Affidavit 1713946574
Affidavit 1713946574
Affidavit 1713946574
ffi
rN'AP80728662ss1233w
Government of Andhra Pradesh
e-st.mp Oae..2,J.,-1g"2-nJ-k..-.-
i
Cartiffcalo No. tN-4P8072886299 t 2fftw
s. No..[1.6.......Page No
? 2.-
a a;
Certif acate lssued Date 20-Apr-2024 01:16 PM
a
i Account Reference NEWIMPACC (SV)/ ap18025904/ AP-WGV/ AP-NStuaptirramu
z
E
q
DDO Code 27002308001 O/o IG R Ir iit' $
Unique Doc. Reference suBrN-APAP1 80259045047 3467 203023W .?
s \\!,
ri Gannabathula matsyavallabha Flao son o, Anjaneyulu R3
Purchased by
f
a
i
R
a
*
: AFTIDAVIT TO BE FILED BY THE CAI{DIDATE ALONGWITE NOITtrNATION
? PAPER BEFORE Tf,E RETI,'RNING OFTICER FOR f,LECTION TO LEGISLATTVE
5
I ASSEMBLY, FROM NARASAPURAM CONSTITUENCY No. 5t.
B
IABIS
(3) My contact telephone num@s) is/are +91 9848 025 665 and my e-mail id
[email protected] and my social media accoun(s) idare
(4) Detrik of Permenent Acc'ount Numbcr (PAN) end stetus of filing of Income tar
returtr:
Sl. No. Names PAN The financial Total income
year for shown in lncome Tax Retum(in
which the Rupees) for
the last five
last Income- Financial Years completed (ason
tax retum has 3ls March)
been filed
19 -20
(iv) k ,f,81,7201
fi1 \,
.G.V. K. SURYA RAo 2l . Q'Zo z-9
6 \) I
NOTARY
Appoint.d by Govt. of A.P Certificale of Practce
AKANAVARITHOT' R{rrEdup h 17-12-2027
rlARSAPUR. TTOGALTUP By G.O. lrrls. No:0a
w.G.rrL. A.P. INFIA Dated :08-01-2024
(v) Rs" 3rl'tt0/-
8 -r9
J HUF flf Candidrte (i)
is Not Not N.A
Krrta/Copercener) Applicable Applicable (ii )
N.A
(iii)
N-A
(iv)
N.A
(v)
N.A
4 Dependent No. I (i) NIL
Bommidi NTWPS Not
Spurthi 1136P Appticable (ii) NIL
(iii) ML
(iv) NIL
( ) NIL
(iiD NIL
(iv) NIL
(v) NIL
Note: It is mandatory for PAN holder to mention PAN and in case of no PAN, it should
be cleuly stated a{o PAN allotted".
(i) I declere ttrt there is no pendlng crlminel crs€ rgrhst me. (Tlck this eltemrtive if
there is no crimind crse ponding egrinst the Cendidrte rnd write NOT APPLICABLE
.g.i$t rltcm.tivc (fl) bclow)
OR
Qf there ere pending criminel case3 rgrilst the cendidate, then tic k this elternadve end
score ofi alternrtive (i) ebove, rnd give deteih of dl pending cescs in the Table bel,ow)
eo 3
Ni1
e€x -v ED
,
A.GV. K. SURYA RAO
NOTARY
!-; .\..20 t\
Appointed bY Govt- ol A-P Certiticale of Practice
AKANAVARITHOT' Rdracd$ to tr-t2.lgl
{ARSAPUR. UOGALTUP By G.O. Ms. No: O!
W,G.'TL. A.P. INPIA Dated :08-01-2024
Table
( a) FIR No. wltt 229n0t9 t94 t 2020 48t2022 322 12022 2W 12022 323/2022
nlme end Narasapuram Narasapuram Narasapuram Bhim3Y4a6 11 Bhivaram Bhim3Y312111
Town PS. Town PS. Town PS. Town PS. Rural PS. lI Town PS.
rddress of
Police Stetion
concermd
o) Cerc No wlth Case is PT Case is PT vide Case was Case was Case is PT Charged but
Nrmeof tie wide STC No. charged charged and vide CC No. not yet
CC No. 799t2022 or20.07.2022 CC No. awaited 162t2023 received
Corrt 13012022 vide SR No. from Hon'ble CC No.
