Annexure 15

ABSTRACT STATEMENT OF ELECTION EXPENSES.' I

PART - I \

I Nameof the CandidateSh./Smt./ Krn. ...1,Y" 1'111\ ,V;! \-Il~ ~ IJ \

II Number and name of Constituency '19 - I\-'Of--!

III Nameof State/Union Territory ~ ft K"1'1\ N+'\-

IV Nature of .Election !~,tctt~ I(Pleasemention whether General J~\/~~ e-\~'l~<IL\.* I

Election to State Assembly / LokSabha/ Bye- election)

V Date of declaration of result ,9 , 10 \ ~D i\.)..

VI Nameand Address of the Election ./::,l,Vi-~I\~L/-e~ . N{ tiJ t:\1\CLfJ !J\Agent

VII If candidate is set up by a political--v

party, Pleasemention the nameof 'f ~~ ( HLP) WC\-\\ '1M Lpthe p_oliticalparty if

VIII Whether the party Is a recognised Yes/No 'IV;political party

Date: . Jl.t /" J 2.01'1

Place: "J l) Ii

~Signature of the Candidate

Name I')" Y f) mAT PA H lLO ~N

103

I

2 - -

-rartr~.jars-,__ ------------r-A-m-t.--l-r--A-m-t-.-_""'-A-m-t-,-1"'-:T~~_, \ . \ ln~~~edbV\~:;~~~~ IrUnedl \ (3)+(4)+(5) l,

candidate d bVpoi. authorize \\ IElectIOn part'! d bV ' i• agent(in (InRS.) latherS . \

__ ~ ----------------------~~~~,.~)--~----~(~iin~R;S~')~~-- \3 4 5 6 ~--,

\\

expenses in publiCmeeting, rallY, procession

etc.:-1. a " expenses in publiCmeeting, rallY,proces~on etc. (te: other than the ones withStar campaignerSof the political partY(Encloseas oer schedule-1)

- -_--- \

\

1. b : expenditure in publiCmeeting rallY,processionetc. with the star campalgner(S) ••(te. other than thOse for general part'! '\oropaoanda) IEnC(oseas per SChedule-2) -

1

III

- --

-- \ -,I\\

\ -campaign materials other than thOse used int\1e publiCmeeting, rally, procession etc.mentioned in S.NO.I abOve(Encloseas per

schedule-3)

-

PART111: ASSTRAcT Of SOURCEOf fUNOS RAISEO BYCl'NDlOA1E3 1

\ 1

Amountof own fund used for the election campaign(Endose as per SChedule- 7) ILumpsum amount receIVedfrom the part'! (Ies) In cash or che<lUeetc.

(Encloseas per Schedule -8)u

ParticularsS NO1 2

1()4

PART-IV

FORMOFAFFIDAVIT

Before the District Election Officer ~Le,4Qf0.:...8.\\.h·:'·d~hfl"(District, State/Union Territory)

Affidavit .of. Shri/Smt/I\is 1'\.( i'tt:l 'J1l~ p.cY:J.!.P..~.h~ (S/O, W/o,D/o)".A.b.d...I.JLR.a..hk~............... I ,,\ vt-~mp,.J...f.a..W.WG\'" son/wife/daughter of

~~I!':~~d'=~~t~'~~d'd~~i~~e :~~~d~;';~'" years, r/oVn(~"DihJe;ih~)1··;·P.g~T~~.~fll.l W. Drstt NVH (M~uXd)

(1) That I was a contesting. candidate at the general election/bye election to the House of the People/LegislativeAssembly of "." H.8.R,..'f,.A-.NA from 7,.9.."":'": N.U.H ...............Parliamentary/ Assembly constituency, the result of which was declared on..... 1.q·f.l·o.·/;J.C:.t.4(2) That I/my election agent kept a separate and correct account of all expenditure incurred /1 __authorised by me / my election agent in connection with the above election between .~s:.!.o.9.14 Io(the date on which I was nominated) and the date of declaration of the result thereof, both days \sl \0 \ '"inclUsive. •

(3) That the said account was maintained in the Register furnished by the Returning Officer for thepurpose and the said Register itself is annexed hereto with the supporting vouchers/bills mentioned inthe said account.

