FORM 2A
oO (See rule 4) =
y age NOMINATION PAPER i
Election to the House of the People
ely RIKE OFF PART-I OR PART-II BELOW WHICHEVER IS NOT APPLICABLE
ont PART-1
Py (To be used by candidate set up by recognised political party)
[nominate
AGE
Candidate for election to the House of the People from the ...>!=. IAMOND.. HARZOVR
v». Parliamentary Constituency.
Candidate Name : AGHISHEK_ BAAERTEE
Father’s/ Mothers/Musband's Name AMIT RANERTEE
His Postal Address: ; 308, HARISH Ch omaLeRTEE STREET,
KELKATA - 700026
365 in Part No.
Assembly Constituency comprised within) 22:
.of the electoral roll for
i name is entre at 81 No
Nola TA DAEHN)
199: Maga nuieur (Ge
Parliamentary Constituency.
My name is
in PartNo ofthe letra rol fr!
“Si-biawony os
stituency comprised withiy lin cd i ene
Moyo. feller
pate: 24.04. 20/9 Signature of Proposer
PART
(To be used by candidate NOT set up by recognised political party)
candidate for election to the House of the People fromthe...
~arliamentary Constituency.
We hereby nominat
Candidate's Name
Father’s/ Mother's/Husband’s Name
His Postal Address
of the electoral roll for
vin Part No. ..
}(Assembly Constituency comprised within)
His name is entered at SI. No.
liamentary Constituency.
We declare that we are electors of the above Parliamentary Constituency and our names are entered in
the electoral roll for that Parliamentary Constituency as indicated below and we append our signatures below in
token of subscribing to this nomination. Particulars of the proposers and their signatures
St] Name of component eet pullname Signature Date
No. | Assembly Constituency | Part No. of | SLNo. in m
electoral Roll | that part :
1 2 3 4 5
1
2
3
a
9
10
N.B. : There should be ten electors of the Constituency as proposers.
PART - Il
|, the candidate mentioned in Part-l/ Barf“ (Strike out which is not applicable) assent to this nomination and
hereby declare:
a) | am a citizen of India and have not acquired the citizenship of any foreign State / Country.
b) that | have completed nnn... years of age.
[STRIKE OUT c(i) OR c() BELOW WHICHEVER IS NOT APPLICABLE
€) i) That | am set up at this election by the ALL. INDIA “TRInaryont. ON GRE ST ich is recognised National
Party/State Party in this. State and that the symbol reserved for the above party be allotted to me. OR
¢) (i that | am set up at this election by th Ese party, which is a registered - unrecognised
political party that | am contesting this election as-aff independent candidate. (Strike out which is not applicable)
4) that my name a
FAGLICH..... (name of the
@) that to the best of my knowledge and belief, | am qualified and not also disqualified for being chosen to fill
the seat in the House of the Peopl
‘further declare that | am a member of th
caste [tribe ofthe State of
Jaleo deciare that! have not!
the bye-elections being
Constituencies.
pate 2A 04 7.014 tcl Roo)
‘Score out the words “assembly constitiency comprised within" In the case of Jammu and Kashmir, Andaman and Nicobar
Islands, Chandigarh, Dadra and Nagar Havell, Daman & Diu and Lakshadweep.
Score out this paragraph, if not applicable
= Score out the words not applicable.
Nl: A”recognised political party" means a political party recognised by the Election Commission under the Election Symbols,
(Reservation and Allotment) Order, 1968 in the State Concerned
"hd shall not be nominated as a candidate at the present general election’
fmultaneously, to the House of the People from more than two Parliamentary (To be filled by the Candicatey
(1) Whether the candidate- as
i) has been convicted -
* a) of any offence(s) under sub-section (1);0r
'b) for contravention of any law specified in sub-section (2), of section 8 of the Representation
of the People Act, 1951 (43 of 1951); or
li) has been convicted for any other offence(s) for which he has been sentenced to imprisonment
for two years or more.
