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201..2-......aa.A.@'?).fi......-.......-..1rcao";... .....27...................-c" o)lco(oilcr)o)jc6nrcoodsl(dlojlaor.d.

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AEARGEEUTTY ADMI!A',.8.'!I.} . 2. ffDco[oo6doleJo,60] aDoJt rrojlerrolc 6oo"l.'v6rD{a(Oath CamDitlgglbr6; Wgffl;|1i;-'-*c(ni oalc'lic(sdoqcaoc c(r)cs.il or6Rl66iloolccoc ol(r)lco6 /t{6t{tJ{?d,!IA{,rd}O:ts6o6rE ogsrt.
3. dOSo cd,ce@rjg)o dlo1dlc66)6rB(6)lo @co6rc@l c6jcgoJlo (oJ o.icsl Sc (610) oc 6m-. cruo6nic\D'l4lgg onoig "Ooo)61ello @cDoGto) (r)aoEa,c(rjlo$F,lcd, (srd(o)(d)l cDo(,(oilcorcoet, a(m)6"16E'(]ol(r)jo' (6rooR .O.fl; L"tmirocoi ca6,6rrc o)c6rii. a91

mrolorcea'o1ero ft oddl llolco6rE.og6nj.

rruor5o-rcoio]oo i.mgaloE oo"1 o,rciro)co)J loaoRgloE cr$"l.s doero)lcooc crg(oilolc6o6rB(')c5rii.

f-

AII{EXURE- tl A DE?AILS OF OVAFLEASSEIS (Assets joiit nane Indicating extentofjoint ovfietshipwill alsohavoto be given) tle In S. No. DScridion
5n

, ' ''.:

Spou.e(s) Depndent- Dependent- Dependent Name(s) 1 Name 2 Name 3 itc- Name

(t

Cash

25000,0t) TOTAL (iD Depa6iB Banks, in Financial h8lihriions Non-Benking and Finano:al Companics (a) Federal BankLtd., E.nakulam Wttla Brandr (S.8. No.l410t)100023375) 15n8.26 F/o (b) Fderal BenkLld,, Nar{hencode Baandl frivandrum '12760.90 (6.8,A./c No.13170100058680) (c) sbte Ea[k of lndie Vytlila Branch (S.8.A./cNo.2005t69828) 29708.50 (d) Fderel BankLtd., Piravam Branch (S.8. No.10600'100190426) 20000. 00 A"/c (e) Fedcral BankLtd., Branch Piravom 15000. (S.8. No.,|0600100189260) 00 A/q (0 Slategankof Travancote Nandencode tsranch Trivandrum 120979.00 (S.B.A/G N0.67022954455) (l) StateBankofTaavancoe Piravam Branch 15083.00 tS-8.A./c No.67080793122) TOTAL Ttl1f.fi

35000.00 350q'.00

15t062.00

AM.B,AJ,b,,, RG GEO iKiJ f TY AERAH NOTARY & AD/OCA']'E MUVATTUPUZHA

@
(tiD Bonds, Deber{ures in andShales Other fimncial instruments, NSS;
P$ial Savinge, LIC etc. Polioies, (a) Bida ln8urance Sunfie Premium (b) LICPolicy 14 No.774467'l (c) Llc Policy No.784953139 (d) LICPoliq No.78,4953140 (e) LICPolicy No.775184446 (t LICPolicyNo.778E67067 Savings ) Postal (h) LICPolicvNo.782986467 TOTAL

(iv)

107441.4 184512.00 184257.OO 1U257,00 201480.00

10420.00
12600.00

,r.rlr.oo
a5,/.22-61 5063:t7.0{)t0*t20.00

(v)

MotorVehicles (details make, of etc.) 2007model Maruthi S,rrift Reo.No.KL 39A333 TOTAL

520000.00

5200u).00

(give (vD Jewellery detailsot weight value) and 8 gmsgoldring 800gmsof goldjewellery al obtained the timeof mafiiaoe oiftfromDarcnls TOTAL

