tamil nadu i(i) i am a candidate set up by bharatiya janata party (name of the political party) / am...
TRANSCRIPT
Before the Returning Officer
Affidavit to be Furnished by the candidate along with Nomination Paper
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For election to TAMILNADU STATE ASSEMBLY (name of the House)
From VIRUDHUNAGAR Constituency (Name of the Constituency)
(I) I am a candidate set up by Bharatiya Janata Party (name of the political party) / am contesting as anIndependent candidate.
(2) Details of PAN and status of filing of Income tax return :
SLNo. Names PennanentThe financial year forTotal incomeAccount Number
which the lastshown In Income(PAN)
Income-tax return hasTax Return ( inbcen filcd
Rupees)
1.
Self S.KAMATCHTAEZPK9917R2009 - 102,49,5502.
Spouse-KJAYAKODTACITPJl716H2009 -102,12,4903.
Dependent I K.THANGA VIGNESHNilNilNil4.
Dependent 25.
Dependent 3 .........
(3) The following case(s) is/ are pending against me in which cognizance has been taken by the court:-
SI. Offence DescriptionNo. (a)
The details of cases where the court has taken Nil
cognizance, Sections ofthe Act and description of the offence for which cognizance taken:(b)Name of the court, Case No. and Date of order Nil
taking cognizance: (c)Details of Appeal (s) / Application(s) for revisionNil
(if any) filed against the above order(s) :
4. Cases in which I have been convicted by a court of law(other those referred to in Form 26):
(a) The details of cases, Sections of theNil
Act and description ofthc offence for which convicted:
(b)
Name of the Court(s), Case No. andNil
Date(s) oforder(s):,
(c)Punishment imposed: Nil
(5) That I give herein below the details of the assets (movable and immovable etc.) of myself,my spouse and all dependents:
A. Details of movable assets:
(Note:I. Assets in joint name indicating the extent ofjoint ownership will also have to be given
2. In case of deposit/Investment, the details including Serial Number, Amount, Date of Deposit, the Scheme,Name of Bank/ Institution and Branch are to be given
3. Value of Bonds/Share/Debentures as pcr the currcnt market value in Stock Exchange in rcspect of listedcompanies and as per books in case of non- listed companies should be given.
4. Dependent', here means a person, substantially dependent on the income of the candidate.
5. Details including amount is to be given separately in respect of each investment)
S. Description SelfSpouseDependent-IDependent-2Dependent-3No. (i)
Cash in hand Rs.2,95,600Rs.82,350Nil
( ii)
Details of Deposits in Bank NilNilNil
accounts (FDRs, Tenn Deposits and all other types of Depositsincluding saving accounts),Deposits with FinancialInstitutions, Non BankingFinancial Companies andCooperative societies and thcamount in each such deposit(iii)
Details ofinvestrnent in Bonds.NilNilNilDcbentures/shares and units in companies/Mutual Funds andothcrs and thc amount.
(iv)
Details of investment in NSS,LlC PolicyNilNil
Postal Savings, InsuranceRs.6,OO,OOO
Policies and investment in any FinancialInstmment in Post oftice orInsurance Company and theamount(v)
Personal loans/advance given toNilNilNil
any pcrson or entity including finn, Company, Trust etc. andother receivablcs from debtorsand the amount.(vi)
Motor Vchicles/ Aircrafts/ Tavera - 2008NilNil
Yachts/Ships (details of Make,
TN67H9799
Registration No. etc, Year ofRs.7,65,OOO
Purchase and amount)
HcroHonda~2009TN67AB0464Rs.51.00(vii)
Jewelry, bullion and valuable ]6 Sovereigns70 Sovereigns9 Sovercignsthing (give details of weight and
Rs.2,08,OOORs.9,1O.000Rs.I.l7.000value)
(viii)
Any other assets such as value ofClaims/interest
(ix)
Gross Total value Rs.16,24,OOORs.9,92,350Rs. I, 17,000
B. Details of Immovable assets:
(Note: I. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated
2 . Each land or building or apartment should be mentioned separately in this fonnat.)
