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FORM 26(See rule 4A)
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frAFFIDAVIT TO BE FITED BY THE CANDIDATE ATONG WITH NOMINATION PAPER BEFORE THERETURNING oFFlcER FoR EtEcrloN To TELANGANA tEGlst-ATtvE AssEMBLy FROM 106 -WARANGAL EAST - tAC CONSTITUENCY.
PART -A
IvENKATESHWARLU CHtppA son of MAttAtAH CHtppA aged 42 years, resident of H.No, LL-25-a47,Padmanagar, Near Markandaya Temple, Kothawada, warangal (Urban) - 506002 a candidate at theabove election, do hereby solemnly affirm and state On oath as under:-
(1) I am candidate set up by |ND|PENDENT CANDTDATE.(2) My name is enrolled in 106-Warangal East, Telangana at Serial No,246 in part No.g(3) My Contact telephone number is 9849221300 and my E-mail tD is.
[email protected] media account: chippa venkateshwarlu netha (face book)
(4) Details of Permanent Account Number (pAN) and status of filing of lncome Tax return.
S.No. Names
VENKATESHWARLU
CHIPPA
PANThe Financial Year fo r
which the last lncome-Taxreturn has been filed
Total incomeshown in
lncome-taxreturn (inRupees)
1 AWZPC4936G Financial Year 2018-19 Rs.4,69,678/-
2 TAXMICHIPPA NIL Not submitted NOT
APPLICABLE
3 Dependent - 1NOT
APPTICABLENOT
APPLICABI.E
4 Dependent - 2NOT
APPLICABLENOT APPLICABTE
NOT
APPLICABLE
(5) Pending criminal cases
(i) I declare that there is no pending criminal case against me. No cases pending
frick this alternative ifthere is no criminal case pending against the candidate and write NorAPPLICABLE against alternative (ii) below)
OR
Y
1
?-/
\ntGA
s
to/*
H-Z
L;4---
TftA GA"A
NOT APPLICABLE
DaA
in the Table below)Table
(a)
FIR No. With name and
address of Police
Station concerned
NOT APPLICABLE
NOT APPLICABLE
(b)Case No. with Name ofthe Court
NOT APPTICABLE l-
I
OT APPLICABLE
(c)
Section(s) of concerned
Acts/Codes involved(give no. of the Section,
e.g. section.... Of lPC,
etc)
NOT APPLICAETE NOT APPI-ICABLE
(d)Brief description ofoffence
NOI APPLICASLE OT APPLICABTE
(e)
Whether charges have
been framed (mention
YES or No)
OT APPLICABLE OT APPLICABLE
(f)
lf answer against (e)
above is YES, then give
the date on which
charges were framed
NOT APPLICABLE NOT APPLICABLE
(e)
Whether any Appeal /Application for revision
has been filed against
the proceedings
(Mention YES or NO)
NOT APPLICABLE OT APPLICABLE
:)
t\0.\ 2
Atl \,
ufTz
d*ih.
(a) Case No. Not ApplicableNot Applicable
(b) Name of the Court Not Applicable
Not Applicable
(c)Sections of Acts/Codes involved(give no. of the Section, E.g.
section.... Of lPC, etc)Not Applicable
Not Applicable
(d)Brief description of offence forwhich convicted Not Applicable
Not Applicable
(e) Dates of orders of conviction Not Applicable
(f) Punishment lmposed Not ApplicableNot Applicable
Whether any Appeal has beenfiled against conviction order(Mention YES or No)
Not Applicable
Not Applicable
(h) Not ApplicableNot Applicable
(7)
oteN
(64) lhavegivenfull and up-to-date information to my political partyaboutall pending criminal casesagainst me and about all cases of conviction as given in paragraphs (5) and (6).
