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- Indian Election
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- 1. Name of Candidate : _______________________
- 2. Present Address
- (i) Name of Jail : _______________________
- (ii) Cell Number : _______________________
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- 3. Political Party : _______________________
- (List ONLY the Last Five parties in Chronological Order)
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- 4. Nationality: [ ]
- A - Italian
- B - Indian
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- 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
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- 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)
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- 7. How many years of public service experience do you possess?
- A - 1-2 yrs
- B - 2-6yrs
- C - 6-15yrs
- D - 15+yrs
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- 8. Give details of any criminal cases pending against you (Use as many Additional Sheets
as you want)
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- 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
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- 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
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- 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)
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- 12. Do you have any developmental plans for India in mind? [ ]
- A - No
- B - No
- C - No
- D - No
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- 13. How many people have you killed or murdered ?[ ]
- A - 50
- B - 100
- C - 1000
- D - Lost count
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- 14. Describe your achievements in space provided: [___]
- Thumb Impresssion of candidate
- (Not that of the person who filled the form)
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