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ELECTION COMMISSION OF INDIANirvac-han Sadan, Ashoka Road, New Delhi_l1000176IECI/INSTiFIINC/EEM/EEPSi261qlvot. ttt --bated:5th

March,20t9

The Chief Electoral Om""r, ofAll States and Union Territories

Subject:-Corrigendum- Form 26- Compendium of Instructions on Election ExpenditureMonitoring (February, 20 I 9)_Reg.

Madam/Sir,

I am directed to refer to the commission's letter of even number dated 2gth Februa ry, 2019

regarding amended Form 26 and, to state that against item no. 8 (iii) under part,A, of the said

Form, the words "D were inadvertently

mentioned, instead of .,

aircrafts and helicopters)". As such, you are requested to kindly substitute the words ..Dues to

" in place of

2' corrected Form26 (English version only) is being forwarded herewith with the request to

bring this to the notice of DEos, Ros, candidates, political parlies and all election authorities and

incorPorate the same in the "compendiurn of Instructions on Election Err.rrditu.. Monirorin*

(Februar)r. 20 1 9)" accordingly.

Yours faithfully,

KUMAR)SECRETARY

Form 26

(See rule 4A)

Please affix your

recent passport

size photograph

here

AFFIDAVIT TO BE FILED BY THE CANDIDATE ALONGWITH

NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION

TO………………..(NAME OF THE HOUSE)

FROM……………………………CONSTITUENCY (NAME OF THE

CONSTITUENCY)

PART A

I………………………………..**son/daughter/wife

of………………………………………………….Aged……………………………..y

ears, resident of……………………………………………………………(mention

full postal address), a candidate at the above election, do hereby solemnly affirm and

state on oath as under:-

(1) I am a candidate set up by------------------------------

(**name of the political party) / **am contesting as an Independent candidate.

(**strike out whichever is not applicable)

(2) My name is enrolled in…………………………………………(Name of the

Constituency and the State), at Serial No……….in Part No……………..

(3) My contact telephone number(s) is/are………………………………………and my

e-mail id (if any) is…………………………… and my social media account(s) (if

any) is/are

(i)……………

(ii)……………….

(iii)………………….

(4) Details of Permanent Account Number (PAN) and status of filing of Income Tax return:

Sl. No. Names PAN The financial year for which the last Income-tax return has been filed

Total income shown in Income-tax return (in Rupees) for the last five Financial Years (as on the 31

st March)

1. Self (i)

(ii)

(iii)

(iv)

(v)

2. Spouse (i)

(ii)

(iii)

(iv)

(v)

3. HUF (If the Candidate is Karta or Coparcener)

(i)

(ii)

(iii)

(iv)

(v)

4. Dependent-1 (i)

(ii)

(iii)

(iv)

(v)

5. Dependent-2 (i)

(ii)

(iii)

(iv)

(v)

6. Dependent-3

(i)

(ii)

(iii)

(iv)

(v)

Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should

be clearly stated “No PAN allotted”.

(5) Pending criminal cases

(i) I declare that there is no pending criminal case against me. (Tick this alternative if

there is no criminal case pending against the Candidate and write NOT APPLICABLE

against alternative (ii) below)

OR

(ii) The following criminal cases are pending against me:

(If there are pending criminal cases against the candidate, then tick this alternative and

score off alternative (i) above, and give details of all pending cases in the Table below)

Table

(a) FIR No. with name

and address of

Police Station

concerned

(b) Case No. with Name

of the Court

(c) Section(s) of

concerned

Acts/Codes involved

(give no. of the

Section, e.g.

Section…….of IPC,

etc.).

(d) Brief description of

offence

(e) Whether charges

have been framed

(mention YES or

NO)

(f) If answer against (e)

above is YES, then

give the date on

which charges were

framed

(g) Whether any

Appeal/Application

for revision has been

filed against the

proceedings

(Mention YES or

NO)

(6) Cases of conviction

(i) I declare that I have not been convicted for any criminal offence. (Tick this

alternative, if the candidate has not been convicted and write NOT APPLICABLE

against alternative (ii) below)

OR

(ii) I have been convicted for the offences mentioned below:

(If the candidate has been convicted, then tick this alternative and score off alternative

(i) above, and give details in the Table below)

Table

(a) Case No.

(b) Name of the Court

(c) Sections of

Acts/Codes involved

(give no. of the

Section, e.g.

Section……. of IPC,

etc.).