[candidates to whom this item is not applicable should clearly write Nor AppucABtE tN vtEW oFENTRIES lN 5(iland 6(i), abovel
1. Details should be entered clearly and legible in BOLD letters2' Details to be given separatery for each case under different corumns against each item.3. Details should be given in reverse chronorogicar order, r.e., the latest case to be mentioned
first and backwards in the order of dates for the other cases.4. Additional sheet may be added if required.5. candidate is responsibre for supprying aI information in compriance of Hon,bre supreme
Court's judgement in W.p(C ) No.53G of 2011.
That I give herein below the detairs of the assets (movabre and immovabre etc.) of myserf, myspouse and all dependents:
3
.Jt.,t1 '9i
L(J^A
(6) Cases of conviction(il I declare that I have not been convlcted for any crimlnal offence. No Conyictions
(rck thls alternative, lf the candidate has not convicted and write Nor Appl-tcABLE againstalternative (lll below)
OR(iil I have been convicted for the offences mentioned below: NOT AppL|CABLf
{lf the candldate has been convicted, then tlck this alternatfue and score off alternative (l}above, and give details ln the Table below)
Table
Not Applicable
(c)
lf anser to (g) above is YES, givedetails and present status ofappeal
(?r
d"trbz
A. Details of movable assets:Note:1' Assets in ioint name indicating the extent ofjoint ownership will also have to be given.Note:2. ln case of deposit/tnvestment, the details including serial Number, Amount, date of deposit,
the secheme, Name of the Bank/tnstitution and Branch are to be givenNote:3. value of Bonds/share Debentures as per current market value in stock exchange in respect of
listed companies and as per books in case of non{isted companies should be givenNote:4. 'Dependent' means parents, son(s), daughter(s) of the candidate or spouse and any other
person related to the candidate whether by blood or marriage, who have no separate meansof income and who are dependent on the candidate for their livelihood.
Note:5. Details including amount is to be given separately in r€spect of each investment
DescriptionSpouseTAXMI
CHIPPA
Dependent1
CHIPPA
KIRAN
NUMAR
Dependent2
CHIPPA
KAVYA
I Cash in hand Rs.50,000/- Rs.30,000/- Nit NI"
Details of deposit in bankaccounts (FDR, Term Depositsand all other types of depositsincluding saving accounts),Deposits with Financiallnstitutions, Non-BankingFinancial Companies andCooperative societies and theamount in each such deposit.
1). SBl, lndustrialEstate, A,/c.No.3AO75907577
Rs.5,000/- (ElectionAccount)2).SBl, lndustrialEstate, A/c.No.33515642928,Rs.2,58,800/-3).581, lndustrialEstate, A/c.No.31872575884,Rs.8,185/-4).Andhra Bank,HNK, A/c.NO.
o2061002s27367s,Rs.82s4/-
5).Andhra Bank, LB
nagar, A,/c.NO.
076070027000472,Rs.7102/-
1).SBr,
lndustrialEstate,A/c.No.35591872988,Rs.10,158/-
1).SBr.
lndustrialEstate,
A/c.No.35198861929Rs.762/-
1). SBr,
MGMWarangal Br,
A"/c.No.
62207893384Rs.21,366/-
Deposits Financial lnstitutions.Non - Banking financialCompanies and Co-operativesocieties and the amount ineach such deposit.
NIL NIL NIL NIL
Details of investment in gonds
debentures/shares and units incompanies/mutual funds andothers and the amount
NIL NIL NIL NIL
iD
Details of investment in NSS.
Postal Savings. lnsurancepolicies and investment anyFinancial instruments in post
-office or lnsurance company
Ad the amount.
NIL NIL NIL
4
,Io
Ir{0.
s.
No.
SelfVENI(ATESHWARLU
CHIPPA
lr
NIL
NG+*
a
Personal loans/advance given
to any person or entityincluding firm. company. Trustetc and other receivables fromdebtors and the amount.