“Yes, the candidate shall furniah the following information :
i) Case/First information report No./Nos.
) Police station(s)
{il Sections) of the concerned Act(s) and brief description of the oes chin heibuei comes
af
iv) Date(s) of conviction(s) IS
+) Court(s) which convicted the candidate.
vi) Punishment(s) imposed [indicate period of imprisonment(s) and /or quantam of fine(s)}...
vil) Date(s) of release from prison, NA
vill) Wasiwere any appeal(s)irevision(s) filed agair
|x) Date and particulars of appeal(s) / application(s) for revisi
sbove conviction(s)
filed
x) Name of the court(s) before which the appeal(s)/applications for revision filed
xi) Whether the said appeal(s)/application(s) for rovision has/have been disposed of or is/are pending
xii) Ifthe sald appeal(s)/application(s) for revision has/have been disposed of -
a) Date(s) of disposal... ANA. b) Nature of order(s) passed...
(2) Whether the candidate is holding any office of profit under the Government of india or State Government?.
It Yes, details of the office held.
(3) Whether the candidate has been declarod insolvent by any Court.
IF Yes, has he boon discharged from insolvency.
(4) Whether the candidate is under allegiance or adherence to any foreign country?...
IFYes, give details... e
(5) Whether the candidate has been disqualified under section 8A of the said Act by an order of the President?..
(¥e2INo) IF Yes, the period for which disqualified.........MA....
(6) Whether the candidate was dismissed for corruption or for disloyalty while holding office under the Government of
India or the Government of any State?.........¥es/No) -If Yes, the date of such dismissal...... NA.
(7) Whether the candidate has any subsisting contract(s) with the Government either in individual capacity or by trust or
partnership in which the candidate has a share for supply of any goods to that Government or for execution of works
Undertaken by that Government?. (¥es/No) «If ¥es, with wi
ccontract(s). NA.
(8) Whether the candidate is a managing agent, or manager or Say ofa Sena. Compton (other ase
h Government and details of subsisting
cooperative society) in the capital of which the Central Government or Stato Government has not less than twenty-five
percent share? {esino) -If Yes, with which Government and the details thereof .. NA.
(9} Whether the candidate has been disqualified by the Commission under section 10A of the said Act..
NA...
No) -Ityes, the date of disqualification.
Place: KOLKATA,
ome: D4, 04.2014 vind aac} | PART ~ IV
(To be filled by the Returning Officer)
pio|t?/2014] 20
Sorial No. of Nomination Paper
This nomination was delivered to me at my office at ...2°3\ 0M
SAJA LIS.
-. (hour) on
(date) by the * candida
| proposer {Name of Proposer
Dat
— a
*Score out the word not applicable.
PART=V !
Decision of Returning Officer Accepting or Rejecting the Nomination Paper
'have examined this Nomination Paper in accordance with Section 36 of the Representation of the
People Act, 1951 (43 of 1981) and decide as follows :
Date: Returning Officer Te ater BENGAL
FORM 26
(See rule 44)
AFFIDAVIT
AFFIDAVIT TO. BE FILED BY THE CANDIDATE ALONGWITH
NOMINATION PAPER BEFORE THE RETURNING OFFICER FOR ELECTION TO.
HOUSE OF THE PEOPLE (NAME OF THE HOUSE) FROM 21- DIAMOND
HARBOUR (GENERAL) PARLIAMENTARY CONSTITUENCY
(NAME OF THE CONSTITUENCY) WEST BENGAL
ae Amit Banerjee Aged 31 years,
it, Kolkata-700026 (mention full postal
ne by solemnly affirm and state on oath as (1) Tam a candidate set up by ALL INDIA TRINAMOOL CON
(**name of the political party)/ *
(**sttike out whichever is not applicable)
(2) My name is enrolled in 159-BHABANIPUR (GENERAL) ASSEMBLY
CONSTITUENCY and State West Bengal (Name of the Constituency and
the State), at Serial No. 365 in Part No.209
(3) My contact telephone number(s) is/are 98305-10000 and my
e-mail-id (if any) is abhishekbanerjee.mp@email.com and my social media account(s)
(ifany) is/are
(i
i) AbhishekBanerjeeOfficial (FACE BOOK. AIC)
(i) abhishekaite (TWITTER A/C).