(d) Brief description of

offence for which

convicted

(e) Dates of orders of

conviction

(f) Punishment imposed

(g) Whether any Appeal

has been filed

against conviction

order (Mention YES

or No)

(h) If answer to (g)

above is YES, give

details and present

status of appeal

(6A) I have given full and up-to-date information to my political party about all pending

criminal cases against 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 NOT

APPLICABLE IN VIEW OF ENTRIES IN 5(i) and 6(i), above]

Note:

1. Details should be entered clearly and legibly in BOLD letters.

2. Details to be given separately for each case under different columns against each

item.

3. Details should be given in reverse chronological order, i.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 responsible for supplying all information in compliance of Hon’ble

Supreme Court’s judgment in W. P (C) No. 536 of 2011.

(7) 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: 1. Assets in joint name indicating the extent of joint ownership will also have to be

given.

Note: 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.

Note: 3.Value of Bonds/Share Debentures as per the current market value in Stock Exchange in respect of listed companies and as per books in case of non-listed companies should be given.

Note: 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 means of income and who are dependent on the candidate for their livelihood.

Note: 5. Details including amount is to be given separately in respect of each investment.

Note: 6. Details should include the interest in or ownership of offshore assets.

Explanation- For the purpose of this Form, the expression “offshore assets” includes,

details of all deposits or investments in Foreign banks and any other body

or institution abroad, and details of all assets and liabilities in foreign

countries.

S. No. Description Self Spouse HUF Dependent-1 Dependent-2 Dependent-3

(i) Cash in hand

(ii) Details of deposit in Bank

accounts (FDRs, Term

Deposits and all other

types of deposits

including saving

accounts), Deposits with

Financial Institutions,

Non-Banking Financial

Companies and

Cooperative societies and

the amount in each such

deposit

(iii) Details of investment in

Bonds,

Debentures/Shares and

units in

companies/Mutual Funds

and others and the

amount.

(iv) Details of investment in NSS, Postal Saving, Insurance Policies and investment in any Financial instruments in Post office or Insurance Company and the amount

(v) Personal loans/advance

given to any person or

entity including firm,

company, Trust etc. and

other receivables from

debtors and the amount.

(vi) Motor Vehicles/Aircrafts/ Yachts/Ships (Details of Make, registration number. etc. year of purchase and amount )

(vii) Jewellery, bullion and valuable thing(s) (give details of weight and value)

(viii) Any other assets such as

value of claims/interest

(ix) Gross Total value

B. Details of Immovable assets:

Note: 1. Properties in joint ownership indicating the extent of joint ownership will also have to be indicated.

Note: 2. Each land or building or apartment should be mentioned separately in this format.

Note: 3. Details should include the interest in or ownership of offshore assets.

S. No Description Self Spouse HUF Dependent-1 Dependent-2 Dependent-3

(i) Agricultural Land

Location(s) Survey number(s)

Area (total measurement in acres)

Whether inherited property (Yes or No)

Date of purchase in

case of self - acquired

property

Cost of Land (in case of purchase) at the time of purchase

Any Investment on the

land by way of

development,

construction etc.

Approximate Current market value

(ii) Non-Agricultural Land

Location(s) Survey number(s)

Area (total

measurement in sq. ft.)

Whether inherited

property

(Yes or No)

Date of purchase in

case of self - acquired

property

Cost of Land (in case

of purchase) at the time

of purchase

Any Investment on the land by way of development, construction etc.

Approximate current market value

(iii) Commercial Buildings

(including apartments) -Location(s)

-Survey number(s)

Area (total measurement in sq. ft.)

Built-up Area (total measurement in sq.ft.)

Whether inherited property (Yes or No)

Date of purchase in

case of self - acquired

property

Cost of property (in case of purchase) at the time of purchase

Any Investment on the property by way of development, construction etc.

Approximate current market value

(iv) Residential Buildings (including apartments):

-Location (s)

-Survey number(s)

Area (Total measurement in sq. ft)

Built up Area (Total measurement in sq. ft.)

Whether inherited property (Yes or No)

Date of purchase in case of self – acquired property

Cost of property (in

case of purchase) at the

time of purchase

Any Investment on the

land by way of

development,

construction etc.

Approximate current

market value

(v) Others (such as interest in property)

(vi) Total of current market value of (i) to (v) above

(8) I give herein below the details of liabilities/dues to public financial institutions and

government:-

(Note: Please give separate details of name of bank, institution, entity or individual and

amount before each item)

S. No. Description Self Spouse HUF Dependent-1 Dependent-2 Dependent-3

(i) Loan or dues to Bank/Financial Institution(s)

Name of Bank or Financial Institution, Amount outstanding, Nature of loan

Loan or dues to any other individuals/ entity other than mentioned above.

