Beforf the District Election officer Ambala (Haryana) (District, State /Union Territory)

Affidavit of Presently at _ I . . .

I, .Varun Chaudhary Son of Sh. Phool Chand Aged 3Y. years R/o H.No.936-A Sector-7 Ambfa City Haryana do hereby solemnly and sincerely state and declare as under:-

. (~ That I was a contesting candidate at the ge~eral election to ~he Lok Sabha Election - ,. 2014 of Haryana from 01-Am9ala(SC) Parliamentary Constituency, the result of ' which was declared on 16-5-2014. .

(2) That I Kept a separate and correct account of all expenditure incurred/authorized I by me/my election agent in connection with the above election 15-03-2014to16-

05-2014 (the date on which I was nominated) and the date of declaration of the C result thereof ,both days inclusive.

(3) That the said account was maintained in the Register furnished by the Returning ,,,. ~ office for the purpose and the said Register itself is a~nexed hereto with the

~~ J:1.'' supporting vouchers/bills mentioned in the said account. ./ • ~/ ~d 1:: ~A~hat the account of my election expenditure as annexed hereto includes all items of

o~a1e * . :tr ~& . a · 1 election expenditure incurred or authorized by me or by my election agent, the \~') A ~,: 1, }0itical:part~ V.:hich spo~sored me, o~her associations/body of p~rsons and

_')t.-;~~~nect10n with the election and nothmg has been concealed of with , -~.~~ 8. held/suppressed there frolll: (other than the expense on travel of Leaders' Co

Affidavit 33AA 402408

I ~R~1011 HARYANA

a

. ·vv_..,. ~rf.;;:=i .. :. -: .• ~.,;~ .. ·:! c..!!'.)!i·: n~.~.; .. , ·he [}E:~:~..: ;·1c:1(..· t:.~et:: .. c .. fi- ;r c! :•:·· i:t~. ;19 rt~ . .:.!· "11~;. (~cnt~rns or above afe ·rru:;:-: .... >

(Signature and seal of the Attesting authority). / Deponent----'&.-:'----

Solemnly affirmed /Sworn on this day of _, Before me,

(5) by Explanation 1 and 2 under section 77(1) of the Representation of the people Act,1951).

(6) That the Abstra~t statements of Election Expenses annexed as Annexure II to the said account also includes all expenditure incurred or authorized by me, my election agent the political party which sponsored me, other associations/body of persons and other individuals supporting me, in connection with the election.

(7) That the statements in the foregoing paragraphs(l) to (5) are true to the best of my knowledge and belief,that nothing is false and nothing ma~r~~ <%ice~/

Deponent ~v t:J

"c .

Manager

Unless constituent notifies the bank immediately of any discrepancy found by him in his statement of Account, it will be taken that he has found the account correct.

38,262.00 6,01,000.00 5,62,738.00Cr Cumulative Totals:

17,107.00 13-10-2014 NEfT:S0120 424203 21,155.00 424202 5,79,845.00C 11-10-2014 TO PUNJAB

6,00,000.00 6,01,000.00C 01-10-2014 BY BILL : 1,000.00 1,000.00C 27-09-2014 BY CASH

0 27-09-2014 B/f

BALANCE DATE PARTICULARS CHO.NO. WITHDRAWALS DEPOSITS STATEMENT Of ACCOUNT FOR THE PERIOD Of 27-09-2014 to 21-11-2014

AMBALA (AMBALA) HARYANA INDIA

936A SECTOR 7 URBAN ESTATE AMBALA CITY

TO: MR. VARUN CHAUDHARY SO PHOOL CHAND MULLANA

PIN CODE: 133002 A/C NO: 82792100000545 INR PAGE: l

DATE: 21-11-2014

AHBALA CAHTT. 505, PRABHU PREM PURAN KARDHAN ROAD AMBALA CANTT.

