof

Dft = Draft

dish/dsh = Dashonour

DR = DebitDoB = Date of Birth

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REQUEST FORM

For contact details of candidates standing in

General Elections to Legislative Assembty 2016

No. and Name of Assembty Constrtuer,cy 208-Trruchuli Assembly Con5orue

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FronrThiru N.Thiyagarajan,B Sc.,ReruDring Officer.20S Iiruchuli Assenbly Constituenc),&SpecraL Deputy Collector (SSS)

Vi.udhLrnagar.

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Electron lo l-anrrl Nrdu l,egislarivc r\sscrnblr 2r-,16 106 liruchulrAssembly Constituency Maintcnancc of accounl ol clcctronc)ipcrlscs ilnd lodging oftruc copy thcrc or

l. Your attcDtion is rnvilcd t() Scction 77 r;l thc Repre:cnLatio of Lhe p!opl. .\er. i.,ilwhrch slipulales (h^t evety cunclidate ilt an clcclron shall r'ithcr hv hirns:lior hr hir t[,t.litrnugenl. keep a scparate and correct accoLlnt oj_ all expendiltlrc in conneclion with the ele(tionbttwecr) (hc date on which he has bcen nonllnated and the (late ol declaratiou ol tit-.rc.ullLhcrcol, both dates inclusive2. Your attention is also invited to SectioLr 78 of the said Act which firflhef slipulittes (hal

cvcry contesting candidale at an clection shall. within thirly cia)s liom the date ol ctcr ttori olthe retumed candidate. lodge with the District Election OfTicer. an accounr of lhe electioncxpenses which shall be a true copy ofthe aocoLlnr kept bl him or by his election agent urrlerScction 77

l. l},en if a contestrng candiclate cloes nol srriouslv (onLcsl the .JLfclion. 1,, .,:r, rui.o:\\hiltsoevof. rnd incum only lr nonrinal cxpt':tditurr: on his:ecurrrr derro;rr. lLr. i:. ,. r;qt,r,cdby law lo lodge his itccoullt oI elcction c\pc!]ses:[. A contesling caDdid.rte \.!l]o.tails lo conpl\ w.iLh reilrirenleDts ol la\\ ir,!rerjinll.hclotiging of accoL|lrt ()l clectioD expcnscs is liable Lo bc disqualiticd by. iirr Llctr,onCorlmission under Section - I0A of the Represenration ol the pcoplc Act, I95 l tbr a pet rod

of three years

5. fhe accourll ol election expenscs to be kept by a cdndidate or- his elecrion olrenl ur,Jelscction 77 ol the Representation ofthe People Act- l95l shall contain the parlicLrlars otc\pendilure. iDcurred/authorized from day to day as prescfibed undet rule 86 of the Lon(luc1ol l-.lections Rules 196L6. A registef is belng i mished to you herewith. you alc requ ed to mainiuin )i)ur (ir, loday account ol election expeuses in this Yen Regisrcr and in no other doc[nrerrt {lisuppoftinq vouchers- bills. etc- shoLlld also be kepl feadv alonq with the Regist.j rLrr1lrrr:eC inpropcr chronological ordcf al nll limes- An absrracl statement of(\pendiLurc ,r rt,,) l() be

pieparcd bvrouafier thc dcclaration ofresrll ofclcctron itr parlslroVjol tlte toilrar.

7. All docunlenls sJch !s 1rr:icrrers- fecr!llts- arcknou lcciga,nan,a- a,a ,r suppon or Lh!.erpcndrturc rn!ur.-.u --r ;"U:-,::z.d shal [)r obLalned o,t clay ro tlar b:rsr:: ..nJ sh.,r b.mainraincd in the correcr chrr.n".locical o.der along with rhe Register show.rn! tite dav to cja\accounl

8- \'oU shoulJ m:ie Lhis Reeisier and the sllpporting documents avaijable l.irr i|spc.:Lrrrn rrdenrnnded ar a:r iinTe dunng rhe process or election bv rhe r)istrict I:LcctrLrn ()fliccrRe:n.irg Ctil.-e:- Eiecrion (Jbsener appointed by the lrleclion (.ornmissioD or any orhcrs-!--_ a-il:oil\ ir:'n:n3:eJ b\ rhe Commission in thrs behail. FailLrre to pfodLcc thlJ aellisLel'.rt:r le:nandeJ rrill be considered a{ a maiol default on voLrr part in maintaintJ)s vour da\ rolJ\ r.ccrnt anJ aou ma\ render \ourself illble to penal itction u|dcr Scr!(,r, I rl_l oi lh.ln;ir PJnal Coic., l-i,is \ery rc!lsrer il) \ht(lr )ou at! r\r tDailtain )o\, .l"r 16.;.,_,

e\i-n5.s shoukl irself be filed as \oLrf afi-.ount ol electian c\pcuse. aRLr .r. ..rcr oo a\.r-ctirrcl under Sccrron 7fl ot lh!, Rcpresc|lrLioli of the l,rofl. nc1 951 n..!lir(ne(, abo\,()J- sh\,t:ld Lcep .r cop\ ol_ tlt. lccount rc ntarnl.lined tr ih. Rcg,sL!r l,rj .. I c((Jj., .n..cl:reDr! Along \\ith rhe Registcl. you rrust lrle thc aLr,,rc,rrrcnrrorretr :Lrir,a!, strLr!iircr,,conliriilinll details oi expenditLrrc- and lhc Janle nlusl bc supported bY an lt,-i.rvil rn thclcmral enclosed -fhe

allldavit should bc shown helbre a \4 gistraie ofthc trsl(.ta\c(1! afOarh Comurissioner or a Notary pUblic

l0 If Dtily be noled thEt Section TT (l) has l)ee antcnde(l \idc ljiccLron ln. olljcr R!l.rlelj[.il\s (Anrendute]rl) Act- 2001 As pcf Lhe amended provislons ol -.1 \planii{rorr (l)--(,t lhisSection all cxpcndrture incurred or authol1seci iI oonr)ectioll rvith the clertiotr ot th.candi(i1lte by the polirical parly which has sct hlm up, any other associationtb{(r.\ ot pefson:or xr1) orhcr individual shall also bc fcq.ired to bc Inclucled rn LLr( rcc(t:r,r! rf.rcitroic\I)cn5esof(IrccilndidateuIldcIlhc\:lids!c1i(llr77l.iconlvc\eclll|o|]inc!rrcd on Lhc tra\,cl ol Lhe -iradr.s ol thc D(,lltt(ili Iart] ,i,t fropasirir,t! lir,.. :) .,.,(,r r:,_ (,1thcpolittcal parl) \\hoarcco\r,tc(l uf(lrl .lr\plaIrlr()n r,ril : ()fSrclrl n 7r,,,l1 ll_vou conlest election lioDt llore lhdn o ccollstttrenc\. \()!r are rrqUlrcd r(r iliunLall dnulo(lg. ir scparate ilcco.'l ol yo.t c ccli{)n e\pandllutc lr lc\llr,!l ol each sucf fors.tLlc'!\Il liindl), ackno\ lcdge lhe rcccifl olthclcLrcf alon8 * tlr iL: crrclosu|rs inri lr.i,Lel),| th!cnclr)sed acknowlcdgcntcnt lornl

Yours

l()r I

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Enciosur e:,

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