FORM.2A

Nomi..rto. P.F.Elction |o tlt I .!'slatv. Asmbly of Jmu dd lchmi.

STIUKE OIl' PART I OR PART II BEI,OW WHTCIIEVER IS NOTAPPLICAf,LE

PART I

{Tob.u*d b} ( J'Jre *r up b} Eognii.d pohriol Fny)

.: ! 14 Asnbh ( {NiuN C!idi&r. s N.ft_r_r=+ 1=4_^snD,\ \ tNtr4.gi (.||er. s NM yt*4ta </v,{,{"4:HrZI i4"ffn$ff"*lifffi*"

-""ill%-., isdraldds.No. l'.J ,npJnNo {!'"l .iF:tr;16 \dl!lrD4!4JA'mblr(on{ruLr- / |

I mnid..a. qtdidll. for.lern{ |o $c Ggistxivc Asbly fion rh.

Dat gltQlt! lta(SisDa

' dEd*'od D ror_Jl:lt4l. r.*.t rr c.ngncft)-:fy* i"S

P..r ll(To b. us.d bt ca iltft tun *| up h! @g.i$d pothic.t psny)

wr n.rcby nomidrc !s crndiJrrL to' .t(crion ro rhc As*nbty Conjritucncy fron rh./'//n Asbly Conn(EN!clndidar.! ime _ N/A __ r hf !4vorh.is/H6b€rd.s M.NIA In\ pliJta.j.tcsHis'|e b cnrdld d S. No

fh..lcrodlrcll for ah

S No. Elcb6l RollNo. or r',ur\,\y

Nn in P.n No.

^-r.mhb co,,sri'ffiy

4!./11

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P.rrLlLB olii! DnleB.nd thci. {ilnrtue

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to.

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(.) drd lh.v.mpt.r.d I 6 ,sorrsc,ISTRIKE OoT b(i) oR h,, r Du_ow wHlcHEvER ts NoT AppltcaaLEl

(bt (', rhd I m*r up sr rh^..$"n b' ft 7( /A / Fny. enich i, r@snircd^.'lN r.n'/sLk t"nr) in rhi sd. !d 0!r dE,ymbot

't*n.d for dr.bov; F,r,b. .ltorEd ro ft.

I iit dEr I m.l uplr rrn. (tenun b! rh. ^U4 prny. *r,ictr i, u

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Ir.E : nEr 3l[!td bG i.n .k b^;-Fi;iiifi-, d Fqo*B

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i. Fn4{,4\ ir.-\ ,,r'rt'( lsnsu!8.,;

ofn) In.\Lrdsc u l bclici I o qlrlilicd lld d !l$ dilqu.lifi.d fdb.in8.h@tr b fill rh. a.i .

' r|I |.cshldiE Asnbty of fiis St rc.

! I funts dchr rhlr lN,',irtrrtrrof rhc JlA C.n wnichir!sch.dur.d ( sk orrlE surc or J,,,,..,,!t tiJ\hnn i;hidi _ _&- r.Er.r,r,.t

I slso d*I.rc lhd I h!\( n.,r r.cn. Jnd sholl nor b. nonin.l.d a. a crndidlt..r rhcptEgt 8*El cl.cliovthc bl({l(.'irF lxins h(ld sihulbEuely. ro fi. laSistllit Ashbtyof Jdmu !d Kashmir rDm m,\ 'rrr nv, \\*nhh connirw*t /l*rla)o.a o/ /J.lollt (sis'rufordccoidi&k,.I S.oc od lh. wor& mt .pplicuhl(N.B. : A _colnisd pohical $' r\' tr,..tr\ J rrlnical Fn, cos.i*{ b} the Ele on C@misionurndfi. tlcio. symboh {Rc*..n,tr or x /\lldmn0or!.( |96E in dnu lnd yGhmii

PAIT IV(Io b. lilcd V ttt 'rilidtrc)

*,t $.. ft Ctrnld'r. :_

lil bs b..n @'rvicr'6 -

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fo.ts Ydr q trsll rtE lBs 't

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'lt off'e'ts) rd ehch lt hr3

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l'4 rr c(s,of dvi.todst ^//(v) cou(!) snich dvictcd ln. ctntU' N /tcfui) Punirhh.n(r) inPoicd l in4rc'r' Pcriod or imtri3onhcn(31 lnd/or qu'nrlm ol

tttAetl N I A

(viD tht<3)ofEl.&fmnt \,-(viii) wd/w{y.Plal(syBiio(s)filcd.sr1Nrbo!'coilktio{' - Y6No

(ir) D.r. dr<r Fnicul6 ol.ppol(3y.ttliqrioi(s) for Bisio.ltLd N/4(r) N.n. of lhc cou (s) b.for. shich lh. .pp.tl(s)/.pplic.tion(3) for r'!i3ion

lGylDDliorim (r) for Gvisiq h!''lEr bdn dkF!.d of ot itu!

(xii) lf th€ eid rpFsl(sylppliclrion(s) lor Evision havl'!rc b..n

r!, Dardr)ord,s@l ArlA. i_--_(bl NduEolodclt! D.s*d /1,/,//

,*m:^rr.

