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 5 parties in Chronological (Order)
4.Sex: [ ]
A- Male
B- Female
C- Mayawati
D- Uma Bharathi
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. No of years of public service experience do you possess?
A- 1-2 yrs
B- 2-6yrs
C- 6-15yrs
D- 15+yrs
8. List the criminal cases pending against you (Use as many
Additional Sheets as you want)
9. 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
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 Crore
B- 500-1000 Crore
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.