NIL NIL NIL
T. s.
B. Details of lm ble Assets:Note: 1. Properties in joint ownership indicating the extent ofjoint ownership will also have to beindicated.Note: 2. Each land or buildin or apartment should be mentioned separa in this format
7AGI
NIL
1)TwoWheeler,GLAMOUR,AP36AE1114, 2012,Rs. 20000/-2)TwoWheeler,GLAMOUR,AP35428034, 2013,Rs.20000/-
3)Four Wheeler,TATA INDICA VISTA,
AP36TV202s, 2013,Rs.350000/-
NIL
Jewellery, bullion and valuablething(s) (give details of weightand value)
30 grams cold,Rs.90,00O/-
80 grams
Gold,Rs.2,40,000/-
Nit Nit
v t
Any other assets such as valueof claims/interest
NIL NIL NIL NIL
Gross Total Value Rs.8,77,847/- Rs.2,50,158/- Rs.162/- Rs.27,3661-
OescriptionselfVENKATESHWARLU
CHIPPA
Spouse
LA)(MI CHIPPA
Oependent 1
CHIPPA KIRAN
KUMAR
Dependentz
CHIPPA
KAVYA
Agricultural Land
Location (5) Surveynumbers(s)
Nil Nil Nil NIL
Area (totalmeasurement inacres
NILNIL
NIL
Whether inheritedproperty (Yes or No)
Not Applicable Not Applicable NotApplicable
NotApp lica b le
Date of purchasein case of self -acquired property
Not Applicable Not ApplicableNotApplicable
NotApplicable
Cost of Land (in
case of purchase)at the time ofpurchase
Not Applicable Not Applicable NotApplicable
NotApplicable
Any investment onthe land by way of NIL NIL NIL
ct.
ll,lG trbe
5
MotorVehicles/Aircraft s/Yachts/Ships(Details of Make, Registrationnumber etc. year of purchase
and amount,
Nit NIL
v
tx
s.No.
NIL
\
(i)
NIL
*r
development,construction etc-
Approximatecurrent marketvalue
NIL NIL NIL
tturalNon -
Land:
location(s) Surveynumber(s)
NIL NIL NIL
Area (totalmeasurement insq.ft.)
NIL NIL NIL NIL
Whether inheritedproperty (Yes orNo)
NO NO NO
Date of purchase
in case of self-acquired property
Not Applica ble Not Applicable Not
Applica ble
Not
Applicable
Cost of Land (in
case of purchase)
at the time ofpurchase
Not Applicable Not Applicable Not
Applicable
Not
Applicable
Any investment on thtland by way ofdevelopment,construction etc.
NILNIL NIL NIL
(ii)
Approximatecurrent marketvalue
NIL NIL NIL
Commercialbuildings(including
apartments)LocationsSurvey no.(s)
NIL NIL NIL NIL
Area (totalmeasurment insq.ft)
NIL NIL NIL NIL
Built-up Area(totalmeasurement insq.ft)
NIL NIL NIL NIL
Whether inheritedproperty (Yes orNo)
NO NO NO NO
Date of purchasein case of self -acquired property
NIL NIL
(iii)
Cost of property(in case ofpurchase) at the
NIL NIL NIL NIL
6
I
2 t
GAL
\.)
t5l"t
NIL
N IL
NO
NIL
NIL NIL
4,,,
time of purchase.
Any investment onthe property by wayof developmentconsruction etc.
NIL NIL Nrt NIL
Approximatecurrent marketvalue
Ntt Nil Nrt NIL
ResidentialBuildinqs(including
apartments)Location(s)-Survey
numbe s
1).H.No:11-25-847ll,Kothawada2l .H .Not22-8-21 6/36,MarkandeyaNagar
NIL NIL NIL
area (totalmeasurement in
acres)
1).60 sq.yrd,
2J .720 sq.yrd , NIL Ntt N IL
Built up area (Totalmeasurment in
.ft)
NILNIL Ntt NIL
No)
Whether inheritedproperty (yes or 1). Yes
2). No NO NO
ertya cquired p
Date of purchasein case of self -
1).Not applicable2).2005 NIL NIL NIL
Cost of property(in case of
purchase) at thetime of purchase
1).Not applicable2]..2o0o00/- NIL NIL NIL
Any investment on theland by way ofdevelopment,
construction etc.
