S0120190326122058.pdf

If the answer is yes the candidate shall furnish the

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If the answer is "Yes", the candidate shall furnish the following information: (i) Case/First information report No.A{os. . . -. . . . . NIL. (ii)Policestation(s) ...... NIL ...... District(s) ......... NIL ...... State(s) .NIL ....... - (iii) Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been convicted ... .......... NIL ..... (iv)Date(s) ofconviction(s)... .NIL ......... (v) Cour(s) which convicted the candidate .. ...NIL. (vi) Punishment(s) imposed [indicate period of imprisonment(s) and/or quantum of fine(s)l ... ...NIL... .... (vii) Date(s) of release from prison . -NIL. (viii) Was/were any appea(s)/revision(s) filed against above conviction(s) . . . NO . . . Yes/Itlo (ix) Date andparticulars of the appeal(s/application(s) forrevision fiIed ........ NIL .... (x) Name of the court(s) before which the appeal(s)/application(s) forrevision filed.. ..... NIL. (xi) Whether the said appeal(s)/application(s) for revision has/have been disposed of or is/arepending .... ...... NIL ........ (xii) If the said appeal(s)iapplication(s) for revision has/have been disposed of-- (a) Date(s) of disPosal. ..-NIL (b) Nature of order(s) passed . . . NIL - - . (l)Whether the candidate is holding any offrce of profit under the Government of India or StateGovernment?..No. ES/I{O -lf Yes, details of the office held.."..' ....... '...NOT APPLICABLE ........ "" ..... (2) Whether the candidate has been declared insolvent by any Court?..NO.. SS/NO -lf Yes, has he been discharged from insolvency..' ..... 'NOT APPLICABLE""""""' (3) Whether the candidate is r:nder allegiance or adherence to any foreign country?..NO . ESNO -If Yes, give details. ...NOT APPLICABLE.'... (4)Whether the candidate has been disqualified rmder section 8A of the said Act by an order of the President? ..NO... WS|]IO -lf Yes, the period for which disqualified..'.' .... NOT APPLICABLE'...'.."'
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(5)Whether the candidate was dismissed for comrption or for disloyalty while holdingoffrce under the Govemment of [ndia or the Government of any State? ..NO.. - #SNO -If Yes, the date of such dismissal... ... ...NOT APPLICABLE... ... ... . (6) Whether the candidat€ has any subsisting contrac(s) with the Government either in individual capacity or by trust or partnership in which the candidate has a share for supply of any goods to that Government or for execution of works tmdertaken by that Govemment?..No.. YESNO -lf Yes, with which Govemment and details of subsisting contract(s) ........ ,...NOT APPLICABLE ..... ' ...... (7)Whether the candidate is a managing agent, or manager or Secretary of any company or Corporation (other than a cooperative society) in the capital of which the CentraUGovernment or State Govemment has not less than twenty-five percent share?..NO.. ESNO -If Yes, with which Govemmentandthe details thereof NOT APPLICABLE... ........ (8)Whether the candidate has been disqualified by the Commission under section 10A of the said Act..NO... YESAIO -lf yes, the date of disqualification ............ NOT APPLICABLE ............. Place : - ONGOLE Date :- 25-03-2019 Signatur
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PART IV (To be filled by the Returning Officer) Serial No. of nomination paper ................. This nomination was delivered to me at my office at ..............
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  • Fall '19
  • Andhra Pradesh

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