eo .

- LANGANA 4571
SL.NO .. 9.t::t\ ...Dt.~ .I.~ ..12015lliu ~ .1 K.GO REDDY
LICENSED STAMP VENDOR

Sold To ... C-t+.r~

..~~l1~'" . anna <1'-lL . evCN ct.l .,.), D'Jlli)'c!o.SAI
"-L' LicenceLEELA
0.15-30-020/2014
:J c.+.\-.:..~lLa-~.~I;
/O •• . FO 26 t- I J Y\-Lt.) ENTERPRISES,
Plot No.325 Part, Siddartba Nagar,
For whom ~ dL ~......... (See rule 4A) Dammaiguda, Keesara (M), R.R.Dist
1014705777

Affidavit to be filed by the candidate along with nomination paper before the returning officer
fol election to Telangana State Legislative Council, (name of the House) from Warangal-
Khammam-Nalgonda Graduates Constituency.

I
PART-A
I
I, TEE MAAR MALLA A S/o CHINTHA PANDU BAGAIAH, Aged 31 years.,
It> H.No: 2-79, Madhapuram Village, Thurkapally MandaI, Nalgonda District.
A candidate at the above Election, do hereby solemnly affirm and state on oath as under:
(sdike out whichever is not applicable)

TT SlED
(I) I am candidate set up by Indian National Congress Party.
~
N. CHA~DR\IAH B.A., LL.B.

" ,v;~ ....

m ~
NOTA.RY (ADVOCATE)
AppOIntment Vide G.O.Ms. No. 2310 of 2011
1 bl Govt. of A.P. (INDIA)
H. No. 2-S-76/A, Bharath Nagar, .
Uppal, Hyderabad-SOO 039. R.R. Oist.
 2

(2) My name is enrolled in 97 - Alair Assembly constituency of Telangana State

(Name of the Constituency and State), at Serial No ( 654 ) in Part No ( 40 )
(3) My Contact telephone number(s) is 9866524314 and my e-mail id (if any) is

[email protected]
Details of Permanent Account Number (PAN) and status of filing ofIncome tax return:-
Sl. Name: Permanent The financial year Total income
No: account number for which the last shown in Income
(PAN) Income Tax return Tax Return
has been filed. (In Rupees)
I. Self: Teenmaar
MaJianna AKBPC7220K 2013-14 Rs. 3,50,000/-

Spouse- Smt. BELTK2355G 2013-14 Rs.2,52,000/-

Kondapuram
Mathamma
3. Dependent .1 No No No
-NiI-
4. Dependent 2. No No No
-Nil-

(4) I am Not accused of any offence(s) punishable with imprisonment for two years
or more in a pending case(s) in which a charge(s) has I have framed by the
court(s) of competent jurisdiction. Not Applicable
If the deponent is accused of any such offence(s) he shall furnish the following
information:-No

SI.No. Offence Description

A Casel First Information Report No./Nos, together with Not applicable

complete details of concerned Police Station!
district/State.
B Section(s) of the concerned Act(s) and Short Not applicable
description of the offence(s) for Which charged
C Name of the Court, Case No. and Date of order Not applicable
taking cognizance:
D Court(s) which framed the Charge(s) No

E Date(s) on which the charge(s) waslwere framed No

F Whether all or any of the proceeding(s) have been No

stayed by any Court(s) of competent Jurisdiction
(ii) The following cases(s) is/are pending against me in which cognizance has been taken
by the court. ( other than the cases mentioned in item (i) above NIL

A Name of the Court, case No. and date of order taking. Not applicable
/
B Details of Cases where the court has taken cognizance, Not Applicable
section(s) of the Act(s) and description
C Details of Appeal (s) / Application(s) for revision ( if any) Not Applicable
filed against the above order (s)