(4) That the account of my election expenditure as annexed hereto includes all items of electionexpenditure incurred or authorised by me or by my election agent, the politicai party which sponsoredme, other associations / body of persons and other inqividuals supporting me, in connection with theejection, and nothing has been concealed or withheld/suppressed therefrom (other than the expense ontravel of leaders' covered by Explanations 1 and 2 under section 77 (1) of the Representation of thePeopleAct, 1951).

(5) That the Abstract Statement of Election Expenses annexed as Annexure II to the said account alsoincludes all expenditure incurred or authorised by me, my election agent, the political party whichsponsored me, other associations / body of persons and other individuals supporting me, in connectionwith the election.

(6) That the statements in the foregoing paragraphs (1) to (5) are true to the best of my knowledgeand belief, that nothing is false and nothing material has been concealed.

Deponent .[). . f'Ji'f<!\~ icJJ.wC\Y\. .

Solemnly affirmed/sworn by " at " this day of 201 before me.

(Signature and seal of the Attesting authority, i.e. Magistrate of the first Class or OathCommissionor Notary Public)

;

105

ACKNOWLEDGEMENT FORM

To

THERETURNINGOFFICER,

NUH ("1£WAT_JCONSt,'tU e.n c.~ ~ 79

Sir,

. :2oILl/qS73 - 'fl,o;J 21 _ 10 - 20 \ 4 '.I acknowledge receipt of your letter No dated along with Itsenclosurescontaining, among other documents, a Register bearing serial No for maintaining ofmy accounts of election expenses.

2. I have noted the requirements of law for maintenance of account of election.expenses andlodging of true copy of that account Wi~ the District ElectionOfficer / Returning Officer.

Yours faithfully, ~~U\rtr

(Signature of Candidate with date)* Strike off whichever is inapplicable.

•

. ........................................................................................................................................................

ACKNOWLEDGEMENT(To be filled up by Office)

The account of the election expenses in respect of (Constituency) result of whichwas declared on "'"'''''''''''''''''''' (Date) has been filed by him Ion his behalf on (Date)and has been received by me today the (Date) of..................."." .(Month) (Yeart-r

District. _Office Seal District Electoral Officer

106

Schedules- 1 to 9: Details of Elections Fundsand Expenditure of Candidate

Schedule- 1. i

I

Expensesin public meeting, rally, processionetc. (ie: other than those with Star Campaignersof the Politicalparty)

S. Nature of Expenditure Total Amount Sourceof ExpenditureNo in Rs. Amt. incurred / Amt. Amt. incurred

. Auth. by incurred / by othersCandidate/ by Pol. Iagent Party with I

name !i

1 2 3 4 5 6

1 Vehiclesfor transporting visitors >- NIL NiL Nj L NIL2 ErectingStage, Pandal& Furniture, Fixtures,

f'..//'L ;'/" L j'\/r'L IV/Lpolesetc.

3 Arches& Barricadesetc. Nr'L f\-(r'LJ NiL If'\.f I l

4 Flowers/garlands NIL I\.} / LI "';L i ___f\ILLi

15 I IHiring Loudspeakers,Microphone, amplifiers, N/L /\.(/L

r I ~fiLcomparers etc. I nu I i

6 Posters,hand bills, pamphlets, Banners,Cut- f\f; t ! AI/ L I 1\// L ! N/L Iouts, hoardirlgs .. ",.. ,_ , I i

1

7 Beverageslike tea, Water, cold drink, juice etc. I f\j; L ",,; L NIl 1 NILI-8 Digital TV -boards display, Projector display, ~. , J\I/ l i , I

tickers boards, 3D display NIL Nil i 1\1 , LII

19IExpenseson celebrities, payment to musicians, Nil I N/L I NiLother artists remuneration etc. N'fL i

10 Illumination items like serial lights, boardsetc.'" iI

I Nil NiL Nil !

