Rs.20ftsI

;5.20TWENTYRUPEES

)3/ tl I

t Afiidrvit to bc frled by the candidate alongwithNomination Paper Before the Returning Ollicer for

T

! t P. TAMILSELVAN son of Thiru.

lI

election to House ofthe People From fi25, Perambalur Perliament Constituency X-J

cihltl

resident of54/1, Gendhi Nagar' 4th Street' Velskrnrthtm Rosd' Muriri Post

t& Talut{, Ttichy Distict, Pit z 621 2ll'' a candidate at the above election, do

fiereby solemnly affirm and stat€ on oath as under i(1) I am acandidate setup by United Commutrbt Prrty oflndia (name

Sfthe political party P:Oa 9 i 6t$1ah

(2) My name is enrolled in 145, Musiri Ass€mbly Constituency, Tamilnadu at Serial. No. 279 in Part No.234 comprised within 25, perambalur pariiement Constituency.

(3) My contact telephone numbers are 98/.35 491m,9g417 90634 and my e-mail id (ifany) is ..N!1... and my social media accounts (ifanyj are ...N.i1...

(4) Details of Permanent Account Number (pAN) and status of filing of Income Taxretum:

(5) I am not accused ofany offence(s) punishable with imprisonment for two years or morein a pending case(s) in which a charge(s) hasluve been framed by the court(s) ofcompetent jurisdiction.lf the deponent is accused of any such offence(s) he shall furnish the followinsinformalion:-

(i) The following case(s) is/are pending againstme in which charges have been fiamed bythe coult for an offence punishable with imprisonment for two years or more:-

ta, Case/First Information Report No.A.los.together with complete details ofconcemedPolice Station/Districvstate.

Nil

(b) Section(s) ofthe condemed Act(s) and shortdescription ofthe offence(s) for whichcharsed.

Nil

(cl Name oftheCour! Case No. and date ofordertaking cognizance: Nil

(d) Court(s) which framed the charge(s) Nil(e) Date(s) on which the charge(s) was/were hamed. Nit(0 Whether all or any ofthe proceeding(s) have been

stayed by any Court(s) of competentjudsdiction. Nit

sl.

No.Names PAN

The financial yearfor which the lastIncome-tax retum

has been filed.

Total incomeshown in Income

Tax retum (inRupees)

l. Self P.Tamilselvan ALCPT 35I5A Nil Nil2. Spouse T.Uma Nil Nil Nit

Dependent-l T.Vinothini Nil Nil NilDependent- 2 T.Sridevi Nil Nil Nil

5. Dependent- 3

f.BalamuruganBNBPB8235K Nil Nil

f--,rgyiaZz.t*'.

-3-

(6) I have not been convicted of an offence(s) (other than any offence(s) refered to insub-section-(t) or sub.s€ction (2), or covered in sub-section (3), of section g of theRepresentation ofthe People Act. l95l (43 of l95l) and sentenceJ ro impmsonment ibrone year or more.

If the deponent is convicted and punished as aforesaid, he shall furnish thefollowing information:ln the following cases, I have been convicted and sentenced to imprisooment by a court oflaw:

(ii) The following case(s) iVare pending against me in which cognizance has been takenby the court (other than the cases mentioned in item (i) above):_

(a)

(b)

The details ofcases Section(s) oftheconcemed Act(s) and descripion oftheoffences(s) for which convicted

Nil

Name ofthe Coun(s), Case No.and date(s) oforde(s) Nil

(c) Punishment imposed Nil

(d) Whether any appeal was/has been filed againstthe conviction order lfso, details and thepresent status of the appeal:

Nil

(7) That I give herein below the details of theofmyself, my spouse and all dependents:

assets (movable and immovable etc..)

A. Details ofmovable assets:Note : l. Assets in joint name indicating the extent ofjoint ownership will

also have to be givenNote : 2. In case of deposMnvestment, the details including Serial Number, Amount,

date of deposit, the Scheme, Name of the BanMnstitution and Branch are tobe siven.

Note : 3. Value ofBonds/Share Debentures as per curent market value in Stock Exchaneein respect oflisted compaaies and as per books in case ofnon-listed companiisshould be given. ro _... ^

(a)

(b)

(c,

Name ofthe Cour! Case No. and date ofordertaking cognizance: NiIThe details ofcases where the court has takencognizance, section(s) of lhe Act(s)and description ofthe offence(s) for whichcognizance taken.

