Application Form For Lok Sabha Election 1. Name of Candidate: ___________ 2.Present Address: (i.)Name of Jail: ____________ _________ (ii.)Cell Number: ____________ _________ 3.Political Party: ____________ _________ *List ONLY the Last Five parties in Chronological (Order) 4.Nationality: [ ] A- Italian B- Indian 5.Reasons for leaving last party (circle one or more) A- Defected B- Expelled C- Bought out D- None of above E- All of above 6.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, attach Certificate of Sanity from a Recognized Government Psychiatrist) 7.How many years of public service experience do you possess? A- 1-2 yrs B- 2-6yrs C- 6-15yrs D- 15+yrs 8.Give details of any criminal cases pending against you (Use as many Additional Sheets as you want) 9.How many years have you spent in Jail? [ ] (Do not confuse with question 8) A- 1-2 years B- 2-6 years C- 6-15 years D- 15+years 10.Are you involved in any financial scams? [ ] A- Why not B- Of Course C- Definitely D- I deny it all E- I see a foreign hand. 11. What is your Annual Corruption Income? [ ] A- 100-500 Crores B- 500-1000 Crores C- Overflow… (Convert all your $ earning from Hawala etc to Rupees) 12. Do you have any developmental plans for India in mind? [ ] A- No B- No C- No D- No 13.Describe your achievements in space provided: [_________] Issued in public interest by Election Commission of India.
Posted on: Sun, 16 Mar 2014 04:25:25 +0000
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