11 Expenseson transport, Helicopter/ aircraft / I 1vehicles/ boats etc. charges ( for self, celebrity "

,NiL I1\(" L 1\11 t '\~ILor any other campaigner other than Star ,

Campaigner)

12 Powerconsumption/ generator charges f'.-.\i L Nil I Nil , ~iLI i

13 Rentfor venue Nil NI L i , 1 ~ILI f\tll' i II

114 J Guards& security charges 1\11L NIL I . , I ~l'lt-U t I J, I I I15 Boarding& lodging expensesof self, celebrity, ~ I NtL I Hi L 1party functionary or any other campaigner NIL t--.\ j' l i

includingStar Campaigner i i16 Othersexpenses 1'--\ \ L Nl \- ,\11L I I~" l. !

__ ~\\ L_ I ,,-,; L I l\tl'l I i~\ l II Total iI

Schedule- 2Expenditurein public meeting rally:,processionetc. with the Star Campaigner(s)as apportioned to candidate (ie:otherthan those for general party propaganda)

107

.......

S. Nv Date and Name of the Star Amount of Expenditure on PlJblic meeting Remarks, if anyVenue Campaigner(s) & Name of Party rally, procession etc. with the Star

Campaigner(s} apportioned to the candidate(As ' other than for general party

! :IJ[ '':J ) in Rs.

1 2 3 4 5

1 - - - -2 - - - -3 - - - -4 - - - - ---Total - -Schedule-3Details o~expenditure.on campaign materials, li.k~h~ndbil.Ls,:pamphl~ts,-'po~~rs,hC?<lrdings,~anl'1ers,cut-?uts, gates &arches, video and audio cassettes, CDs/ DVDs,Loud speakers, amphfiersl'dlgltal TV/ board display, 3.0 display etc. forcandidate's election ca......"'''':~p( le: other thantbQse,covered·in Sched.ul~-.1& 2)

S. Nature of Expenses Tota! Amount: 1"",,1';';"''''' of Expenditure 1;:\","101"''', if anyNo. in·Rs. I""" : .

Am~.~y. Amt. By Pol. Amt. By others

.~

". .,.'. . .

1 Il:i:;~~.'~';'}:',/,:' , : .....h [.Sit" , . ," , ):';') . f'~ .: ' ~~~.7\1'7'"'' .[.:1 IFt};~~1;Ip~~'~f." 3> 'bO 0 .',:3c. - '''' .W't11\' '~-tilJR: M-2 l ou.d -sbe.a.l{~ 4~ooo' 42000 - - -3 .'" - - - -- - ~ . » . » -4 - - - - -,Total '1%"00 78'~()O - - -Schedule- 4Details of expenditure on'campaign through print and eleqrooic.,media including cable n.etvvork,bulk SMSor internet orsocial media etc. for candidates. NatiJre of .Name and address Name and add~~ss'of ITotal Amount SQIJfCeSofExpehditure

·h~."' :

No medium Ofmedia provider: agency, reporter:~.;sUi9$ler:,lin Rs.(electronic / (print /eJectro(lic company on ar:l¥~.persor,tto Amt. By Amt. By Arnt. Byprint) and Isms I voiCe/cable whom. charqes I candidatel Pol. othersduration TV, sodal media commission etc. paid! agent Party

etc.) payable, jf any Col. (3) +(4)

1 2 3j

4 5 6 7 I.?'. ·'r "iIt~i;'~:'1 - - . , '.: - - - -

2 - - - - - - -!

3 - - - - - --. I4 - - - - - - , -Total - - - -

108

"\~

\ I

"

schedule -5DetailSof ex~eodlture,Ql>>I¥'_i>,W;b!f1~~nd,J?;IlI! exp~l\,!r~n ye,h;,t~(5J (or candid,ate's election q!mpaign

s. Regn. No. ofHiring Charges of vehide

. NO. of Total amt.Source of Expenoiture

No Vehicle &.