9962DO22 court
(c) Sectl,on(s) of Uls 143 ,147 U/s 341, 143 , U/s 341 , 188 , U/s 143, 188, U/s 341, U/s
concerred ,149, 186, R/w - 149 IPC -
I43,R/w-149 2X) ,341 rlw 188,290, 143,188,290,
188,341 , IPC 149 IPC 143 R/w 34 34l rlw 149
Acts/Codca 3$,rrc,32- IPC IPC
lrvotvcd(give no, PA - 186l
of tte Scction,
e.g.
Secdon.......of
IPC,etc-),
(d) Brlef dcscriptfun Charge filed Charge filed for Charge Filed Charges framed Charges Charges
of ofiencc duing the Blocking rode thring the with respect to frarned with framdwith
dhama rt rcarGovt protest aDd above rcspect to respect to
main raod ftospital and Dama done at mentioned above above
before [aising voice Ambedkar center Sections. metrtioned. mentiond.
Narasapuram bgainst Govt at Narasapuram
Town police bocto. in for non-
station with felation to death allocation of
respect to the hf l-ate smt- district Head
rcuroval of k Quarters to
flex and "rai dng.. Narasapuram at
B^"k
banners by Nong with the tte time of
s."$ -../
2t ' \'znz-\
8"#-
A.GV. K. SURYA RAO
NOTARY
ADDoantod bY GoYt' ol A'P
AKANAVARlTHOT' Cdtif,cate of Pradice
NARSAPUR. TIOGALTUP RilndlDht?-12{@?
W.G.'TL. A.P. INFIA By GO- Ms. No: (X
Dated 08-r]1-2024
municipal followers revision of26
authority on districts from 13
the occasion districts by State
of Pawan Govemment.
Kalyan
birthday and
the issue went
to the police
station the
pmtest
continued in
the evening.
( e) Whether herges No No No No No
hrve been fremed
NO
(mentbn YES or
NO)
(0 If atrswer grlDst Not Not Not Not Not Not
e) $ove b YES, Applicable Applicable fuplicable Alplicable Applicable Applicable
(O Ceses of conviction
(i) I dechre thrt I hrve not been convicted for eny criminel ofience. (Iick this
alternative, if the candidate hes not been convicted and write NOT APPLICABLE
rgrinst rlternrtive (ii) below) ( v )
OR
(If the cendidete hes been convictd then tick this eltenrtive end score ofi elternative
r
F.,
A.GV. K. SURYA
NOTARY 2J .Q .2-o4
e"/-
Appointcd by Govt. of A.P
AKANAVARITHOT' Certificde dPradi-
{OGALTUP R.nacdtobtr.t2flI
'{ARSAPUR.
W.G.tlt. A.P. INFIA By G O. Ms. No:04
i)ald:0E-o1-2024
(i) above and give detells in the Trble bclow)
Trble
(b) Name of the Court Not Applicable Not Applicable Not Applicable
Section....... of IPC,
etc).
(e) Whetter eny Appeel Not Applicable Not Applicable Not Applicable
hes been liled
rgeinst conviction
order (Mention YES
or NO)
(h) If enswer to (g) Not Applicable Not Applicable Not Applicable
ebove is YES, give
detalls and prBent
strtus of eppeel
(6A) I have given full and uptoJate 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).
lcandidetes to whom this ltem is not appliceble should cleerly write NOT
APPLICABLE IN VIEW OF ENTRIES IN s(D and 6(i), abovel
ATTESTED \)
-\: --
A.GV. K. SURYA RAO 2t. Q'2-o Aq
, NOTARY
Appointed by Govt. of A.P
AKANAVARITHOT' Ce,tificale o, Praclico
t{ARSAPUR . ISOGALTUP Rcracd4b t7-12{O?
yy.G.t.L. A.P. ltlFlA -ly G.O. lrls. No: (X
Di'ted :08-01-2024
Note:
l. Detrils should be entered clerrty rnd tegibly in BOLD letters.
