(i.) Name of Jail:_____________________
(ii.) Cell Number:_____________________
3. Political Party:_____________________
List ONLY the last 5 parties in Chronological (Order)
A- Male
B- Female
C- Mayawati
D- Uma Bharathi
5. Nationality: [ ]
A- Italian
B- Indian
6. Reasons for leaving last party (circle one or more)
A- Defected
B- Expelled
C- Bought out
D- None of above
E- All of above
7. 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)
8. No of years of public service experience do you possess?
A- 1-2 yrs
B- 2-6yrs
C- 6-15yrs
D- 15+yrs
9. List the criminal cases pending against you (You May Use as many Additional Sheets as you want)
10. 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
11. Are you involved in any financial scams? [ ]
A- If Not, Why not
B- Of course
C- Definitely
D- I deny it all
E- I see a foreign hand.
12. 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)
13. Do you have any developmental plans for India in mind? [ ]
A- No
B- No
C- No
D- No
14. Describe your achievements in space provided:
15. Education: NOT REQUIRED
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