Oaysfor incurredl

Type of Rate for Fu~' charges :Oriver'.swhich auth. in R~. Amt. By Amt. By ,Pol. Amt.

Vehicleused

Hiring of (If not charg~S~ndidatel Party By

vehlde I covered (lfOQ~agent

other

malntenan under ,hiring) covered

s

ceunder-hh:logl

..

:'_ . -

1 2 3a . 3b 3c it 5

..

AlA.: ~s "ODt-

6 7 8

. lo~o - - ,-0 ~ 30~0

HI.: SS400i

, '3000 - -1

t}._.,. .

1000 -6r

• - ,_.0 3· -- 3poo .~ooo \,_.

2 HI..SS""1

- '('I

lcoo S-oo -;500- 1~" .: :. \.i 2.~oc _.

Y,1oo.o

3 'HP.. '_'fo~'7 2.~,o~o.. ,'.

- -Sot>

,-

Seo - \~-- ~Sooo '4S0bO

4 h ~-~S'~S"q4, ... ,_' - .

" -- -

2.ooD; .. '; Soo S~o r."."s-

' '

~. Hi(- t~lS"'.S" 2..~~o

',-" ;.' ~56C>0" \.\5"000 - -

. .. . .'..

~Ct) S''bb. .-

.- .

~"'" H ~ - 2.c. "~'!l< .2;0'00,. - \5' .. \..\5t>6c ~ S"()flb - -

Soo $'00: " ~:.

_.

LI.. H1R·?'CZJt5'78 2.0~'b

..: t~ ,-\sooo \.\·S 006

Soo . S'e()< .'

- -~8 HR· 5S 466"1

' . \5... ..

~600

' .. '45MC 4StlOb

500 .' SO~." . "-;','

, - -

~9 H~·~7~~1 ,J060

tl; . e;:b66 9o()0

SO~ $60' '''''.-~ .. " .,"

-lio '1~-~ b ~'1.

..~.~

9~:(,()-

~O~O'"

.- ..: -. _"9060

I I"}~.$60

-~. HA.~1C.7~2.

sot. &6 '''3'6001.. -

I&bb» -

.. ~&.Q

- --

i12 HI\-2.!.12. ' 10'0'0.. 0(, :"'"660

-722. ..

-' ....-.

6eootrr

- .... ",- ~; .. ()c. ":"'l:t~o'o,. :-_ -

Total .. "

. 000, 0 d'o:!.t:'15! ' r

ve

"'/130~30o I

-~-.'

'30,6300-r - .:r.=-, DbI~chedule- 6

sourc~s of ExpenditureS D ..,'" ," ..,.,',,~,," p 90 workers / agentsN~ vate and ExpensesonCampaig " " ......~,,:,~., ",-~etail~ ~~e~penditureonCam ai·

enue ' n workers' . ~.. "-."~..' '.' - _.Nature of Expenses' Total amt.Qty. No. Of workers Incurred/

,\'agents auth. In Rs.Amt. By Amt Bcandidate/ pa~ y Pol.agent

Amt. Byothers

83a 3b 3c2 6 71 91 Campaignworkers

honorarium/ salaryetc.

Total

ISchedule- 7iDetails of Amount ofown fund u1ed for the election campaignS. No. Date Cash I 00/ Cheque no. etc. with Total Amount in Remarksdetails of drawee bank Rs.1 2 3 4 5 61 1:25-""''1 /6000 :::00 - !DOOO::IS"O NoM1n4:/.it.2 I

