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<h1
5
FORM2B
(See
rule 4)
NOMINATION PAPER
Election
to the Legislative
Assembly
of Maharashtra
State
(Strike off Part I or Part II below whichever is not applicable)
PART-I
(To be used by candidate set up by recognised political party)
I nominate as a candidate for election to the Legislative Assembly from the
Assembly Constituency.
.
Candidate's
.
Name:
Father's /Mother's/Husband's
His postal address
Name:
.
:
.
His name is entered at Sr.No
:
in Part No
of the electoral roll for the
.
Assembly Constituency.
My name is
and it is entered
in Part No
at S. No
.
of the electoral rolls for the
.
Assembly Constituency.
Date
.
(Signature
of proposer)
PART-II
(To be used by candidate NOT set up by recognised political party)
We hereby nominate as candidatefor
............................................
election to the Legislative Assembly from the
Father's
.
Assembly Constituency.
.
Candidate's
.
.
N ame :
.
/Mother's/Husband's
Name :
:
:
His postal address:
His name is entered
.
,';: '
at Sr.No
:
.
.in Part No
of the elector.al roll for the
.
Assembly Constituency.
.
.
We declare that we are electors of this Assembly Constituency and our names are entered in the electoral
roll for this Assembly Constituency as indicated below and we append our signatures below in token of subscribing to this nomination :-
6
Particulars
Sr.No.
of the proposers and their signatures
-
Electoral Roll No.ofproposer
Part No.of
Electoral Roll of
Constituency
S.No.in
that part
(2)
(1)
Full Name
Signature
(5)
(3)
(4)
ten electors of the constituency
as proposers.
Date
(6)
1
2
3
4
5
6
7
8
9
10
N.B.-There
shouldbs
PART III
I, the candidate mentioned in Part I /Part II (strike out which is not applicable) assent to this nomination, and hereby declare(a)
That I have completed
:
years of age;
[ STRIKE OUT b (i) OR b(ii) BELOW WHICHEVER IS NOT APPLICABLE]
(b)
(i)
(b)
(ii)
that I am set up at this election by the
party, which is recognised
National Party /State Party in this State and that the symbol reserved for the above party
be allotted to me.
that"! am set up at this election by the
party,which is .
a registered unrecognised political party/that I am contesting this election as an independent
candidate.rfltrike out which is not applicable) and that the symbols I have chosen, in order of
preference are- .
(i)
(c)
that my name
above in
(ii)......
and my father's
tiii)
. . . . .. . .. . . . . . . . .. . . . . .. . .. . .. ..
.
/mother's/husba~d's
name have been correctly
:
(name of the language) ;
spelt out
Cd) that to the best of my. knowledge and belief, I am qualified and not also disqualified for being
chosen to fill the seat in the Legislative Assembly of this State.
£ I further declare that I am a member of the
scheduled ** caste/tribe of the State of
v- ••...•..•.
in that State.
** caste/tribe
, ••• , .,.
, ••.•••.
in relation to
which is
(area)
I also declare that I have not been, and shall not be, nominated as a candidate at the present general'
election
/the bye-elections
being held simultaneously,
to the
Legislative
Assembly
of.
;
(State) from more than two Assembly Constituencies
Date:
.
(Signature
of Candidate)
£ Strike out this paragraph, if not applicable.
words not applicable.
N.B. -A "recognised political party" means a political party recognised by the Election Commission under the Election
** Score out the
symbols (Reservations and Allotment)
Order, 1968 in the State concerned.
17
7
PART III-A
(To be filled by the candidate)
Whether the candidate Ci) has been convicted -
(ii)
(a)
of any offenceis) under sub-section (1) ; or
(b)
for contravention of any law specified in sub-section (2),
of section 8 of the Represen tation of the People Act, 1951
(43 of1951); or
I Yes/ No
has been convicted for any other offence(s) for which he has been sentenced
years or more
If the answer is ''Yes'', the candidate shall furnish the following information
(i)
(ii)
Case/First
information
(v)
:.
Police Station(s)
District(s)
:
.
'.
Section(s) of the concerned Act(s) and brief description of the offence(s) for which he has been
convicted
(iv)
"
Daters) of convictionts)
,'
.
-
.
Court(s) which convicted the candidate
:
........ ... .~
(vi)
for two
report No.lNos
State(s)
(iii)
to imprisonment
,'
Punishni.ent(s) imposed (indicate period ofimprisonment(s)
. .-
"
.',
~
.