Gil) abhishekaite (INSTAGRAM A/C)
poser Self-Abhishek
Banerjee
Spouse - Rujira
Banerjee
HUF (If Candidate is
Karta/Coparcener
Dependent 1
The financial year
for which the last
Income-tax return
(17-18)
Total income shown in
Income-tax return (in Rupees)
for the last five Financial
Years completed (as on 31st
March)
RS. 7503130.00
(16-17)
IRS. $778690.00
(15-16)
IRS. 3897530.00
(14-15)
RS. 3708850.00
‘ASFPB7624)
(13-14)
IRS. 3688000.00
(17-18)
IRS. 15161150.00
(16-17)
RS. 9049200.00
(15-16)
ji) (14-15)
RS. 6568830.00
IRS. 5198440.00
AJNPN2286R
(13-14)
RS. 4634320.00
N/A
N/A
N/A
N/A
N/A
N/A
N/A
WA
N/A
N/A
Dependent 2
Dependent 3
ee
: It is mandatory for PAN holder to mention PAN and in Case of no PAN.
It should be clearly stated “No PAN allotted”
2.3 APR 7019
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
at Ref (5) Pending criminal cases
V (i) I declare that there is no pending criminal case against me. (Tick this alter
if there is no criminal case pending against the Candidate and write NOT
APPLICABLE against alternative (ii) below)
OR
(ii) The following criminal cases are pending me:
If there are pending ct
and score off alternativ Wve, and give details of all pending cases in the Table below)
FIR No. with name and address
lof Police Station concerned
N/A
N/A
Whether charges
been framed (mention
YES or NO)
lif answer against (e)
above is YES, then give
the date on which charges
lwere framed
Whether any
|Appeal/Application for revision
WS. © (@)eases ofconviction 9.3: APR pe |
ga Pos. (S)/ Sif
‘s
Tee CAI | dectare that | have not been convicted for any criminal offence. (Tick this
~ alternative, if the candidate has not been convicted and write NOT APPLICABLE
against alternative {ii) below)
fa-/ : 5
Bor AL) :
ii) (if the candidate has been convicted, then tick this alternative and scot
alternative (i) above, and give details in the Table below )
Table
Case No
Name of the Court
Section(s) of Acts/Codes
involved
(give no. of the Section, e.g. N/A N/A
isectio IPC, etc).
Brief description of
loffence for which convicted
Orders of
N/A
Punishment imposed a
Whether any Appeal has
been filed against the. “ Wa
No
If answer to (g) above is YES, give|
|details and present status of sh
lappeal
(6A) _ have given full and up-to-date 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).
[candidates to whom this Item is not applicable should clearly write NOT APPLICABLE
IN VIEW OF ENTRIES IN 5(i) and6 (i), above]
Note:
1. Details should be entered clearly and legibly in BOLD letters
2. Details,
be given separately for each case under different columns against each item.
should be given in reverse chronological order, i.e., the latest case to be
\dditional sheet may be added if required
‘Candidate is responsible for supplying all information in compliance of Hon'ble
ipreme Court's judgment in W.P(C) No.536 of 2011. (7) That | give here in below the details of the assets (movable and immovable etc,
myself, my spouse and all dependents:
A. Details of movable asset:
Note: 1. Assets in joint name indicating the extent of joint ownership will also have to be given
Note: 2. In case of deposit/Investment, the details including Serial Number, Amount, date
of deposit, the scheme, Name of Bank/Institution and Branch are to be given
Note:3.Value of Bonds/Share Debentures as per current market value in Stock exchange. =
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