2't000.00

2100000.0c

21000.00 2t0d)00.tx)

(viD Otherassets, sucha9

values claims/interestg of TOTAL TOTAL GRAT{D

9t8,!70,29 3302309.00

t4 +.e^
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t^ t-{ \\

ANOOPJACOB

aA - A.Lh B. HM !ffia/a l'3^"^NOTART "B' ADVOCAIE &

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ANNEXURE I
TO BY AFFIDAVIT BE FURNISHED CANDIDATE ALONGWITH NOMINATION PAPER Beforethe Returning Officer

ror erecrion to.K.3.t.-,-e.l.r.*.:S.*n.f*e.fifiIlJTr t" Ho,""y

I

rrom ...$..8.S.....(.!.8.4\!,S.|n............. constituency

( Nameofthe Constituency )

({::F).."r ,,....s..*psR.,.$.hftr.b.............,,,.........,.....,sonr0asy'nter/wi(e..I.l:..Te.9g.
......................aged...*9-........years, of resident .....1..F1*r,.ry.1.kr?.$.si*. ...9L!.6!!v!Le!n .,!s.,',e:i/*.e[t0.Lq!Ililt candidate ti]e aboveeleotion, do at hereby solemnly affirmand stateon oath as underi

(Stike out whichevet appilicable) not

pendingagainstme in which cognizance been taken by lhe The following case(s)is/are. has courti (i) (I) (iiD (iv) (v) Section ofthe Act and description oJtheoffence forwhich cognizance taken: I ne uoun wntcnnas laKen cognrzance : CaseNo.: Dateof orderofthe Courttakingcognizance : Details ofappeal(s) for /application(s) revision, etc.,if any,filedagainsf aboveordei takingcognizance :

That I give hereinbelawthe detailsof the assels(immovable, movable, bankbalance, etc.)of spouse, dependents myself: my and

e9
' ail, /'" Rl*f Eo : G RGKJr rY -A.E *l;^-'t

^"iii^1'''u rlo.lou i{,6:"';: tutat

298

A.

DETATLS MOVABLE OF ASSETS

(Assets jointnameindicatjnglhe in extent ofjointownership atsohaveto be grven) wrll s. Description Self Spouse(s) Dependent- Dependent- Dependen! N0, Name(s) l Name 2 Name 3 etc. Name

{i) (iD

3506o -60 &fo oo- ^ Deposits Banks, in Financial Institutions tzt+tland Non-Banking Financial Companies (.9*,r Sl
A^ir\!+Eti

l5to6!-0, ) 6-r0.rA

(iii) Bonds, Debentures

andSliares in companies
(iv) Otherflnancial instruments, NSS, PostalSavings,LIC Policies, etc. (vJ MotorVehicles

zdJ

<*

g6+cee-l,
r ril /tz O lljl o

Ti cr.r) (

5ot 3))-60 Ia4 4a-^ o crqr,{Ad A

5Ioo"o-o'

(details make, of etc.)

(vi) Jewellery (give details ofweight and Rlono-^ value) ( .ulr,.,.1 b(vii) Otherassets,such as valuesof ilaims / interests

cm$i

rRtxR^.,
2?

*""':::""::,r,",:::

't oGaL

?F?qa:-X,

"m tn" *.tr.#r'i"t varuJin Exchanse stocx in respect ljstedi::1.""_i?::"11";"Jp"lin the of companies.and per books as caseof non,n,;; ;";;;,* gven. ";ilir"J;

'Dependent herc rheans perconsubsiantialy a dependents the incomeofthe candidate. an

,n

3'l'!:. '.t !' GE}RG:K

;il:-a1"- r!',lfot L. MtJt/ "ZHA'

A.t;,?,1;1"e'&
299

B. DETAILS IMMOVABLTASSETS OF tn indicating extentof joint ownership also haveto be lhe will lNote : Properties joint ownership

s.
No.