.
',
and or quantum of
finets)
(vii)
(viii)
.
Date(s) of release from prison
Was/were any appeal(s)/revision(s)
:.:
file against above conviction(s)
(ix)
Date and particulars
of appeal(s)/application(s)
(x)
Name of the court(s) before which the appeal(s)/application(s)
Whether the said appeal(s)/application(s)
YesINo
for revision filed
.
for revision filed
.
.
................................................................................................................................................
(xi)
.
.
.
for revision has / have been disposed of or is / are
pending
(xii)
.
If the said appeal(s)/application(s)
for revision haslhave been disposed of-
(a)
Date(s) of disposal
.
(b)
Nature
.
of order(s) passed
Place:
Date:
.
(Signature of Candidate)
PART IV
(To be filled by the Returning
Serial No. of nomination
paper
.
This nomination was delivered to me at my office at
by the *candidate/proposer.
Date:
* Score out the
Officer)
.
word not applicable.
(hour) on
Returning Officer
(date)
8
PART V
Decision
of Returning
Officer Accepting
or Rejecting
the Nomination
Paper
I have examined this nomination paper in accordance with section 36 of the Representation
Act,1951 and decide as follows :-
Date:
.
Returning
of the People
Officer.
PART VI
Receipt
for Nomination
Paper
and Notice of Scrutiny
( To be handed over to the person presenting
Serial No. of nomination paper
The nomination
Date:
a candidate
for election from
Assembly Constituency was delivered
to me at my office
(date) by the* candidate/ proposer. All nomination
(hour) on
papers will be taken up for scrutiny
paper)
.
paper of
the
at
at
the nomination
at
(hour) on
(date)
(place).
:
.
*Score out the word not applicable.
Returning
Officer.
,"UleO a f1egrsrerell
9
at Serial No- 2f.!..~14
"
.
'"
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KC 459954
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- ••/Annexure I
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Page 18
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4.
The specimen signatures of the above mentioned person(s) so authorised are given
below:
1. Specimen Signatures of Shri
(i)
I{--,--, _11_S_I-I_o_K.. __ J)_H-,---,A_4!-=---.o.../J,-l._E. __
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~-----------(ii)
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3. Specimen signat
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(i)
(iii)
Place:
Date:
_J)_'
_
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-----------T------
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lYE W JJ!i L H L
OJ-0'f~
20ft,
N.B.
1. This must be delivered to the Returning Officer and the Chief Electoral Officer not
later than 3 p.m. on the last date for making nominations.
2. Form must be signed in ink by the office bearer(s) mentioned above. No facsimile
signature or signature by means of rubber stamp, etc., of any office bearer shall be
accepted.
3. " No form transmitted by fax shall be accepted.
J
"Inserted by Notification No. 56i97/Judl-III, dated 15.12.1997
~~=======-~=====--
IForm 'A'
Communication With Regard to Authorised Persons To Intimate
Names of Candidates Set Up By Recognised NATIONAL OR STATE
Political Party or REGISTERED UNRECOGNISED Political Party
.
(See Para l3( c), (d) and (e) of the Election Symbols
(Reservation and Allotment) Order, 1968)
To,
1. The Chief Electoral Officer
l1ftJ.-l.Ir.~/f.~N.r!\A.
2. The Returning Officer for the
tj$ - .PI} .11:1. f:;;'
Stateltffiion T@rritoFy-
Constituency
V
Subject: General/Bye- Elections to /J> If A H 9A-/31f A
froml1lt H A ;ZI}J/(( gBtatelUniGa
-- Allotment of Symbols -- Authorisation of persons to intimate names of candidates
TerritO!)')
Sir,
In pursuance of paragraph 13 (c), (d) and (e) of the Election symbols (Reservation
and Allotment) Order, 1968, I hereby communicate that the following person(s) has/have
been authorised by the Party, which is a National party/state party in the state of
______
........;/fegisteredunrecogniscd to intimate the names of the candidates
. proposed to be set up by the Party at the elections cited above:
.Name
of
the
person
authorised to send notice
Name of the office held in
the Party
1
l. vf<.
2
A G If 0 k:
J;>JfA
WALE..
stlrf£.
