PLEASE FILL UP THE ATTACHED FORM AND HAND OVER TO THE NEAREST OFFICE OF THE ELECTION COMMISSION
Application Form for Contesting Indian Elections
- Name of Candidate : _______________________
- Present Address
(i) Name of Jail : _______________________
(ii) Cell Number : _______________________
(If not in Jail, please attach proof of residence)
- Political Party : _______________________ (List ONLY the Last Five parties in Chronological Order)
- Sex [ ]A – Male
[ ]B – Female
[ ]C – Mayawathi
[ ]D – Jayalalitha
- Nationality [ ]A – Italian
[ ]B – Indian
- Reasons for leaving last party (please tick one or more)
[ ]A – Defected
[ ]B – Expelled
[ ]C – Bought out
[ ]D – None of above
[ ]E – All of above
- Reasons for contesting elections (circle one or more)
A – To make money
B – To escape court trial
C – To grossly misuse power
D – To serve the public*
E – I have no clue
*(if you choose ‘D’ please attach Certificate of Sanity from a recognised
- How many years of public service experience do you possess ?
[ ]A – less than a year
[ ]B – none
[ ]C – are you joking?
[ ]D – what is this ‘public’?
[ ]E – I am not not servant of public, I am their ‘neta’…what you mean?
- Give details of any criminal cases pending against you
(Use as many additional sheets as you want)
- How many years have you spent in Jail ?
(Do not confuse with question 8)
[ ] A – 1-2 years
[ ] B – 2-6 years
[ ] C – 6-15years
[ ] D – 15+ years
- Are you involved in any financial scams ?
[ ] A – Why not (please explain separately)
[ ] B – Of Course
[ ] C – Definitely
[ ] D – I deny it all
[ ] E – see a foreign hand.
- What is your Annual Corruption Income ?
[ ] A – 100-500 Crores
[ ] B – 500-1000 Crores
[ ] C – Overflow…
(Convert all your $ earnings from Hawala etc to Rupees)
- Do you have any developmental plans for the country in mind?
[ ] A – No
[ ] B – No
[ ] C – No
[ ] D – No
- Describe in space provided, all your achievements: ____
Thank you for taking the time to fill this up…we will revert to you.
Thumb Impression of Candidate
(Not that of the person who
filled the form)