1:U.4-14 -- - - -3 '~'-'1-ILt ). t:t;~oo ::'00 - ~'800=()Cl , De. t-cu..L A+t e.4 1:2.%-,-14 3S,s-o =00 - -:;g.,So =&6 - c:lo -5 !J.7-1-'4 311tflO'::~0 - ~44Io:t6CJ - clo-6 130- 't- tlt 31"t>o:oo C;S IIo,64Q, ~~,J" 31400 ':'bO - cJ.o-7 01-10 -Itt '3 ~()OO .=. 00 UN'e "'I - '~ 1'\ \\4 !'' 3t2.660 ::06 - d.o-NO.H_ 00 L,,,S'8 o ~--/0 -''1 .t_q, 70 : C)(;) II c , SO~ll J..lfl,~ ::06 - e(o-9' 103-10-'4 ,,900 =e,o - "geo :60 - e(.o-10 ioLt-to..t(f , .:29770 :'00 '" - '-8770 =0tI _·c{o-11 I Os- to -(tf j_ct" 80 :.tso - :tq lJ B 0 u:rD -do12 0(,-10 -IV ~g9.:2.o =tm - :1.99 ,20 =~ -dor-----.:, ,

o '!l./o~/'I ~q8€'o ::60 u t.4 Iot.rl~·;!t'lll~~S',; :'_Cfg l,o ':.t1b - d.cl13I

6~ -/0 -I't :(8s 10 -:00 ~gS7-0 =0& - etc14 -.15 09-/o-t4 ' :t7_~bO ::00 I~~; 180a~~J8~~1. 3.7"'0::.00 -do16 10 -IO-fit ~91:16 ::'00 I) 180,/, 18tJ'~ :91/f):'oo -do17 i (i-If) ..t'f J"3,c =00 .J) 18097 ..t!l3 "=60 -clo-1.8 [I '-.-/0 -lit ~q .:tc,o ::ot> .1,1 » ',I Jt, '-.1,0=00 - el «19 1~-/f)./4 II '"3' ~b() )} 2) 2_' 11 (3 c..:. 60 ell" x,

IJ;:_;_:J~ ~:;J~Z~"u I" -., '.. (-:~I~~<> .......20 :,~ :.~ ..I_, ..tI ..., ~I!3 =-e.b - e.I..

Total 54t.93~~e,o - 5q'93'~oo - do

\

Total

Schedule· 8Details of Lump sum amount received from the party (ies) In cash or cheque or DD or by Account Transfer

S. Nameof the Political Party Date Cash DD! Cheque no. etc. Total Amount Remarks, if

No.

with detailSof drawee in Rs. any

bank

1 23 4 5 6 7

1 - - - - -, ......

2 - - - -- - -3 - - - - - -4 - - ~ - - - -

--

Total- - - -

Schedule· 9-

Details of Lump sum amount received from any personlcompany/firm/associations/bodY of persons etc. as loan, ~Ift or

donation etc.

S. Nameand address 'Date cash DD! Cheque -Mention Total Amount Remarks

No.no. etc. with whether loan, in Rs.

.detalls of gift ordrawee bank donation etc. .

1 2 '3 4 5 6 7 8

- -.... -: _-- -..

1 - - -,-,.-,

2 - - - -3 - - - -4 - - - -

Total- - -

Note:1. In Schedule 5:-(a) copy of the order containing list of all vehicles for which permit issued by the Returning Officer tobe

enclosed.(b) If the vehicle is owned by the candidate/his relative!agent are used for election purpose, noticoalcost of hire of all such vehicles, except one vehicle if owned and used by the candidate, notional costoffuel and drivers salary for such vehicle, shall be included in total amount of expenditure in the atnve

table. ;2. In all schedules if any expenditure on goods and services, provided by the Political Party; or provsedby any person! company! firm /associations/ body of persons etc. on behalf of the candidate, tnentnenotional market value of such goods or serVicesare to be indicated, in respective columns.3. In Part -Ill, the Lump-sum amount of fund received from the political party or others or thecandidate'Sown funds, shou'ldbe mentioned date wise. In all such cases such amounts are requiredtobe first deposited in the bank account of the candidate, opened for election expenses.4, Eachpage of the Abstract Statement should be signed by the candidate.

110