Application Form For The Next
National Assembly Elections
**1. Name of Candidate: ** ______________________
**2. Present Address: **
(i) Name of Jail: _____________________________
(ii) Cell Number: _____________________________
(If not in Jail, attach proof of residence)
3. Political Party: ___________________________
(List ONLY the Last Five parties in the Chronological Order)
3.a. Size of party
A. Myself B. Me & my family C. Enough to occupy a Tonga
4. Sex : A - Male B - Female
C - Benazir D - “General” (any)
5. Reasons for leaving last party: (circle one or more)
A - Defected B - Expelled C - Bought out
D - All of above
**6. Reasons for contesting elections: **(circle one or more)
A - To make money B - To escape Court Martial
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 Very well known Psychiatrist )
**7. How many years of public corruption experience do you possess? **
A - 1-2 yrs B - 2-6yrs C - 6-15yrs D - 15+yrs
8. Give details of best criminal cases pending against you:
(Restrict upto best 5; Attach a separate sheet)
**9. How many years have you spent in Jail ? ** 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 - 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 the country in mind ?
A - No B - No C - No D - No E - All of the
above
13. Describe in space provided, your achievements, if any.
_________________.
Thumb Impression of the candidate
(Not that of the person who filled the form)
**“define QUESTION ((bb) | | !(bb))” — *Shakespeare ***