Nil

Details ofAppeal(s) /Application(s) forrevision (ifany) hled against the Aboveorde(s)

Nil

V:A aylow;l-,rn

-!L

Note:4. Dependent here has the same meaning as assigned in Explanation (v) undersection 75A ofthe Representation ofthe peopleAct, l95l.

' Note :5. Details including amount is to be given separately in respect ofeach investment.

(iD Details of depositin Bank accounts(FDRs, TermDeposits and allothcr types ofdeposits includingsaving accounts),Deposits wirhFinancialInstitutions, Non-Banking FinancialCompanies andCooperativesocieties and theamount in eachsuch deposit.

as on4.4.20t4

Rs.4211.64SB JointA/c No.

3t249378353SBI Musiri

Branch,Rs.946l-SB A/c

20t9t65g23SBI Musiri

Branch,

a5 0n4.4.20t4

Rs.3,67,076/.

in SB A"/c

No.8065,TDCC Bank

MusiriBmnch

as on4.4.2014

Rs.l,189.64in SB A/c

No. 3128664t200

SBI MusiriBmnch

Rs.500/-SB A/c

500101010220778 inCity Union

Bank,Musiri

Branch forelectionpurpose

Details ofinvestment inBonds, deben-tures/sharesand units incompanies/Mu-tual funds andothers and theamount.

(5A9vifua-r;

B, Detdls of Immovsble Assets :Note : L Properties in joint ownership indicating the extent ofjoint ov,nenhip will also

have to be indicated.Note : 2. Each land or building or apartment should be mentioned separately in this fomat.

(iv) Details of investrnent inNSS, Postal Saving,lnsurance Policies andinveslment in anyFinancial lnstruments inPost office or InsuranceCornpany and the amormt

Rs.50.000/- SBI LIFEIJNIT Plus III Pension

Poticy No.38006225503,Rs.17554/- SBI LIFE

Smart Money Back Goldhoposal

No.lNQF29l998

Nil Nil Nil Nil

(v,Personal loans/advancegiven to any person orentity including firm,Company, Trust etc. andother receivables fromdebtors and tbe amount.

Nil Nit Nil Nil Nil

(vi) Motor VehicleVAircraftVYachts/Ships (Details ofMake, registrationnumber etc. year ofpurchase and amount)

TN 47 X 7031 SplendorPlus, Hero Hond4 4i2011

5.5.201I, Rs.54,000/-

Nil Nit Nit Nil

(vii) Jewellry, bullion andvaluable thing(s) (givedetails of weight andvalue)

8 gms.

Rs.17,200/-40

gms.

Rs.

t6,000/.

42gns.Rs.

94,500/-

42gms.

Rs.

94,500/-

Nil

(viii Any other ass€ts such as

value of claims/int€restNil Nil Nil Nil Nil

(ix) Gross Total value Rs.1,70,911.64P.s.

86,400

P.s.

\6,n6Rs. Ps.

9s989.eNil

sl.No

DescriptionSelf

P.TamilselvarSpouseT.Uma

Dependent-lT.Vurothini

Dependent-2T.Sridevi

Dependent-3tBalanwugan

(D Agricultural LandLocation(s)Survey number{s)

Nil Nil Nil Nil Nil

Area (Totalmeasurementin acres)

Nil Nil Nil Nil Nil

lgtA gi6b-^z-ro.

-6-

Whether inheritedproperty (Yes or No) Nil Nil Nil Nil Nil

Date of purchas€ in caseof salf-acquired property. Nil Nil Nil Nil Nil

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

Nil Nil NiI Nil Nil

Any Investment on theland by way ofdevelopment, constructionelc.

Nil Nil Nil Nil Nil

Approximate currentmarket value NiI Nil Nil Nil Nil

(ii) Non-Aericultural Land:Location(s)Survey numbe(s)

Musiri (East)S.F.No.236i l82

Nil Nil Nil Nil

Area(Total measurement insq.ft.)

4630 Sq.ft. Nit Nil Nil Nil

Whether inheritedproperty (Yes or No) No Nil Nil Nit Nil

Date of purchase in caseof Self - acquired property.

2.6.200826.6.2008

Nil Nit NiI Nil

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

Rs.6,15,000/- Nil Nit Nil Nil

Any Investment on theland by way ofdevelopment, constructionetc.