S. Description SelfSpouseDependentDependentDependentNo
-I-2-3
(i)Agricultural Land
Location(s)Survey number(s)Area (Total measurement inacres)Whether inherited property(Yes or NO)Date ofpureha~e in case of selfacquired propertvCost of Land (in case ofpurchase)at the time ofpurchaseAny Investment on the land byway of development,construction etc.Approximate Current marketvalue(ii)
Non-Agricultural Land S.No.166, KandapuramS.No.l66, PartLocation(s)
Street, VirudhunagarKandapuram Street,Survey number(s)
VirudhunagarPlot No.9 & 10Area (Total measurement in
574.75 Sq.ft682 Sq.ftsq. 1'1.) Whether inherited property
NoNo(Yes or NO) Date of purchase in case of self
27.08.1027.08.10acquired propertv Cost of Land (in case of
Rs.3,03,080Rs.3,57,208pureha~e )at the time of purchaseAny Investment on the land by
NilNil
way of development construction etc.Approximate Current marketRs.2,76,055Rs.3,27,570
Value Non-Agricultural Land
S.No.472/2C/2E DDLocation(s)
Road, VirudhunagarSurvev number(s) Area (Total measurement in
3259.5 Sqftsq. ft.) Whether inherited property
2006(Yes or NO) Date of purchase in case of self
11.10.2006acquired property Cost of Land (in case of
Rs.5,43,575purchase)at the time of purchaseAny Investment on the land by
Nil
way of development, construction etc.Approximate Current marketRs.5,71,000
Value
-
(iii) Commercial Buildings D.No.63/l ,64,65,65/1,65/2D.No.3/1, S.No.75/2,(including apartments)
,66Kambar Street,Location(s)
S.No. 93/2,94/Bl, 94/B,VirudhunagarSurvcy numbcr(s)
Kambar Street,Virudh un agarBuilt up Area (Total
830.27 Sq.ft139.84 Sq.ftmeasurement in sq. ft.) Whether inhcritcd property
NoNo
(Yes or NO) Date of purchase in case of self
14.11.199613.11.2002acquired propertv Cost of property (in case of
Rs.l,45,500Rs.68,930purchase)at the timc of purchaseAny Investment on the land by
NilNil
way of development, construction etc.Approximate Current marketRs.9,00,000Rs.I,07,000
Value Commercial BuildingsD.No.374/1, S.No.312,
(including apartments)Kadai Street,
Location(s)Virudhunagar
Survey number(s) Built up Area (rotal369 Sq.ft
measurement in Sq. ft.) Whether inherited property
No(Yes or NO) Date of purchase in case of self
15.09.09acquired property Cost of property (in case of
RsA,67,150purehase)at the time of purchaseAny Investment on the land by
Nilway of development, construction etc.Approximate Current market
Rs.7,42,700Value Commercial Buildings
D.No.34, S.No.331,(including apartments)
Pazakadai Lane,Loeation(s)
VirudhunagarSurvev number(s)Built up Area (Total
340 Sq.ftmeasurement in sq. 11.) Whether inherited property
No(Yes or NO) Date of purchase in ease of self
23.04.10acquired propertv Cost of property (in case of
Rs.2,94,450purehase)at the time of purchaseAny Investment on the hmd by
Nilway of development, construction etc.Approximate Current market
Rs.2,70,000value Commercial Buildings
D.No.28, S.No.261 P,(including apartments)
Pazakadai Lane,Loeation(s)
VirudhunagarSurvey number(s)
Built up Area (Total 383 5/8 Sq.ftmeasurement in SQ. n.) Whether inherited property
No(Yes or NO) Date of purchase in ease of self
08.11.10acquired property Cost of property (in case of
Rs.I ,33,340purchase )at the time of purchaseAny Investment on the land by
Nil
way of development, construction etc.Approximate Current marketRs.3,OO,OOO