I
.-s-
~
l\T CHJ"-' ""''''''
v>
T '.
~
B B.A., Ll.B.
l~. (ADVOCAfE)
. I

NOTAR'o \. GOMs. I 2'100'2011

'J... I

Appolrtment v ce 'f A' p' ( N'DIA)

bo, GO\lt. 0 . o' .
~ -,6/A Bharoth Nagar, .
H 0 2 -)- "
L' cnlabac-500 039. R.R. !)Ist.
LIppa, r I -
 3

(6).1 have not been convicted of an offence (s) ( other than any offence(s) referred to in
sub-section(1) or sub-section(2), or cover in sub -section (3), of section 8 of the
representation of the people Act, 1951 (43 of 1951» and sentenced to imprisonment for one
year or more.
If the deponent is convicted and finished as aforesaid, he shall furnish the following
information: in the following cases, I have been convicted and Sentence to imprisonment by a
court oflaw.

A The details of cases, section(s) of the concerned Act(s) Not Applicable

and description of the offence(s) for

B Name of the Court (s), Case No and date (s) of order (s): Not Applicable

C Punishment imposed. Not Applicable

D Whether any appeal was/has been filed against the Not Applicable
conviction order. If so, details and the present Status of
the appeal.

(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,
2. In case of deposit/investment, the details including Serial Number, amount and date
of deposit, the scheme, name ofbankllnstitution and Branch are i\to be given)
3. Value of Bonds/SharefDebentures 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.
4. Dependent', here has the same meaning as assigned in explanation(v) under section
75 A of the Representation of the People Act.195 1.
5. Details including amount is to be given separately in respect of each investment.

SI.
No. Description. Self: Teenmaar Spouse Smt. Dependent 1.- Dependent
Mallanna Kondapuram NO- 2.-NO-
Mathamma
(i)
Cash in hand. Rs.25,OOO/- 50,000/-
Nil Nil

(ii) Details of Deposits in ICICI Bank Rs. 10,000/- in Nil Nil

Bankaccounts (FDRs, Kharkhana SBHBhongir
term Deposits and all branch,Secuendrabad branch
other types of 1,00,000/-
Deposits including
saving accounts),
Deposits with
Financial Institution, --TESTE 0
UK,,/ :,
»=:«:
~A.,LL.B.
N. CHAN' DVOCATE)
\01p..R 'I NOT.A~Y ~~ Ms. No. 2310 012011
/::-:' Appointment Vide G' A' P 'INDIA)
by Govt. 0f .' \ .
5-76/A, Bharath Nagar,.
-\~
H. No. 2- d 500039. R.R.D1St.
uppal, Hyderaba -
 4

Non-Banking=-
financial Companies
and Co-operative
societies and the
amounts in each such
deposit.
(iii) Details of Investment
in Bonds Debentures
1 shares and units in
companies 1 Mutual Nil Nil Nil Nil
Funds and others and
the amount.

(iv) Details of investment

In NSS, postal
savings, Insurance
Policies and
investment In any LIC 30,0001- LIC 30,0001- Nil Nil
Financial Instruments
In Post Office or
Insurance Company
and the amount.
(v) Personal
loans/advance given
to any person or
entity including firm, Nil Nil Nil Nil
company trust etc.,
and other receivables
from debtors and the
amount.
(vi) Motor Vehiclesl
Aircrafts 1 Yachts AP 29-AL 7986 AP24-AW6614
Iships ( details of Honda Motor cycle Honda Pleasure
Make, Registration Yr.ofmake:2011 Yr. of
No., etc., year of Yr. of purchase. 2011 make:2013 Nil Nil
Purchase and amount Cost. Rs. 55,000/-
Cost.
Rs50,000/-

(vii) Jewelry, bullion and

valuable thing ( give 50 grams gold
details of weight and ornaments.
value) Worth of
Nil Rs. Nil Nil
1,00,000/-