HARYANA GRAMIN BANK

;

PART-Il: ABSTRACT OF STATEMENT OF ELECTION EXPENDITURE OF CANDIDATE

Sr. Particulars Amt. Incurred/ Amt. Incurred/ Amt. Incurred/ Total No. Auth. by auth. by Pol. auth. by others Election

Candidate/ Party (in Rs.) (in Rs.) expenditure Election agent (3)+(4)+(5)

(in Rs.) I Expenses in public meeting,

rally, procession etc. :-

I. a : Expenses in public meeting, rally, procession etc. (ie : other than the ones with star Campaigners of the

Political party (Enclose as ~a53o -- - ~o5jo .... o)

per Schedule-I)

I. b : Expenditure in public meeting rally, procession etc. with the Star Campaigner(s)

(ie: other than those for general party propaganda) 5( b)J?V ,..__ - YlbS>~ (Enclose as per Schedule-2)

~:of the Candidate

Name Date: Place:

ABSTRACT STATEMENT OF ELECTION EXPENSES , ... PART-I I Name of the Candidate Sh./Smt./Km. Vo... '"YU'V'\ GlA.o.il~YW· lI Number and name of Constituency tJ - b - fYl L.Ul.A.~ - m Name of State/Union Territory f-{O\Y~'Y\D IV Nature of Election (Please mention whether v

General Election to State Assembly I Lok Sabha I By- election l-.-l0t~)4-0\~ ~'1l_LlL~

v Date of declaration of result v ' ....-\ 0 ~) '1 VI Name and Address of the Election Agent

VII lf candidate is set up by a political party, Please t 'l'\Clf Q VI l}J..~:Ho'Vl~ ~~ t5 mention the name of the political party

- VIII Whether the party is a recognised political party Yes/No 'YcC0,

II Campaign materials other ~

than those used in the public

meeting, rally, procession

etc. mentioned in S. No. I

above (Enclose as per ~ l 0 g- ;l_ -:2- %1~ b'a=- t> - - Schedule-3)

m Campaign, through print and

electronic media including

cable network, bulk SMS or

internet and Social media

(Enclose as per Schedule-4) - __. - (>...(1L

rv Expenditure on campaign

vehicles(s), used by

candidate (Enclose as per '35CJ65S - 35lf sss-. ---

schedule-5)

v Expenses of campaign

workers/agents (Enclose as

per Schedule-6) - - ...__ o--11 L

Vl Any other campaign

expenditure ~...,, - - - Grand Total

513 ~~~~~ v

PART Ill: ABSTRACT OF SOURCE OF FUNDS RAISED BY CANDIDATE

Sr. Particulars Amount (in Rs.) No. I Amount of own fund used for the election campaign

(; 6_LO C!J o (Enclose as per Schedule -7)

Il Lump sum amount received from the party (ies) in cash or cheque

etc. - (Enclose as per Schedule-8)

Ill Lump sum amount received from any

person/company/firm/associations/body of persons etc. as loan, .._

gift or donation etc.

(Enclose as per Schedule-9) '\

Total - ~ t,o to~ .. v

Schedule- 1

Expenses in public meeting, rally, procession etc. (ie: other than those with Star Campaigners of the Political party)

s. Nature of Expenditure Total Amount Source of Expenditure No in Rs.

Amt. incurred I Amt. incurred Amt. Auth. by incurred I by others Candidate I by Pol. agent Party with

name 1 2 3 4 5 6 1 Vehicles for transporting visitors lte-DOit::-CJ 2 Erecting Stage, Panda! & Furniture, Fixtures,

poles etc. ..----

3 Arches & Barricades etc. - 4 Flowers/ garlands - 5 Hiring Loud speakers, Microphone, amplifiers, I _)oo - comparers etc.

6 Posters, hand bills, pamphlets, Banners, Cut-

/~b3" - outs, hoardings

7 Beverages like tea, Water, cold drink, juice etc. ~C( o o - 8 Digital TV -boards display, Projector display,

tickers boards, 30 display - 9 Expenses on celebrities, payment to musicians,

r---- other artists remuneration etc.

10 Illumination items like serial lights, boards etc. ·- 11 Expenses on transport, Helicopter/ aircraft/

vehicles/ boats etc. charges ( for self, celebrity - or any other campaigner other than Star Campaigner)

12 Power consumption/ generator charges r--

13 Rent for venue .--

14 Guards & security charges - 15 Boarding & lodging expenses of self, celebrity,

party functionary or any other campaigner ....- including Star Campaigner

16 Others expenses - /

Total f?J o5~o -r:=-v r< Schedule- 2

Expenditure in public meeting rally, procession etc. with the Star Campaigner(s) as apportioned to candidate (ie: other than those for general party propaganda)

I

Schedules- 1 to 9: Details of Elections Funds and Expenditure of Candidate

S. No Date and Name of the Star Amount of Expenditure on public meeting Remarks, if any Venue Campaigner(s) & Name of Party rally, procession etc. with the Star

Campaigner(s) apportioned to the candidate (As other than for general party propaganda) in Rs.