Value (iv)Residential Buildings D.No.97 & 99, S.No.139,D.No.63, S.No.94/Bl,
(including apartments)Subbiah Street,93/2, Kambar Street,
Loeation(s)VirudhunagarVirudhunagar
Survey number(s)Area (Total measurement in
769.50 Sq.ft585.75 Sq.ftSq. ft.) Whether inherited property
NoNo(Yes or NO) Date of purchase in ease of self
15.09.200014.11.96acquired property Cost ofpropeliy (in ease of
Rs.I,86,650Rs.I,45,500purehase)at the time of purchaseAny Investment on the land by
NilNil
way of development, construction etc.Approximate Current marketRs.7,00,000Rs.3,OO,OOO
Value Residential Buildings
2/2, DD Road,(including apartments)
VirudhunagarLocation(s)
S.No.472/2Survey number(s)
Area (Total measurement in
1066.18 Sq.ftsq. ft.) Whether inherited property
No(Yes or NO) Date of purchase in ease of self
05.11.1992acquired property Cost of property (in case of
Rs.38,74Ipurchase)at the time of purchaseAny Inyestment on the land by
Rs.ll,07,140way of development, construction etc.Approximate Current market
Rs.12,30,000Value (v)
Others (such as interest inproperty)(vi)
Total of Current Market Rs.31,06,055Rs.26,18,270Value of (j) to (v) above
(6) I give herein below the details of Iiabilities/ dues to public financial institutions and government :(Note: Please give separate details of name of Bank ,institution, entity or individual and amount foreach item)
S. Description SelfSpouse(s)Dependent-lDependent-2Dependent-3No. (i)
Loan or dues to BanklFinancialNilNilNilInstitution(s) Name of Bank or FIAmount outstandingNature ofloanLoan or dues to any
NilNilNilindividuals/ Entity other than mentioned in (i) above.Name(s)Amount outstlmdingNature of loanAny other liabilityGrand total of liabilities
NilNilNil
(ii)
Government Dues: NilNilNilDues to departments dealing with governmental:l:ommodationDues to departments dealing
NilNilNilwith supply of water Dues to departments dealing
NilNilNilwith supply of electricity Dues to departments dealing
NilNilNilwith supply of telephones/mobilesDues to departments dealing
NilNilNilwith government transport (including aireratls andhelicopters)Inwme Tax Dues
NilNilNilWealth Tax Dues
NilNilNilService Tax Dues
NilNilNil
Municipal/Property Tax Dues
NilNilNilSales Tax Dues
NilNilNil
Any other dues
NilNilNilGrand total of all Govt. dues
NilNilNil
(7) Details of profession or occupation:
a. Self Groceries & Real Estate
b. Spouse Rental Income & Real Estate
(8) My educational qualification is as under:
(Give details of highest School/University education with full form of the certificate/ diploma! degree course)
(Name of the School /College/ University and the year in which the course was completed.)
DEPONENT
(9). ABSTRACT OF THE DETAILS GIVEN IN (I) TO (8) ABOVE:
I. Name ofthc candidate Sh./Smt./Kum. S.KAMATCHI
2.
Full postal address 2/2, DD ROAD, VIRUDIIUNAGAR
3.
Number and Name ofthc constituency and state206VIRUDHUNAGAR
4.
Name ofthe Political party which set up the Bharatiya Janata Partycandidate (otherwise write 'Independent') 5.
(a) Number of cases in which conviction orderNil
passed (other than those referred to in Form 26) (c) Total number of Pending cases where the
Nil
court (s) have taken co.e,nizance 6.
PAN of Year for which lastTotal Income ShownIncome Tax Rcturn filed(a) Candidate
AEZPK 9917 R200910 2,49,550
(b) Spouse:
ACHPJ 1716 H2009 -102,12,490
(c) Dependents
SON NilNil
7.