(viii Any other assets such

as value of Claims 1 Nil. Nil. Nil Nil
interest.
(ix) Gross Total value. Rs.2, 10,000/- Rs. 2,40,000/-

l.J~/~/ •••
-.~:
, '~A.,ll.B'
N Cll}\. TlJ I VOCATE)
• NoT.l' RY ~.C>. OM No. 23~O oj 20t\
'Vc',GO. s.
;..ppoiotrneO, \. ~ . f
A,p, tll DIA)
b'{ Go,t, 0 Bharath Nagar, .
H, NO. 2-5-76/A, 039. R.R. Dist.
u"derabad-500
uppa \ ,el,

~----------------------------------------------------------------------------
 5

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

format

SI.
No. Description. Self Teenmaar Spouse Smt. Dependent Dependent 2
Mall ann a Kondapuram 1 -No-
Matharnma -No-

(i) Agricultural land

_Location (s) Survey No No
number (s) No No
Area(total
Measurement in No No No No
Acres)
Whether inherited NO. NO. No No
property(Yes or No)
Date of Purchase in
case of self acquired No No No No
property
Cost of Land(in case
of Purchase at the No No No No
Itime of Purchase
Any investment on
the land by way of No No No No
development,
construction etc.
Approximate current No No No No
market val ue
(ii) Non -Agricultural
land. Nil. .Telephone Nil Nil
Location (s) Survey colony, survey
number (s) no.70,71,72.
Area(total No 133 sq yds .. No No
Measurement in Sq.
fts)
Whether inherited No No. No No
property(Yes or No)
Date of Purchase in No 15-11-2011 No No
case of self acquired
property

Cost of Land(in case No 3,00,0001- No No

of Purchase at the
Itime of Purchase
Any investment on
the land by way of 0 Nil No No
development,
construction etc.

-rTt;. - --
~.ll.B.
• CHA .•' DVOC TE)
• NOTt>-RY {A M- No 23~ooI20~~
',J"d GO J. •
APpointment A P (INeIA)
I e 'f
b I GO_'t ', o . harath Nagar, .
H. 0. 2-5-75/~, :00039. R.I'\.. Dist.
uppa , rl'lderaba -
 6

Approximate current Not applicable. 8,00,0001- No No

market value
(iii) Commercial
Buildings: including
apartments )Location Nil Nil. Nil Nil
s(s)-survey number
(s)
Area(total Not applicable. Not applicable. Not Not applicable
Measurement in applicable
Sq.ft)
\

Built-up Area (total Not applicable. Not applicable. Not Not applicable
measurement in applicable
sq.ft)
Whether inherited Not applicable. Not applicable. Not Not applicable
property (Yes or No) applicable
Date of Purchase in Not applicable. Not applicable. Not Not applicable
case of Self- applicable
acquired property
Cost of Property (in Not applicable. Not applicable. Not Not applicable
case of purchase at applicable
the time of.
purchase)
Any investment on Not applicable. Not applicable. Not Not applicable
the property by way applicable
of development
construction etc.,
Approximate current Not applicable. Not applicable. Not Not applicable
market value applicable

iv Residential
Buildings (1)
(including
apartments) Nil Nil Nil Nil
-location(s)
-Survey number(s)

Area(total No No
measurement in sq Nil Nil
ft)
Built-up Area (total Nil Nil No No
measurement in
SQ.ft)
Whether inherited Nil NO No
property (Yes or No) Nil
Date of Purchase in Nil Nil No No
case of Self-
acquired property
Cost of Property (in Nil Nil No No
case of purchase at
the time of purchase

,
~
• ..,1- •
1 1 B.
A. ~ .

IOTAR ' ) -)) N • CnA '- l-

:-, ADVOCATE
.- )

NOTAR'o.· G O.Ms. N0 2'1"020

• J v '1 '
APpo,nlrr.enl V v~ 'f A p 'If CIA)
--/' t•.Go,;t.o
/
.' \
/ B\\,'rath ~'agar,
-\ ~ H. No. 2-S-7E A, ~ R.R. Dist.
I H ,derabad-500 039.
Uppa,
 7

Any investment on Nil No No

the land by way of Nil
development,
construction etc.
Approximate current Nil Nil No No
market value
(v) Others (such as
interest in property) Nil Nil Nil Nil.