Nil Nil Nil Nil Nil

Approximate currentmarket value

Rs.7,00,000/- Nil Nil Nil NiI

(iii) Commercial Buildings(including apartments) -Location(s)-survey numbe(s)

Nil Nil Nil Nil Nit

Area (total measurementin sq.fi.) Nit Nil Nil NiI Nil

Built-up Area (Totalmeasurement in sq,ft,)

Nil Nil Nil Nil Nil

Whether inheritedproperty (Yes or No) Nit Nil NiI Nil Nil

Date ofpuchase in case ofself-acquired property

Nil Nil Nil Nil Nil

Cost of property (in caseofpurchase) at the time ofpurchase

Nit Nil Nil Nil Nil

Any Investment on theproperty by way ofdevelopment, constructionetc,

Nil Nil Nil Nil Nil

Approximate gurrent

market valueNil Nit Nil Nil Nil

(iv) Residential Buildinss(including aspatments,)- Location(s)- Survey numbe(s)

Musiri (East)S.F.No.388/l82

(Natham S.nNo. 239l3C)

Nit Nil Nil Nil

Area (Totrl measurementin sq.ft.)

872 Sq.ft. Nit Nil Nil NiI

Built-up Ar€a (totalmeasurement in sq.ft.) 728 Sq.ft Nit Nil Nil Nil

Whether inheritedproperty (Yes or No) No Nit Nil Nil Nil

Date of purchase in caseof self-acquiredproperE,

29.12.2006 Nil Nil Nil Nil

Cost of property (in caseofpurchase) at the time ofpurchase

20,000/- Nil Nil Nil Nil

Any lnvestment on theland by way ofdevelopm€nt, constructionetc.

r,7 5,000t- Nil Nil Nil Nil

Approximate currentmarket value

5,00,000/- Nil Nil Nil Nil

(v) Others (such as intercst inproperty)

Nil Nil Nit Nil Nil

(vi) Total of current marketvalue of(i) to (v) above.

12,00,000/- Nil Nil Nil Nil

?-o *yi c1r-v"tn

-8-(8) | give herein below the details of liabilities/dues to public furancial institutions andgovemment.

(Note please give separate details of name of banlq institution, entity or individual andamout before each item)each item

sl.No

DescriptionSelf

P.TamilselvanSpouseT.Uma

Dependenf l

T.MnothiniDependent-2

T.SrideviDependenr3f.Batanrugar

(i) Loan or dues toBank/financialInstitution(s)Name of the Banko r f i n a n c i a Iinstitutiorf Amountoutstanding,Nature of Loan

Nil Nil Nil Nil

EducationLoan as on31.3.2014Rs.20,413LLoan A/c No.31947380632SBI, MusiriBranch &Rs.1,15,969/-Loan A/c No.32783296849SBI, MusiriBranch

Loan or dues to anyother individuals/€ntity other thanmentioned aboveName(s), Amountoutstanding, natureofloan

Nil Nil Nil Nil Nil

Any other liability Nil Nil Nil NiI Nil

Grand total ofliabilities

Nil Nil Nil Nil Rs.1,36,382/-

(iD Govemment dues:Dues to departnentdealingwithgovernmentaccommodation

Nil Nil Nil Nil Nil

Dues to deportrnentdealing with supplyof water

Nil Nil Nil Nil NiI

Dues to deportmentdealing with supplyofelectricity

Nil NiI Nit Nil Nil

Lrues to deportrnentCealing with supply)ftelephones/mobiles

Nil Nil Nil Nil Nil

f*K,,oil 'l-'1X"-

f'->rt:ilou)a;

(e) Details of profession or occupation:

(a)

(b)

( l0) My educational qualification is as under:-

3rd Standerd-l971, Panchayat Union Primary School, T.puthur, Musiri Taluk(Give details of highest Schooyuniversity education with full form of the certificate/diploma/degree course, name ofthe SchooUCollege/university and the year in which thecourse ws completed.) (- c;; fiF"l -tao

-------..

-9-

Dues to deporfinentdealing withgovemmenttransport (includingaircrafts andhelicopters)

Nil Nil Nil Nil Nil

Income tax dues Nil Nil Nil Nil Nil

Wealth tax dues Nil Nil Nit Nil Nil

Service tax dues Nit Nit Nil Nil Nil

Municipal /Prop€rty Tax dues

Nil Nil Nil Nil Nil

Sales Tax dues NIL A,ftL ryt(- N IL- Nl\-Any other dues Nil Nil Nil Nil Nil

(iii) Grand total ofallGovemment dues

Nil Nit NiI Nil Nit

Iiv) Whetber any otherliabilities are indispute, if so,mention theamount inyolvedand the authoritybefore which it ispending.