2. pstalls to bc given seprntely for each case under difierert columns rgelnst eech
item.
3. Deteils should be given in revenc chnonologial ordcr, Le., the lrtest crs€ to be
mentioned first and backwards in the order of detes for the other ceses.
4. Addldonal sheet mry bc edded lf required.
5. Cendldete is nsponsible for supplying all information ln complience of Hon'bh
Supremc 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 ad all depcndents:
Note: l. Assets in joint name indicating the extent ofjoint ownenhip will also have to be
glven.
Note: 2. [n case of deposit/[nvestment, the details including Serial Number, Amount, date of
deposit, the scherne, Name of Bank/Institution and Branch are to be given.
Note: 3.Value ofBondJShare Debentures as per the curr€nt market value in Stock Exchange
in respect of listed companies aod as per books in case of non-listed companies
should be given.
Note: 4. 'Dependent' means parents, son(s), daughte(s) of the candidate or spous€ and any
other person related to the candidate whether by blood or marriage, who have no
sepante 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
Explanation,- For the purpose of this Form, the expression 'ofhhore essets'includeg details
of ell deposits or investments in Foreign benks and any other body or
institution abroad, and deteils of ell essets rnd liabilities in foreign countries';
AS oo 6-04 - 2c.2+
S. No. Description S€lf Spouse HUF Dependent- I Dependent-2
ATTESTED
\
3,
A.G.V. K. SU RYA RAO
NOTARY
2-) . t+'Zo z\
Appointcd by GoYt. ot A.P
AKANAVARITHOT' certificale of PradiE
t{ARSAPUR. ilOGALTUF qEtrd$bl7-12{Qz
W.G.rrL. A.P. ll{FlA By G.O. Ms. No: (X
Daleu l{-r, ;1C24
(i0 Details of
deposit in
Bank accounts (FDRs, Savings Savings Savings Savings
Term Deposits and all Accounts in Accounts in N.A. Accounts in Accounts in
other typesof deposits
Bank [Jaiea Bank Axis Bank SBI Kaikaluru
including saving [-1ai61
Kaikaluru Kaikaluru Kaikalunr Braoch
accounts), Deposis Branch Branch Branch Account
with Financial Account Account Account number -
lnstitutions, Non- number - number - number - 40636232691
Banking Financial 0331l0lm073 0331l0lm025 922010n644n.33il Balance -
Companies 313 AM Balance - Rs.72701-
and Cooperative
Balance - hahnc" - Rs.2,456/-
Rs.1322.75l- Rs.4,645.75l-
societies and
the
amount in each such IOB Lokamudi
IOB Lokamudi
deposit Branch pranch
Account ,\ccount
number - [,rmbe. -
359l0lun00l bssrorooooor
886 b,,
palance-
Rs.10,56E/- 7394t-
Current
Account in m
ATTESTED 6"#-
A.G.V. K. SURYA RAO 2-1. L+-2-o 2-\
I NOTARY
Appointrd by GoYt. of A.P
AKANAVARITHOT/
{ARSAPUR . TIOGALTUF t rn nci&r ot pradie
W.G.rtt. A.P. INFIA ':nral up to 17.i2{El
By GO. rrb.No:Ol
Dared:fi,-01_2@4
number -
2100003288
Balance-
k.4,863.05/-
(iii) Details of investmctrt
in Bods, NiI Nil N.A- Nil Nil
DebentureJShares and
units
in
companies/Iv{utual
Funds and others and
the amount.
iv) Details of investment
in NSS, Postal Saving, IJC Policy LIC Policy Nil Nil
lnsurance Policies and number - nr-rmber - N.A.
