| Nomination 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 5 parties in Chronological (Order) 4.Sex: [ ] A- Male B- Female C- Mayawati D- Uma Bharathi 5. Nationality: [ ] A- Italian B- Indian 6. Reasons for leaving last party (circle one or more) A- Defected B- Expelled C- Bought out D- None of above E- All of above 7. 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) 8. No of years of public service experience do you possess? A- 1-2 yrs B- 2-6yrs C- 6-15yrs D- 15+yrs 9. List the criminal cases pending against you (Use as many Additional Sheets as you want) 10. How many years have you spent in Jail? [ ] (Don�t confuse with question 8) A- 1-2 years B- 2-6 years C- 6-15 years D- 15+years 11. 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. 12. What is your Annual Corruption Income? [ ] A- 100-500 Crore B- 500-1000 Crore C- Overflow... (Convert all your $ earning from hawala etc to Rupees) 13. Do you have any developmental plans for India in mind? [ ] A- No B- No C- No D- No 14. Describe your achievements in space provided: [_________] Issued in public interest by Election Commission of India (For Humour) As received by an Email |
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