Indian Election
 
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)

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