ilvestment inmy 678713212 wm 678713215 surn
Financial instruments insured is for insured is for
in Post ofiice or
lnsurance Company Rs.50 Lakhs Rs.50 Lakhs
and the amount
Paid up value Faid up value
as on date - as on date -
Rs.5,00,m0 Rs.s,00,000
6\)
ATTESTED
\,
.G.v. K. SURYA RAO
NOTARY
Ll . Q.2_\ LV
Appointcd by Govt. of A.P
AKANAVARITHOT'
{ARSAPUR. T'OGALTUP odritiete d PracuE
W.G.rtt. A.P. INFIA Rrwed 9 to l7-t2.827
By GO. !lh. No: O4
Oat€d :06.01-2044
9
(v) Personal
loans/advance Nil Nil N.A. Nil Nil
given to any person
or entity including
firm, company,
Trust etc. and other
receivables from
debtors and the
amoutrt.
(vi) Motor Not Aprplicable 11161 4p,plicable N.A. Not Applicable Not Applicable
VehichJAircrafts/
YachtVShips
(Details of Make,
regisration
number. etc. year of
purchase and
amount )
vii) Jeweter, bullion and N.A.
valuable thing(s) Gold Chains Gold Vaddanam Gold chain weight Gold chain weight
(gt,re details of weight up to 24 weight up to 82 up to 20 grams, up to l0 grams,
weight and value) grams, Value is grams, value is is Value is
[alue
Rs.f,,l4,m0/- Rs.4,92,000/- Rr.r10,000/- Rs.60,000/-
Gold Bangles
weight up to 26
grarns, value is
Rs.156,000/-
Gold Earings
weight up to 9
grams, Value is
Rs.54,fi)0/-
Totel Totel
Totrl Rs.9,18,000/-
lfotd
Rs.60,000/-
Rs.2,04,000/- [".r,ZO,OOOI-
ATTESTED
\
8
A.G.V. K. SURYA RAO 2-l - +'2-o z- \
NOTARY
Appointed by Govt. of A.p Ccrtiicale of prdice
( A I,,IAVARITHOT' Rrtr{$bt7.r2Atr
^
r{ARSAPUR . {OGALTUP By G.O. Ms. No:04
I ,Q.r .t-. A,P. tNFtA Dated:08-01-20?_4
&@
Note: l. Properties in joint ownership indicating the extent ofjoint ownership will also have
to be indicated
Note: 2. Each land ss hrilding or apartrrcnt should be mentioned s€paralely in this format
Lokamudi
11
ATTESTED
Area (total
measurementin sq. Not Applicable Not Applicable N.A. Not Applicable ot Applicable
ft.) F
Builtary Area
(total Not Applicable Not Applicable N.A. Not Applicable Applicable
measurernent in
sq.ft.)
Whether
f-
inherit€d Not Applicable Not Applicable N.A. Not Applicable Applicable
property
[Yes or No)
Date ofpurchase in
f'
case ofself- acquired Not Applicable Not Applicable N.A. Not Applicable Applicable
property
Cost ofproperty (in
f,
case ofpurchase) at Not Applicable Not Applicable N.A. Not Applicable Applicable
the time oSurchase
F.,
ATTESTED 8 t)
!
A.G.V. K. SURYA RAO
NOTARY
ZI ' \'zo 2\
Appointed by Govt. of A.P Cenificate ot Practbe
AKAHAVARITHOT' RltE Gr, e to 17-12{027
TIARSAPUR ' UOGALTUP
By G.O. Ms.No:Ol
w,G.trt. A.P. lNrlA Dated : 08-01-2024
Any Invesunent on the
property by way of Not Applicable Not N.A. Not Applicable Not Applicable
develop,ment, Not Applicable
constnrction
etc.
Approximarc
curentmarket Applicable Not Applicable N.A. Not Applicable Not Applicable
value [.-
(iv) Residentiel Buildinps
(including apartments): [.,lot Applicable Atepekr, N.A. Not Applicable Not Applicable
-Location (s) Kaikeluru
-Survey numbe(s) Mandel, RS. No.