(vi) Total of current

Market value of (i) Nil Rs 8,00,000/- No No
to (v) above.

...
(8)1 give herem 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 for each item)
SI.
No. Description. Self Sri Teenmaar Spouse Dependent 1. Dependen 2.
Mallanna Kondapuram No No
Mathamma
(i) Loan or dues to Bank
!Financial Institution
(s) Name of Bank or
Financial Institution,
Amount outstanding Nil Nil Nil Nil
Nature of loan.

Loan or dues to any

individuals IEntity
other than mentioned
above Name(s) Nil Nil Nil Nil
Amount outstanding,
nature of loan
Any other liability
Nil. Nil. Nil Nil
Grand total of
liabilities Nil Nil Nil

(ii) Government Dues

Dues to departments Nil. Nil Nil Nil
dealing with
government
accommodation.
Dues to departments
dealing with supply of Nil. Nil Nil Nil
water.
Dues to departments
dealing with supply of Nil. Nil Nil Nil
electricity.
Dues to departments
dealing with supply of Nil. Nil Nil Nil
telephones Imobiles. '" ~
h-..-::..:;-r~O
•
.s-:«:
Wh( "

~A.,ll.B.
N CBA. D .\lOCAlE)
. iOTA R I \
,0,1
, ,I
J
• NOI,t>.RY (AD " 23~ooI20~~
\[de G a.Ms. \~o.
/:: I MPointrnent \, . f A.P. tlNelA)
b'l GOI/t. 0 Bharath Nagar, ..
-- /. H. o.2-S-76/A, 0039. R.R. Olst.
H'Iderabad-50
\.lppa,\
 8

Dues to departments
dealing with Nil. Nil Nil
government transport Nil
(including aircrafts and
helicopters)
Income tax dues.
Nil. Nil Nil Nil
WeaIth Tax Dues.
Nil. Nil Nil Nil

Service Tax dues

Nil. Nil Nil Nil
Municipal / Property
Tax dues Nil. Nil Nil Nil

Sales Tax dues

Nil. Nil Nil Nil
Any other dues
Nil. Nil Nil Nil
iii Grand total of all Govt.
dues. Nil. Nil. Nil Nil
iv Whether any other
liabilities are in dispute,
if so, mention the
amount involved, and Nil Nil Nil Nil
the authority before
which it is pending

(9)Details of profession or occupation:

a Self ... Journalist,Social worker

b Spouse ... Governament Teacher

(IO)My educational qualification is as under:

MBA,JNTU,2009

(Give details of highest School/University education with full form of the certificate /
diploma / degree course (Name of the School/College / University and year in which
the course was completed.)

"T'TE T-O

~
HA 'iJRAIAH B.A., Ll.B.
N. C . (DVOCATE)
NOT.A~Y A \s No 2310 of 2011
Appointment Me G'OA·Np·(IN·CIA)
f
b'/ Govt. 0 .'
2-S-76/A, Bharath Nagar, .,

--.
H. No. b d-500 039. R.R. Dist.
uppal, Hydera a
 9

PART-B

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

1 Name of the candidate Sri. TEEN MAAR MALLANNA

2. Full postal address H.No: 2-76, Madhapuram Village,

Turkapally Mandai, Nalgonda
District.
..,
,). Number and name of the constituency and state. Graduates Council Constituencyof
Warangal-Khammam-Nalgonda of
Telangana State

4. Name of the Political party which set up the candidate

(otherwise write' Independent') Indian National Congress Party ....

