Indian Election: Application Form
Name of Candidate: _______________________
Present Address
Name of Jail: _______________________
Cell Number: ________________________
(If not in Jail, attach proof of illegally occupied residence)
Political Party: _______________________ (List ONLY the Last Five parties in the Chronological Order)
Sex : [ ]
Male
Female
Mayawathi
Nationality : [ ]
Italian
Indian
(if Indian attach attested copy of ration card, police certificate, passport, birth-certificate, electricity bill, phone bill and local goondas NOC. If Non-indian just Check box A)
Reasons for leaving last party (circle one or more)
Defected
Expelled
Bought out
None of above
All of above
Reasons for contesting elections (circle one or more)
To make money
To escape court trial
To grossly misuse power
To serve the public
I have no clue
(if you choose "D,- attach Certificate of Sanity from a Recogonised Government Psychiatrist)
How many years of public service experience do you possess ? [ ]
1-2 yrs
2-6yrs
6-15yrs
15+yrs
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)
1-2 years
2-6 years
6-15 years
15+years
Are you involved in any financial scams ? [ ]
Why not
Of Course
Definitely
I deny it all
see a foreign hand
What is your Annual Corruption Income ? [ ]
100-500 Crores
500-1000 Crores
Overflow... (Convert all your $ earning from Hawala etc to Rupees)
Do you have any developmental plans for the country in mind? [ ]
No
No
No
No
Describe in space provided, your achievements :
Thumb Impresssion of candidate
Mera Bharat Mahan

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