133/ll
Area (Total
measurernentin sq. Applicable Undivided Lend N.A. Not Applicable Not Applicable
3
ft)
measuernent in sq. ft.) fuo,o*,,*," l,ffi2.Sq. fe€t N.A. Not Applicable Not Applicable
Whether
iilerited ot Applicable No N.A. Not Applicable Not Applicable
property
(Yes or No)
Date of purchase in
case ofself- acquired ot Applicable 21-01-2011 N.A. Not Applicable jlot nnnlicable
property [.
Cost ofproperty (in
case ofpurchase) at ot Applicable Rs.6,00,m0/- N.A. Not Applicable Not Applicable
the time ofpurchase
Any Invesment on
the land by way of Not Applicable Nit N.A. Not Applicable Not Applicable
developmeog
construction
etc.
Approximate
currcffim*et ot Applicable Rs.2950,000/- N.A. Not Applicable Not Applicable
value
ATTESTED 6u
\
A.G.V. K. SURYA RAO
NOTARY
iL\ 4'>a z\
Appointed by covt. ot A.p
,CKANAVARITHOT' Cenifcat€ ot Pr*lb
r{ARSAPUR . TOGALTUP RerEftd u0 b 17-12-Ag,
VY.G.t.L. A.P. INr,IA By G.O, Ms. No:Oa
Dated:G01-28L3
13
( ) Others (such as hterest
itr ot Applicable Nir N.A. Not Applicable Not Applicable
prop€rty)
(vi) Total of current
marka vatue of (i) Rs57,60,000/- N.A. NIL NIL
to (v) above
(8) I give herein below the details of liabilities/dues to public financial institutions and
govemment:-
(Note: Please give separate dctails of name of bank, institutioq entity or individual ad
amount before each item)
Loan number -
23M2200t0
ATTESTED
\
14
6"€
A.GV. K. SURYA RAO
NOTARY
2 'q.Zo L\1
)
74,5951-
Lorn or dres to
.ny other From From Tiru mdrsetti N.A. Nil Nit
indMduelV Tirumelesetti Lakshmi Chaitanya
entity other then Lekshmi
men6oned
Chritenye Gold
ebove.
Jewelry/Omrments
Name(s), Gold tlken weight up to
Amount Jewelry/Ornament 160 grems. end
outstanding, s teker weight up rveihd brnk gold
nature of loan
to 179 gnns for lorn
rvafled bank gold Velue rs on dete
loan Rs.9,60,fi)0/-
Velue es on drte
R&I0,74,01XY-
Any other liebility Nil Nit N.A Nit NiI
ATTESTED
S-P-
\
A.G.V. K. SURYA RAO
2t.+.Lo4
NOTARY
Appointed by Govt. oI A.P
AKANAVARITHOT' Ce(i,icale o, Pretice
I.IARSAPUR. UOGALTUF n"ae{cd b tl-i2-2027
W
WG.tiL. A.P. lNr"lA i3y G.O. Ms. No:04
Datod:(E-o1-2@/3
15
(ii) SovlrlpcntDlni (A)Has the Deponent been in occupation of ss/No
acmmmodation provided by the Government at (Pl. tick the
Dues to departnents
dealing with any time during the last ten years before the date appropriate
Government ofnotification ofthe curreot election ? altemative)
accommodation
(B) Ifanswer to (A) above is YES, the following
declaration may be fin'nished namely:-
ATTESTED
8 t)
\
A-GV. K. SURYI\ RAO
NOTARY
LI . \,ZO Z\*
Appointod by ccvr. of A.P
AKANAVARITHOT' cenficalo o{ Pracli€
Rcflercd u0 to I 7.12@7
{ARSAPUR . UOGALTUP
W.G.trL. A.P. INFIA By G.O.lrll. No: (X
Oat6d:S-O1-2@4
Self Spouse HTJF Dependent- I Dependent-2
O) Spouse - Busincss
(9A) Details of sourc{s) of imome:
O) Spouse - Bmtnces
(d) details of contracts etrtercd into by Hindu Undivided Family or trust in which the
candidate or spouse or dependents have interest Naveker Cheritable TrusL NrrrsaDunm
(e) details of contracb, entered into by Partnetship Firms in which candidate or
spouse or dependents are partners NA
'B"f-
ATTESTED
L) .4.Lo2_\
A.G.V. K. SURYA RAO
NOTARY
Appoioted by Govt. ol A.P
AKANAVARITHOT' .lenificale of Practb
}.IARSAPUR. IUOGALTUF RerErcd to 17.t2-437
w.G.til. A.P. INFIA By G.O.'r0Ms. No:04
Dated:(Eol.2gL
18
PART-R
(l l). ABSTRACT OT'TIIE DETAII,S GTVEN IN (1) TO (IO) OF PART - A:
2 Full postal address S/o Narasimha Rao, Resident of Door No. ll-4-158/1,
Peechupalern, Narasapuram - 534275,
West Godavari, Andhra Pm&sh.