5. (i)Total number of pending cases where charges have

been framed by the court for offences punishable with iI.
imprisonment for two years or more
(ii) Total Number of pending cases where the court(s)
have taken cognizance(Other than the Casess mentioned Nil.
in item(i) above)
6. Total Number of cases in which convicted and sentenced
to imprisonment for one year or more (EXCEPT FOR Nil.
OFFENCES REFERRED TO IN SUB-SECTIONS (1),
(2) OR (3) OF SECTION 8 OF Representation of the
People Act, 1951)
7 Year for which last Total Income
PAN OF Income tax return Shown.
filed.

Self: TeenMaar Mallanna AKBPC7220K 2013-14 Rs. 3,50,000/-

Spouse- Smt. Kondapuram Mathamma. 2013-14 Rs 2,52,000/-

BELTK2355G
Dependent 1 .- No- No No

Dependent 2. -No- No No

8. Details of Assets and Liabilities in rupees.

SI.
o. Description. Self Sri Spouse Smt. Dependent 1. Dependen 2.
Teen Maar Kondapuram - 0- -No-
Mallanna Mathamma
A Movable
Assets ( Total Rs2,10,000/- Rs. 2,40,0001- No 0

u t ,'" "-
value)
,.,. .
I_-v"-C- .s»

~
' D RA lAH B.A., LL.B.
N. CHA '- VOCAfE)
NOTARY (~~s No 23f)O,20i
Appointment VidiJ G' A' P'lIN'CIA)
b' Govt.o f .' .
, 5-76/A, Bharath Nagar,.
H. No. 2- C 500039. R.R.!)Ist.
uppal, H'/ceraba -
 10

B. Immovable Asset. Nil Nil Nil Nil

(i) Purchase Price

of Self acquired NiI- Rs3,OO,OOO/-- Nil Nil
immovable
Property
(ii) Development
Iconstruction ost i1- Nil Nil Nil.
of immovable
property after
purchase (if
applicable)
Ill. Approximate
Current market Nil Rs.8,OO,OOO/- Nil. Nil.
price

9' Liabilities:

(i) Government
Dues. (total) Nil. Nil. Nil Nil.

(ii) Loans from

Bank, inancial Nil Nil Nil Nil
Institutions and
others (Total)
10 Liabilities that are
under dispute Nil. Nil. Nil. Nil

11. Highest Educational qualification:

MBA ,JNTU 2009.

(Give details of School / University education with full form of the certificate / diploma / Degree course) (Name
of the School / college/ University and year in which the course was comoleted.)

VERI FICA nON

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 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.

(c) Verified at Nalgonda this the ..... J..::>.... yJ: ..day of ~&1~
TEENMAAR MALLANNA

.,..
ES
WIt_

I <>:
~A,L\ ..B.
I' ~OTAR ' ) N CHA DR~VOCArE)
. ,OTARY (A N 2310012011
"d G a.Ms. 0,
f>..ppOIO\\i,eo\ \;1 ~ 'f A.P. t:NC A)
./
b'l GO'it, 0 Bharath Nagar, .
\-1.NO. 2-5-76/A, 039. R.R. Dist.
uppal, Hyderabad-500
 11

Note: 1. Affidavit should be filed latest by 3.00 pm on the last day of filling 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 column should be filled up and no column to be left blank. If there is no
Information to furnish in respect of any item"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"

(F.No.H-IIOI9(6)/20 12-Leg.II)
/ Dr.SANJA Y SINGH, Addl,Secy

Note: The principal rules were published vide notification number S.0.859, dated the 15 th
April 1961 and
Last amended vide notifications-

th
(1) Number S.0.728(E) ,dated the 8 May-2007.
(2) Number S.0.425 (E) dated 23rd February-20 11

ATTE.STED ~

~
. HANDRAIAH B.A., LL.B.
N. C DVOCATE)
NoTARY (A M No 2310012011
\I'd GO s. .
APpOintment ~I e 'f A' P (INDIA)
b Go..••
t 0 .'
V 7'6/A Bharath Nagar, .,
H. No. 2-5- d' 500 039. R.R. Olst.
uppal, Hyderaba -