Nil Nit Nil Nil Nit

;fliloTA

- l0-

PART.B

?-Jt6tA;6v-1"/*

r) ABSTRACT OFTHE )ETAILS GIVEN IN (I) TO (IO) OF PART-A:l. Name ofthe Candidate P. TAMILSELVAN

2. Full Postat Address 5411, Gandhi Negar, 4n Street,

Velakanatham Road,

Musiri Post & TalukTrichy Distict, Pin : 621 211,

3. Number and Name oftheConstituency and state

25, Perembalur PerlirmentConstituencyTamil Nrdu, Indir.

Name ofthe political party which set up thecandidate (otherwise urite'Independent')

United Communist Prrtyoflndia.

5. (i) Total number of pending cases wherecharges have been fiamed by the Coult foroffences punishable with imprisonment fortwo years or more.

Nil

(ii) Total number of pending cases whereth€ court(s) have taken cognizance [oherthan the cases mentioned in itern (i) abovel

Nil

6. Total Numb€r of cases in which convicated

and sentenced to imprisonment for one year

or more [except for offences referred to in

sub-sections ( l), (2) or (3) ofsection 8 ofthe

Representation ofthe People Act, 19511

Nil

7.PAN of

Year for which

last Income Tax

retum filed

Total Income

shown

(a) Candidate

P.TsmilselvanALCPT 35I54 Nil Nil

(b) Spouse

T.UmaNil Nil Nil

(c) Dependents

l. T.Vinotbini NitNil Nil

2. T.Sridevi Nil Nil Nil3,T.Balamurugen BNBPB8235K Nil Nil

-l l-

7:zn9*eA-*

8. Details ofAssets and Liabilities in Rrrpees

DescriptionSelf

P.TamilselvanSpouseT.Uma

Dependent-T.Vinothini

Dependent-2T.Sridevi

Dependent-3T3alammrgar

Moveable Asset(Total value)

| ,70,91| .64t. 86,400/. 4,6t,776t- 9s,989.64 Nil

l"I

ImmovableAssel

Purchase Priceofself-acquiredimmovableproperty

6,35,000/- Nil Nil Nil Nit

II Development /construction cosofimmovableproperty afterpurchase(ifapplicable)

t,75,000/- NiI Nil Nil Nil

u ApproximateCurent marketprice of

(a) self-acquiredassets (TotalValue)

[b) inheritedassets (TotalValue)

12,00,000/-

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nit

9

(i)

Liabilities

Govemmentdues (Total) Nil Nil Nil Nil Nil

:ii) Loans fiomBank, FinancialInstitutions andothen (Total)

Nil Nil Nil Nil 1,36,382/-

t0Liabilites thatare underdispute

Nil Nil Nil Nil Nil

Loans fromBanh FinancialInstitutions andothers (Toral)

Highsst educational qualification :

University and the year in which the course was completed.)

3rd Standlrd-1971, Prnchryrt Union primary School, T.puthur, Musiri Taluk

- (Give details ofhighest School / University education mentioning the fullform of the certificate / diptoma / degree couse, name of the School /

-college /

VERIFICATIONI, the deponen! above named, do hereby veri$ and declare that the contents of thisaffidavit are xre and correct to the best my knowledge and beliefand no part ofit is falseand nothing material has been concealed thereliom. I further declare that :_

(a) there is no case ofconviction or pending case against me other than thosementioned in items 5 and 6 of part A and B above:(b) I, my spouse, or my dependents do not have any asset or liablity, other thanthose mentioned in items 7 and g ofpart A and items g,9 and l0 part Babove.

ais tne .........|L....... aay or April, 2014.

II

fn ,l -

I{OTARY PI'BLICREGD.NO : G;O;ll;S: .{8196

K JAG,ITATHAN, B^Tt.ADrrocAtE e xoun PUEUC

32-A. lXlfNgrON,THURAIVUR - 62r O!O,

TruCHtlArP lU DrslllcT

frasylc>){6DEPONENT

Nore : |. Amdavit shoold be fited lstest hy 3.00 pM on the ILst datc offitiDs nominations.2. Afiidavit should b€ swom befor€ an Oarh Commissioner or Magi;ate ofrhe Firsr Class or b€tore a

Notary Pubtic.3. All colomn should be fillcd up and no column to be lei blsrk. flhere is no bfornation to firnjsh iD

r€sp€ct ofany item, eilhcr'Nil" or ..Not applicable',, as lhe csse nlay be shoutd bc mentioned.4. Tbe afrdavit should b€ either tt?ed or wiflen legibly and neatty.

f ttSi*Aa)/-r-