Indian Election Application Form 1. Name of Candidate : _______________________ 2. Present Address (i) Name of Jail : _______________________ (ii) Cell Number : _______________________ 3. Political Party : _______________________ (List ONLY the Last Five parties in Chronological Order) 4. Nationality: [ ] A - Italian B - Indian 5. Reasons for leaving last party (circle one or more) A - Defected B - Expelled C - Bought out D - None of above E - All of the 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 Recogonised Government Psychiatrist) 7. How many years of public service experience do you possess? A - 1-2 yrs B - 2-6yrs C - 6-15yrs D - 15+yrs 8. Give details of any criminal cases pending against you (Use as many Additional Sheets as you want)
9. How many years have you spent in Jail? [ ] (Do not 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 - 10-50 Crores B - 50-100 Crores 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. How many people have you killed or murdered ?[ ] A - 50 B - 100 C - 1000 D - Lost count 14. Describe your achievements in space provided: [___] Thumb Impresssion of candidate (Not that of the person who filled the form)