S.M.R
SENIOR MEMBER
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- May 3, 2011
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Pakistan Election
1. Name of Candidate : _______________________
2. Present Address
3. Political Party : _______________________
4. Nationality: [ ]
5. Reasons for leaving last party (circle one or more)
6. Reasons for contesting elections (circle one or more)
7. How many years of public service experience do you possess?
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? [ ]
10. Are you involved in any financial scams? [ ]
11. What is your Annual Corruption Income? [ ]
12. Do you have any developmental plans for Pakistan in mind? [ ]
13. How many people have you killed or murdered ?[ ]
14. Describe your achievements in space provided: [___]
Thumb Impresssion of candidate
(Not that of the person who filled the form)
1. Name of Candidate : _______________________
2. Present Address
(i) Name of Jail : _______________________
(ii) Cell Number : _______________________
(ii) Cell Number : _______________________
3. Political Party : _______________________
(List ONLY the Last Five parties in Chronological Order)
4. Nationality: [ ]
A - Italian
B - Pakistani
B - Pakistani
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
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)
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
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 Cool)
A - 1-2 years
B - 2-6 years
C - 6-15 years
D - 15+years
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
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)
B - 50-100 Crores
C - Overflow...
(Convert all your $ earning from Hawala etc. to Rupees)
12. Do you have any developmental plans for Pakistan in mind? [ ]
A - No
B - No
C - No
D - 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
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)