PART V

Vt '(Autncian'd of |tar)

{FullPcbl Add!3s) to &l'vcr Ois nmi;PIE ry^aA. Jtu

!s.@ tu rhi!' r...3nph ifid sti.lbk

| .gc ro rt s 3Eh .urhodad dc .PtG: 4r.\ ,J.tuDd..6t.e.A6/

PART YIflo bG fill.d by rt . Rctl|ni.g Ofiid,

S.nd No. of nffnllioi FF O ?. _rniimminaiq B d.riscd b h., hy onia ar g,.lo?U mq.""JZ,Ln,qh -omdal./6ulhoriz.d.gfr |/preDor.

rs4!ddFllnB|,'|ia.k

- PARI VIIIl..ib. o, R.rrnha Ot[..r ANpti!! o. R.j.ctirS tt. N{i.!ib. p|p.r

D _-Ihakdmixd this rcmin t,on porF,n aed,tr yid s on 4? otrh. rhnu !d Xstntrx.pcFnEld ol rh€ PspL Acr. Io57 &d d*d. a fo ow_.

PARMtt_ .

Re.ipr fo, No.i!.rio! p.Fr..d Nori.rorlituri!'(To b. tbrd.d o!.r to 0E p.Mn penring lrF N@iMtion p.Fr)

Sdill No. oanoniMdon prFr

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pudshlll. *ft iiFiemon

of ey 3E! o|!.d(, lE tlutl tudrh rb'

Fdi.gisritBmbshjchby th. cotlt fd $ otloE

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nEtoEd i! ird(i) .bo*) !

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If rh. dcF*nr b 6nvicr.d ed pqth.d s .fo6id tr rlullfrairh 0E foll@ins iddrrid:

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(7) Ttur I hls hcrin b.low rhc da.its of 0E lsq mkrDr. .ndilmovabL .r.) of dy*ll hy rroc &d .I d.FdaL.

A- Dd.ils of msbl. serr

Norc:|. As.rs i!joi n.m iididring rlE dc ofjoid owi.BD,pwilt d$ hrv. to bc gi!o.

'.rd -8ri,!'"., !ad.'(t.a 'rE

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o Dd.ik of ApFh(3yAtpricdio(O fdEvisioi( il at) nl.d .g!i[n dc .tov.

th. d.hik of cac!, srion(t@M.d *(i) rd deirrio!ofci.qs) for *nid @ivicrcrl

o) Noe orrhc cour(r) ce r,l- ara@t!&rdd{t:t\pL[|Hr inror.d

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h c& ol d.F iutnv.$mr dE d.l!jt! ifttuditrg SdidNmbcr, Amul dlr. of &Fsi( Uc *h.oc, Nlm of dEB.nl4srillnion qd Aneh E b b. siErvda of Bon bStE D.!.nr!B s F .u@r rrtd vttED /iar dch.n8. h BFr of rid.<t @hFri6 trd s Fb@rr ir 6* of mnliecd c@Fni6 outd b. aihlr:d."' l-. ha rr'F nft lfuins s BisrEd inlxPlDtiotr(v) urd.r sid 75A of .h. nllteolid otr

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( civc dcr.ilr of hiShd S.hoouuniv.Biry cductrion renronhs $.u rm ot tnc difiodddonrd.gE @@, l@. of dcsch@, Coll.gc,aJniv6r.y ard dE y@ in which 0E tuuR @

PART.BABSTRACT OF THE DETATIS CIVEN N (I) TO (IO) OF PART

N@ ofrhc clrdidde vi,t.t a S;t42. YlL 6't4jg tr 4t2. 7, 1<A'tlt, T*L/'/41, (r1t)

ndE or rc po|n!c{p.rty stich s up rhcc{didtlc (otn@j$ wib"id.!.n&nf) T tk /e'p

5;;a\/LC I

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5.I tDrou nGtcr --iip..o'ng ccs wlftcha8e h,v. ber tirD.dby O. Coun ior ollaEaputhrbl. wilhnpn$nm for rwo N(

I(ii)

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lll Aptmximt cffil

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tl HiClBr .ds!do;

( Giv. ddils oa high.n

.du.dio. h.nrioning rhctull rom of dFenific$.r'diptoetdeSccou6., nmc of rlESdooUColLgdjliv6iryD.t rb. t6 in *iich th.o@wa@DpLr.4) l

\afru 1^ lv"t ,.".,f d1/.*

I.tg

b"lVERIFICATION

I, dE d.Fn.o! alovc n rE4 do h@by siry &d {h.te rh.r lh. 6ir.nbof 0!i alfi&vir e m. !d @net b rh. b6l ofhy r6eLdS..dt b.ticf&d m Fn of n is f.t$ .Dd rcrhjn8 .lraid bls hco 6rst.d rl@6trn. I

(.) Thd t rc .e of@nvicrion or padirS .e lg.i^n m o$d rleoc @mioncd in ii.@ 5 .nd 6 oap.n A .d B .bovc.(b) I. my spoq, or my dcF.do|! do mr hav€ ey .!4r or lilbitiry,

o|na th& rhos ndrion.d in iGn 7 !d 8 ofp.n A ed ilm 8,9 edl0 of Don B lhovc.

vdin.d !l ,1- ,ri, rlE yhr*lacb.ttieA

C,

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il'i'lv /..'Yluu

/'.eel

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a