Descaiption

Self

Spouse(s) Dependent- Dependent-Dependeni2 Name 3 etc. Name l',lame(s) I Name

(D

(ii)

Agricultural Land -Survey Location(s) +4 62stc, :Extent (Total numbe(s) -Curent 56 rycc6,l lj1easurement) c $1 marketvalue ..Ll Non-Agricultul Land-Survey Location(s) -Extent (Total humbe(s) measurement)'Current X4gooro4 sot rou. r' d'*n 4 markeivdlue

(iij)

Buildings (commercial arid -Location(s) . residgntial) Survey/doornumber(s) (Totalmeasurement) Extent -Current market value'

(iv) HcusesApahments, / etc. -Survey door Location(s) / -Ertent (Toial numbe(s) -Curgnt rneasurcment)
marketvaluediJqlf, .l gz/rg

Z\

.i.i'jil:{?
a(lso,

(v)

Oihers(suchas idterestin property)

.7dt PL

t\?67'1560 -

rgx_o.606{-

I givehereia belowthe detailsof my liabilties/ overdue publicflnancial o4s to institut and -. Government dues: details eachitem] lor lNote:Pleasegive separate

S.tio.

Description

Name.& addressof.Bank / lnstitution(s) / Financial Department(s)

Amount outstanding as on .*?f.c.fl'ola-

(a)

(i)

Loans:from Banks

(ii) Loansffom financialinstituiions

al
o)

Duesto departments dealing with government accommodation

Dues to.departments dealing with supply water of

N u_-

,c:A). _.,.,
. l\t !l

*"." ,) r*.r'F4 .r'__

300

c) o) e)

Duesto departments dealing with supply electriciiy oi

Dues io depa.tmentsdealing lvith te;ephones

DLres departments to dealing \/ith government transport (jncluding aircrafts andhelicopters) Other dues, any if Description Name& address Bank/ of Financial Instituticn(s) / Department(s)
(v 'r-

f)

S.Nc.

Amount oulstanding

ason.*.1.].Al&.ra,

income including Iax surcharge indicate assessment the lAlso Tax Yearupic which'ncorne Refurn fiied.Givealso Permanent AccountNunberiPAN)l (ii) Vy'eaith lAisoin.jicate Tax the yearuptowhich assessment \ryeafth reiurntile.l.l Tax (iii) SalesTax ionly in .3se of pruprelarybirsinessl
(i) (tv l--inFieny Tzx

,\krJ r ()-ii.ruJadr\A _q? + ttr arsr..ytu ;i.,Gi t /A;,i - 4df i r'2 q64 .}e&6! f aY cvo u en[r

l..t cor(i<v r...(-".:4 rt",t k*{^ r-o.*<i a- dhov

.V L.-

*.Lr
\Rc-

. caA* c,."-l!
h4/ bqalf

a'.t

'aPPAcah-0e
N t(-

N u-.
r.Jl'\-

(4)

My ec,J1:atiirnll qualificalicns as undgr are rGlt DFIAiLSOFSCTAOLAtiD UNtVE?"StTy EDUCATIAN) (Na.neof SchDol Unive$ityand the year in !,Jhich coursewas compleied / the shcLrld also bo

given.J

cLt'sr

"tM *,)'"r - k'*a:,t '5-?5 -)-,11 Yl li5.:*-:r

c . r < ; < rs e J ^ o a-(

\C13

^\D

lcer

ka< sa

1..;;6L*G!:fu--

L;- rS.

[*

t o-apottsrut

\,/ERIFiCATICN i, the deDonent abo./ensmed,do herebyvgrily and dec]are tnat the contents this atidavit aie tftto of and coarect the best of my knowledge belief;nc partof it is falseanCnothingmaterial io and has becn concealed therefrom.

verified .lD.eevel!:,tr}Lr thisthe ......R)-.......... or .k hr*.*y:, 20q.A at aay

'y7

rril
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