Details of Assets and Liabilities in rupees
Description
SelfSpouseDependent-IDependent-IIDependent-Ill
A.
Moveable Asset16,24,0009,92,3501,17,OOO(Total value) B.
Immovable Asset
(i)
Purchase Price and 6,73,97120,10,153Development Cost of Immovable Property(Total Value)(ii)
Approximate Current 31,06,05526,18,270Market Priee of Asset (Total Value)Liabilities
(i) Government
NilNilNildues (Total) (ii) Loans from Bank,
NilNilNilFinancial Institutions and others (Total)8.
Highest educational qualification:6th Standard(Give details of School! University education with full form of the certificate! diploma! degree course) (Name ofthe School!College! University and the year in which the course was completed.)
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: no part of it is false and nothing material has been concealed there from. I furtherdeclare that:
(a) there is no case of conviction or pending case against me other than those mentioned in items 3 and 4 above;
(b) 1, my spouse, or my dependents do not have any asset or liability, other than those mentioned in items 5 and 6above.
Verified at Virudhunagar this the 24th day of March 2011
Note: 1. Affidavit should be filed latest by 3.00 PM on the last date of filing nominations.
2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a NotaryPublic.
3. All columns should be filled up and no column to be left blank. If there is no information to furnish in respectof any item, either "Ni I" or "Not applicable", as the case may be, should be mentioned.
4. The affidavit should be either typed or written legibly and neatly.
SOLEMNLy AFFIRMED AND" SIGNED BEFORE ME
RN. PREMKUIVIAR'ADVOCATE & NOTARY
'" VIRUDHUNAGAR
REGISTER No~ ,30 b '~'.'G.O.M.S. 60 (LAW) dt; 16-3-07
ANNEXURE IX - C
(CHAPTER V,PARA-7.2)
FORM 26 (SEE RULE 4A)
Affidavit to b;furnished by the candidate before the Returning Ofticer for election Tamilnadu State Assembly (name ofthe House from Virudhunagar Constituency (Name of the Constituency)
!l~I S.KAMA n~:HISon of SELLAIAH NADAR aged about 58 years, residing 2/2, DD Road, Virudhunagar ofBharatiya Jal,Jata Party candidate at the above election, do hereby solemnly affirm/state on oath as under:
~,1. l/am not accused of any offence(s) punishable with imprisonment for two years or more in a pending case(s) in whicha charge (s) h~~/have been framed by the court (s) of competent jurisdiction.
i:i~
2. 1 have been~/ have not been convicted of an offence (s) [other than any offence (s) referred to in subsection (I) or sub-
section (2), or!fovered in sub-section (3), of section 8 of the Representation of the people Act, 1951 (43 of 1951 )] andsentenced to itilprisonment for one year or more.
Place: Virudhunagarp
Date: 23.~~~~
Signature of Deponent
VERI FICA TION
I, the above - named deponent, do hereby verify and declare that the contents of this affidavit are true and correct to thebest of my knowledge and belief, no part of it is false and nothing material has been concealed therein.
Verified at Virudhunagar this 23rd day of March 2011
~. f!o n.}A~-Jf--/ Signature of Deponent
Note: "The columns in this Form which are not applicable to the deponent may be struck off'
SOLEMNLY AFFIRMED ANDSIGNED BEFORE ME
REGISTER No: 305G.O.M.S. 60 (LAW) dt: 16-3-07
PaN.PREMKUMARADVOCATE & NOTARY
VIRUDHUNAGAR
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APPEN.PIX VI...,tSTATEMENT OF SUMMARY QF PARTICULARS/INFORMATION
fURN(5H~Q Itl AFFIDAVITS(CHAPTER II PARA 4.5(3.1))
206, Virudhunaaar Assembly Constituency.
51. ,
No.
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1
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