Name(s), Amount outstanding, nature of loan

Any other liability

Grand total of liabilities

ii) Government Dues:

Dues to departments dealing with Government accommodation

(A) Has the Deponent been in

occupation of accommodation

provided by the Government at any

time during the last ten years

before the date of notification of

the current election ?

(B) If answer to (A) above is YES, the

following declaration may be

furnished namely:-

(i) The address of the

Government

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 ……….(date)

[the date should be the last date of the

third month prior to the month in

which the election is notified or any

date thereafter].

Note- „No Dues Certificate‟ from the

agencies concerned in respect of rent,

electricity charges, water charges and

telephone charges for the above

Government accommodation should

be submitted.

YES/NO

(Pl. tick the

appropriate

alternative)

(iii) Dues to department dealing

with Government transport

(including aircrafts and

helicopters)

(iv) Income Tax dues

Self Spouse HUF Dependent-1 Dependent-2 Dependent-3

(v) GST dues

(vi) Municipal/Property tax

dues

(vii) Any other dues

(viii) Grand total of all Government dues

(ix) Whether any other liabilities are in dispute, if so, mention the amount involved and the authority before which it is pending.

(9) Details of profession or occupation:

(a) Self………………………………………………

(b) Spouse ………………………………………….

(9A) Details of source(s) of income:

(a) Self ……………………..

(b) Spouse …………………..

(c) Source of income, if any, of dependents,…………………….

(9B) Contracts with appropriate Government and any public company or companies

(a) details of contracts entered by the candidate………….

(b) details of contracts entered into by spouse ……………

(c) details of contracts entered into by dependents …………………….

(d) details of contracts entered into by Hindu Undivided Family or trust in which the

candidate or spouse or dependents have interest …………………………

(e) details of contracts, entered into by Partnership Firms in which candidate or spouse or

dependents are partners …………………………………………….

(f) details of contracts, entered into by private companies in which candidate or spouse or

dependents have share ………………………..

(10) My educational qualification is as under:

…………………………………………………………………………

(Give details of highest School / University education mentioning the full form of the

certificate/ diploma/ degree course, name of the School /College/ University and the year

in which the course was completed.)

PART - B

(11). ABSTRACT OF THE DETAILS GIVEN IN (1) TO (10) OF PART - A:

1. Name of the candidate Sh./Smt./Kum.

2. Full postal address

3. Number and name of the constituency and State

4. Name of the political party which

set up the candidate (otherwise write „Independent‟)

5. Total number of pending criminal cases

6. Total Number of cases in which convicted

7. PAN of Year for which last Income Tax Return filed

Total Income Shown

(a) Candidate (b) Spouse (c) HUF (d) Dependent

8. Details of Assets and Liabilities (including offshore assets) in Rupees

Description Self Spouse HUF Dependent-I Dependent-II Dependent-III

A. Moveable Assets (Total value)

B. Immovable Assets

Asset

I Purchase Price of self-acquired immovable property

II Development/construction cost of immovable property after purchase (if applicable)

III Approximate Current Market Price -

(a) Self-acquired assets (Total Value)

(b) Inherited assets (Total Value)

9. Liabilities

(i) Government dues (Total)

(ii) Loans from Bank, Financial Institutions

and others (Total)

10. Liabilities that are under dispute

(i) Government dues (Total)

(ii) Loans from Bank, Financial Institutions and others (Total)

11. Highest educational qualification:

(Give details of highest School /University education mentioning the full form of the

certificate/ diploma/ degree course, name of the 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 and no part of it is false and

nothing material has been concealed there from. I further declare that:-

(a) there is no case of conviction or pending case against me other than those mentioned in items

5 and 6 of Part A and B above;

(b) I, my spouse, or my dependents do not have any asset or liability, other than those mentioned

in items 7 and 8 of Part A and items 8, 9 and 10 of Part B above.

Verified at………………….…..this the……………………………day

of……………………………….

DEPONENT

Note: 1. Affidavit should be filed latest by 3.00 PM on the last day of filing nominations.

Note: 2. Affidavit should be sworn before an Oath Commissioner or Magistrate of the First Class or before a Notary Public.

Note: 3. All columns should be filled up and no column to be left blank. If there is no

information to furnish in respect of any item, either “Nil” or “Not applicable” as

the case may be, should be mentioned.

Note: 4. The affidavit should be either typed or written legibly and neatly.

Note: 5. Each page of the Affidavit should be signed by the deponent and the Affidavit

should bear on each page the stamp of the Notary or Oath Commissioner or

Magistrate before whom the Affidavit is sworn.

(Ministry of Law & Justice Notification No. H11019(4)/2018-Leg.II, dated 10th

October, 2018

and Notification No. H-11019/13/2016-Leg. II, dated 26th

February, 2019)

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