1).Rs.6,00,000/-2). Rs.1,50,000/- NIL Nrt
(iv)
Approximatecurrent market
va lue
1).Rs.18,00,000/-2).Rs.12,0o,OoO/- NIL NIL NIL
Others (such asinterest in NIL NIL NIL
Totalof currentmarket value of (i) to
(v) aboveRs.30,00,000/- Nrt NIL
NIL
YAr';.$
77L-];
t- Itel qlr/9
NO
NIL
Nrt
--of)--*ry
hRi
(8) I give herein below the details of liabilities/dues to public financial institutions and Governmenti(Note: please give separate details of name of bank, institution, entity or individual and amount
before each item
8
+,
S.No DescriptionSelf
VENKATESHWARI.U
CHIPPA
SpouseLAXMI
CHIPPA
Dependentl CHIPPA
KIRAN
I(UMAR
oependent2
CHIPPA
Loan or dues toBank/financialinstitution(s) Name of theBank or financialinstitution, Amountoutstanding,Nature ofloan
NIL NILNIL NIL
Loan or dues to anyOther individuals / entityother than mentionedabove Name(s) Amountoutstanding, nature ofloan.
NIL NIL NIL NIL
Any other liability NIL NIL NIL NIL
(i)
Grand total of Liabilities NIL NIL NIL NIL
(ii) to departments dealingwith governmentaccommodation
nt dues: DuesGovern
(A) Has the deponent been in occupation ofaccommodation provided by theGovernment at any time during the last tenyears before the date of nofication of thecurrent election?
(B) lf answer to (A) above is YES, the followingdeclaration may be furnished namelyi(i) The address ofthe Governement
accommodation:(ii) There is no dues payable in respect of
above Government accommodation,towards -(a) Rent;(b) Electricity Charges;(c) Water charges; and(d) Telephone charges as on
(The date should be the last date of the thirdmonth prior to the month in which theeletion is notified or any date thereafter)
Notei'No Due Certificate' from the agenciesconcerned in iespect of rent, electricitycharges, water charges and telephonecharges for the above Governmentaccommodation should be submitted.
NO
(iii)
\.r.
Dues to departmentdealing with Governmenttransport (includingaircrafts and helicopters)
Nil
u AL
o
tTbj
a =4.-"q*4
(iv) lncome tax dues NIL NIL NIL NIL
(e) Details of profession or occupation:a) Self: BUSINESS
b) Spouse: House wife(9A) Details of sources of income:
(a) Self: BUSINESS(b) Spouse: Not applicable(c) Source of lncome, if any, of dependents, Dependent - l: NOT AppLICABtE
(98) Contracts with appropriate Governemtn and any public company or companies:(a) Details of contracts entered by the candidate.. Nil ..(b) Details of contracts entered into by spouse .. Nil ..(c) Details of contracts entered into by dependents.. Nil ..(d) Details of contracts entered into by Hindu Undivided Family or trust in which
the candidate or spouse or dependents have interest.. Nil ..(e) Details of contracts, entered into by partnership Firms in which candidate or spouse or
Dependents are partners.. Nil..(f) Details of contracts entered into by private companies in which candidate or spouse or
Dependents have share.. Nil ..
(10) My educational qualification is a underi(B.A. Soclalogy) Kakttay Unlversity 1996
(Give details of highest school/university education mentioning the full from of the certificate/diploma/degree course, name of the School/College/Universiti and the year in which thecourse was completed!
9
Se lf Spouse Dependen! 1 Dependent - 2
(v) GST dues NIL NIL NIL
(vi)Municipal/Property Taxdues NIL NIL NIL
(vii) Any Other Dues NIL NIL NIL NIL
(viii) Grand total of allGovernment dues
NIL NIL NIL NIL
(ix)
Whether any otherliabilities are in dlspute, ifso, mention the amountinvolved, and theauthority before which itis pending.
