Before the District Election Officer ……………………… (District, State/Union Territory)
Affidavit of Shri…………………………… (S/o) ……………………………..………
I …….………………………………… son/wife/daughter of …………………………, aged ………. years, r/o ………………….. do hereby solemnly and sincerely state and declare as under:-
(1) That I was a contesting candidate at the general election/bye election to the House of the People/ Legislative Assembly of ………………………. from ………………………….... Parliamentary/ Assembly constituency, the result of which was declared on …………………. (2) That I/my election agent kept a separate and correct account of all expenditure incurred/ authorized by me / my election agent in connection with the above election between …………….. to …………………. (the date on which I was nominated) and the date of declaration of the result thereof, both days inclusive.
(3) That the said account was maintained in the Register furnished by the Returning Officer for the purpose and the said Register itself is annexed hereto with the supporting vouchers/ bills mentioned in the said account.
(4) That the account of my election expenditure as annexed hereto includes all items of election expenditure incurred or authorized by me or by my election agent, the political party which sponsored me, other associations ‘body of persons and other individuals supporting me, in connection with the election, and nothing has been concealed or withheld/ suppressed there from (other than the expense on travel of leaders’ covered by Explanations 1 and 2 under section 77 (1) of the Representation of the people act, 1951).
(5) That the Abstract Statement of Election Expenses annexed as Annexure II to the said account also includes all expenditure incurred or authorized by me, my election agent, the political party which sponsored me, other associations/ body of persons and other individuals supporting me, in connection with the election.
(6) That the statements in the foregoing paragraphs (1) to (5) are