S£c,I{£.,-rA-iZ /
District( s)/areas, Constituen
cy/Constituencies in respect
of which he has been
authorised
3
s rs re.
of
M /}H II i{1) Sf( -( e
I
I
I
I
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2.
!
!
..,
.>.
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,
lFORM
,
B'
NOTICE AS TO NAME' OF CANDIDATE SET UP'BY
THE POLITICAL,PARTY
. {See paragraphs 13(b], (c) and {e)-and 13A ofth~ Elect/on SymbOls .
{Reservatton·.and AlI6tf!lentiord~r
1968]"
..'
To
The Returning Offic;;er for the
Constituency
18 .p.~.T.1:f.f(X.
.'
Subject.
,
'.
General/Gye
Election to
!f.1.~1.(State/l:lAlon
V(~/.(A-Nf'rralfll
M !t:'1.~f..IJ:?:
C;8:"
.
.
. fltl.ffR..L.·
..,.
from
; .....•...
(Nome
~r:ritor-y) - setting up· of condlcote. '.
.
of> the Constituency)
In
'.
Sir.
In pursuanceof paragraphs .1~ (b). (c) and (81 and 13~~'r)3 Jtection-SyrnboIS(Reservation
Qrder. 1968, I hereby gIve notice on behalf of
,.,(:. .1
(party) '.
.
.
(i) .
~
'.
"
that the person whose portlculors ore turnlshed
condldcte
the'party above riqmeq , and
of
-. --- (ii)
.
theperson whoseporticulcrs
die mentioned id co.lumns:(~J.tO(7.) b910~ is;the. ~0bstitUte candidate
of the' party. whowilfstep-in
on th~'approveq
concldote'snorrmofior,
bein.9 rejeCted on scrutiny
or on his withdrawing from me contest Iftne.substrtUt~:candidate.is
stilf'-a c0ntesting··candiClate,
at the ensuing generaVbye election fromthlsco~titLien6y
:
'.
'.'
..
,
Name of the' .
Conslituency
. .
Name.of the
,,'
Fathers,'
approved
' M9ther'S/
Candidate
Husband's
Narne df
.approved
candidate.
..
..
..
1
se. f1l1HK. r
..
"
Father's/.
Name of the substitute
.Mbthefsi
candidate who will
addressof
.. approved
. step~inon the '
H.~sband's
.apprb¥eq'Ca~Qjqate's.
Name of
candidate•.
nomination being: . . Substitute
'rej~ted·.oli scrutiny. . . candidate
.,.
. or on hls'withdrav.qng
from ihe contest if .
;
substltute candidate is' i
still a contesting Candidate
. Postal
.
..
Postal
of
Address
substitute
Candidate
;
2
.4
3
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(2) to. (.:1) below
In columns
and A110.tment)
'.
.
is the approved
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.
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Inserted by NotificatIon No. 56/97/JUdl-/~/,dated 15.12.'1997
13
!
*2.
The notcert
rm 'B' given earlier in favour O·f3J:lfl/smt.!Sushri
a
. ?ppr
ca~didCite/Shri/smt./ Sushri .. 7~"""""
_ hereby. rescinded.
.
... ,..----
a~ubsiitute
.
.
It is certified that eaph of. the condldotes whose nome Is rnentloned
pOlitical party orid his nome Is duly borne on ·the· rolls of members
.
Place
Date
fI1 u H /3.4.r.
:
.
,.,
a~ve
party's'
candidate
.
I~ a member
of this.
of this pariy .:
.
cl.~
..:..q.1...-:.. {t;,(.q
•.Score off. If notOf?P!!COble.
~s
·
.
•
'.
N~B.
1.
This rnustbe del~ered
nominations.'
2.
Forrn ~uS.fbe slgn8d ·In.lnk by the
signotl,1re\b~ine9ns
. .
.
form
.
to· the. Refuming Officer riot later than
.
last date for making
.
.
6ffice bearer-(sj hie~ff6ned -obove, "N~' f~CSJril:iI~signature or
.of 'rubber stqm'p; e'tc.:
"
..
:.",
'Of ahv
bffl99
.
.
3.
No
4.
Para 2 of the F~rm must be scored off; If not applicable,
transmitted
;3 p.m.ohthe
by fax shall be accepted
beorer shqll be 'cccepted. .
.
.
.:
I
or must be properly filled. if applicable.
. i
14
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