NIL NIL NIL
\6tn
NIL
Ntt
NIL
+tt.t .
P.,r'.Y 11 s'
tt.8.
&tk'gtt
1' \\
1 Name of the Candidates VENKATESHWARLU CHIPPA
2 Full postal address H.NO, 11-25-847, Padmanagar, Near MarkandayaTemple, Kothawada, Warangal (Urban) - 5OG0O2
3Number and name of the constituencyand state
4Name of the political party which setup the candidate (otherwise write'lndependent')
INDEPENDENT
Total number of pending criminal cases Nil5
5 Nit
Pa rticu la rs PAN ofYear for which last income Taxreturn filed
Total incomesh own.
VENKATESHWARLU
CHIPPAAWZPC4936G Financial Year 2018-19 Rs.4,69,678/-
LAXMI CHIPPA NIL Not submitted NOT APPLICABLE
NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE
7
Dependent - 2 NOT APPLICABLE NOT APPLICABLE NOT APPLICABLE
8
DescriptionSelfVENKATESHWAR
LU CHIPPA
SpouseI.AXMI CHIPPA
DependentCHIPPA KIRANI(UMAR
Dependent 2CHIPPA(AVYA
Moveable Assets(Totalvalue) Rs.8,37,34U- Rs.2,80,158/- NIL N[-
B lmmovable Asset NIL NIL NIL N IL
Purchase Price ofself-immovableproperty
Rs.2,00,00O/- NIL NIL
Development/construction cost ofimmovable propertyafter purchase (ifapplicable)
Rs.7,50,000/- NIL Ntt
Approximatecurrent market price(a) self-acquiredassets (TotalValue)(b) inherited assets(Total Value)
a).18,00,000/-b).12,00,000/- NIL NIL NIL
NGAt
10
\\ bt
PART - B(11) ABSTRACT OF THE DETATLS GTVEN tN (1) TO (10) OF PART - A
.)
105 - Warangal East, Telangana
Total number of cases in whichconvicted
Dependent - 1
Details of Assets and Liablllties lnRupees.
1
INIL
NIL
4-*.Yil
9 Liabilities
(i) NIL NIL NIL NIL
(ii)
Loans from Bank,Financial lnstitutionsand others (Total)
Nit NIL NIL NIL
10 Liabilities that under dispute
(i) Government dues(Total NIL NIL
(ii)
and others (Total
Loans from Bank,Financial lnstitutions NIL NIL NIL NIL
11
est educational qualification :(Givedetails of highest SchoouUniversityeducation mentioning the full form ofthe certifi cate/diploma/degree course,name of the School/College/ Universityand the year in which the course wascompleted.)
High
(B.A. Socialogy) Kaktiay University 1996
VERIFICAT]ONI, the deponent, above named, do hereby veri& and declare thatand correct to the best of my knowledge and belief and no partbeen concealed there from. I further declare that:-
(a) there is no case of conviction or pending case against mein items 5 and 6 of part A and B above;
(b) l, my spouse, or my dependents do not have any asset ormentioned in items 7 and 8 of pan A4nd items 8, 9 and 1
\\'o(t .c--^-'"^ \Lo -^-\- q"
the contents of this affidavit are trueof it is false and nothing material has
other than those mentioned
liability, other than those0 of Part B above.
,C-day of ...!..1.=.....}=o t:-
DEPON
Verified at
()
this the \..)...
Y/
Joornnry allirmed lrd stgnco -- . .onthis.......L.7-..-..*yol..\.......... rxl h?nrncal
-
/--..^ / -_-_:
ch. AXa{fEDDFB.Sc., Lt-.8.
Advocate N)!aryFOR HANAM(ONDA & KAZIPEI
'JI/ARANGAL DIST. T.S. INDtAL:.$a
GAL
11
Z
*[zz
Government dues(Total)
NIL NIL