1 2 3 4 5 1 j/l/6Jfl/ ~II~~ 2 I

~ 0 $"'&O 'fLl!(Jlfu ----- ~ v l - 3 l rv a o o -

4 I Total st s ss=>« Schedule-3

Details of expenditure on campaign materials, like handbills, pamphlets, posters, hoardings, banners, cut-outs, gates & arches, video and audio cassettes, CDs/ DVDs, Loud speakers, amplifiers, digital TV/ board display , 3 D display etc. for candidate's election campaign ( ie: other than those covered in Schedule- 1 & 2)

s. Nature of Expenses Total Amount Sources of Expenditure Remarks, if any No. in Rs.

Amt. By Amt. By Pol. Amt. By others candidate I Party agent

1 2 3 4 5 6 7 - 1 ·f~!?-~:1~ I~ 108d~i.el> 2 r r _, -

3 4

Total

Schedule- 4

Details of expenditure on campaign through print and electronic media including cable network, bulk SMS or internet or social media etc. for candidate

s. Nature of Name and address Name and address of Total Amount Sources of Expenditure No medium of media provider agency, reporter, stringer, in Rs.

(electronic I (print /electronic company or any person to Amt. By Amt. By Amt. By print) and /sms / voice/ cable whom charges I candidate/ Pol. others duration TV, social media commission etc. paid/ agent Party

etc.) payable, if any Col. (3) +(4)

1 2 3 4 5 6 7 8

1

2

3 4

Total ~l\ --- ,..."' w

Schedule -5

Details of expenditure on campaign vehicle (s) and poll expenditure on vehicle(s) for candidate's election campaign

s. Regn. No. of Hiring Charges of vehicle No. of Total amt. Source of Expenditure No Vehicle & Days for incurred/

Type of Rate for Fuel charges Driver's which auth. in Rs.

Amt. By Amt. By Pol. Amt. Vehicle used Hiring of (If not charges candidate/ Party By vehicle I covered (If not agent other maintenan under hiring) covered s ce under

hiring)

1 2 3a 3b 3c 4 5 6 7 8

1 4~~f.,,. 69'{txJ- ___., (;;l/l(eo - 2 l_:Js-.. I/_~~ 1~~4J- I CJS7 9;i -::>

3 ..-d.&-- lq/eoo 1~'1){1- J (J I '7 It P-=- 4 ~ ;}q ffu1:> I <r9 !S-- (;a_ 7/:S- _.. / - l< Total - 85(.J65J;> Schedule- 6

Details of expenditure on Campaign workers I agents

s. Date and Expenses on Campaign workers Total amt. Sources of Expenditure No Venue

Nature of Expenses Qty. No. Of workers incurred/

Amt. By Amt. By Pol. Amt. By I agents

auth. In Rs. candidate/ Party others agent

1 2 3a 3b 3c 6 7 8 9 1 Campaign workers

honorarium/ salary etc.

2 Boarding

3 Lodging

4 Others

Total ~I - '

Schedule- 7

Details of Amount of own fund used for the election campaign

S. No. Date Cash DD/ Cheque no. etc. with Total Amount in Remarks details of drawee bank Rs.

1 2 3 4 5 6

1 '500 0 e ?Cl (!; 0 I e:JO 0 ~ '7 st ooc:J Jr -< 2 " 3

4

Total

Schedule~ 8

Details of Lump sum amount received from the party (ies) in cash or cheque or DD or by Account Transfer

s. Name of the Political Party Date Cash DD/ Cheque no. etc. Total Amount Remarks, if No. with details of drawee in Rs. any

bank

1 2 3 4 5 6 7

1 2 3

4

Total -ICl(L -- Schedule~ 9

Details of Lump sum amount received from any person/company/firm/associations/body of persons etc. as loan, gift or donation etc.

s. Name and address Date Cash DD/ Cheque Mention Total Amount Remarks No. no. etc. with whether loan, in Rs.

details of gift or drawee bank donation etc.

1 2 3 4 5 6 7 8

1

2 3

4

Total ~l( L- -