3 Number and name of the No. 58, Narasapuram Assembly Constituency, Andhra Pradesh.
constituency and State
I Plnchase Price of
self-acquired Rs.17,95,000/- Rs 18,80,000/- N.A. NIL NIL
immovable property
ATTESTED
\,
19
6"{
2-l' q'zoL\
A.G.V. K. SURYA RAO
NOTARY
Appointed by Govt. ot A.P ,.,r,lrcale of Practice
AKANAVARITHOT' ;e, wett uD to 17'12'027
}{ARSAPUR . IIOGALTUP
3y G.O. Mr. No: O4
W.G.'''L. A.P. INFIA Diled:@41'2Ql
III Approximate Current
Martet Price
(a) Self-acquired
asseB (Total
Rs.s42s,000/- Rs57,50,000/- N.A. NIL NIL
Value)
9 Liabilities
(i) Govemmert dues I\IIL NIL NA. NIL NIL
(TotaD
lt. educetionel
S.S.C from Board of Secondary Yeer of Passing 1989
Ravindhra Bherethi Scbool Certifcate
Bhimavarem
ATTESTED
3P
-{
A.G.V. K. SURYA RAO L) ' +. Lo 2-\\
NOTARY
Appcintad by Govt. ot A.p
AKANAVARITHOT' Cettiftale of Practice
{ARSAPUR. TOGALTUF RaEwed up to l7-12-2027
W.G,rrL. A.P. INFIA By GO. Ms. No:Ol
Dated:G.O1-2@l
20
VERIFICATION
I, the deponent, above namd do hereby verifr and declare that the contents ofthis 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 fir:ther declare that-
(a) there is no case of conviction or pending case against me other than those mentioned in items
5 and 6 ofPart A and B above;
O) I, my spouse, or my depen&nts do not have any asset or liability, other than those mentioned
in items 7 aod 8 ofPart A and items 8, 9 and l0 ofPart B above.
Note: l. Affidavit should be filed latest by 3.00 PM on the lasc day of filing nominations.
Note: 2. Affdavit should be swom before an Oarh 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 firnish in rcspect 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 Affdavit should
bear on each page the samp of the Notary or Oarlr Cornmissioner or Magistrate
beforc whom the Affdavit is sworn.
ATTESTED
w
1 A ,l A.G.V. K. SURYA RAo 2] ,q.zo+
o 3U R a NOTARY
Appointed by Govt. ot A.P
EI AKANAVARITHOT'
4 {ARSAPUR. {OGALTUF
.o. La It. 116
DI ? 1 z-lw
1 W.G.rrL. A.p. ll{FlA
CdffEa[o dPracti> Jio:9182738055
Rener,la l, h l7-t2{8,
Land : 0EE14-289155
ot ByGO.ftlr.ilqol
thed:(Dol.2B.l Cell : 9441091965
27 Det€.. L oz L
st. No..JI..6....nge xo .e.?