The Institute of Chartered Accountants of India INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2014
CANDIDATE DETAILS Name of Candidate : SHYAM ASHOK RATHI DOB: 20/10/1995 Gender : Male Registration No : WRO0490344 E Mail : shyamrathi20@gmail.com Applied Date: 27/08/2014 Control No: 4628344 Medium Opted : English Landline No: - Exam Applied : Intermediate (IPCE) Group-I / ATE Examination Centre : Akola Center Code: 104 Mobile No : 7588419028 Father's Name: ASHOK JAYNARAYAN RATHI Conversion / Registration date of Intermediate(IPCC)/ATC: 13/02/2014 Revalidation Date: - PIN :7777 Differently Abled :No ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS (IF APPLICABLE) PARTIAL INTERMEDIATE (PASSED ON OR AFTER NOVEMBER 1994)/ PEE-II/ PCE/ I(IPC)E EXAMINATION PASSING DETAILS Exam Passed MONTH & YEAR Roll No. EXEMPTION DETAILS OF EXEMPTION SECURED IN I(IPC)E/ATE Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7 PAYMENT DETAILS Total Amount: 1000 INR Transaction Date: 27/08/2014 Bank Transaction No: EFI_WRO0490344_1230704102 1/3 The Institute of Chartered Accountants of India INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2014
Registration No : WRO0490344 Control No: 4628344 DECLARATION BY THE STUDENT 1. I SHYAM ASHOK RATHI son/daughter of ASHOK JAYNARAYAN RATHI request for permission to present myself at the Intermediate (IPC) /Accounting Technician Examination to be held in NOVEMBER 2014 by the Institute of Chartered Accountants of India and hold valid registration for appearing in Intermediate(IPC) Examination to be held in NOVEMBER 2014. 2. I declare that I am eligible to appear in the Intermediate (IPC) Examination /ATE as I have passed the PEE-I/Foundation/Entrance Examination and have completed eight months study course in IPCC. 3. I have passed the Common Proficiency Test (CPT) as well as Senior Secondary (10+2) Examination or an examination recognized as equivalent thereto by the Central Govt. and have registered for Intermediate (IPC) course / ATC on or before 01st March, 2014 as per registration letter received from the Regional Office; or 4. I was already registered for the erstwhile Intermediate Examination as per syllabus under Paragraph 2 or 2A of Schedule B of Chartered Accountants Regulations 1988 or Professional Education (Course II) under sub-regulation (1) of regulation 28A or Professional Competence Course under Regulation 28 C of the Chartered Accountants Regulations , 1988 and have already converted into the Intermediate (IPC) Course/Accounting Technician Course (ATC). 5. I registered for Intermediate (IPC) course/ATC under the Direct Entry Scheme, under Graduate/Post Graduate category and commenced articled training on or before 01st February, 2014 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st Nov, 2014 as per article registration letter received from the Regional office. 6. I converted to Intermediate (IPC) course /ATC from erstwhile Intermediate or CPT or PE-II or PCC or IPCC,under Direct Entry Scheme, under Graduate/Post Graduate category and commenced articled trainging on or before 01st February, 2014 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st Nov, 2014 as per article registration letter received from the Regional office. 7. I registered for Intermediate (IPC) course/ATC, under Direct Entry Scheme, having passed the Intermediate level examination of the Institute of Cost Accountants of India/The Institute of Company Secretaries of India, on or before 01st March, 2014 and completed or would be completing 8 months study course as per registration letter issued by Regional Office. 8. I converted to Intermediate (IPC) course /ATC, from erstwhile Intermediate/CPT/PE-II/PCC or IPCC, under the Direct Entry Scheme, having passed the Intermediate Level examination of The Institute of Company Secretaries of India/Institute of Cost Accountants of India, and completed/would be completing 8 months of study course, as on 01st Nov, 2014 as per article registration letter received from the Regional office. 9. I declare that the facts and information provided in this form are complete and correct to the best of my knowledge and belief. I am also aware that my admission shall become invalid if I make wrong declaration and undertake to abide by the decision of the Council in such a situation. Signature of the candidate (Sign within the box with black pen) Paste firmly with glue or adhessive like fevicol (Do not staple) a recent color photograph of size 3.5 X 4.5 cms Name : SHYAM ASHOK RATHI Address : SUNDARAM OPP. HANUMAN MANDIR,PRASHANT NAGAR MALKAPUR MAHARASHTRA, Pincode:443101 INDIA I do hereby certify that the photograph affixed above is that of Mr./Ms SHYAM ASHOK RATHI who has signed in my presence.The particulars as furnished on this form have been verified by me and found correct with reference to the documents produced before me by the candidate. Date: Place: Important: Please do not fold this document while posting Name & Signature of the Member of ICAI/ Principal / Gazetted Officer with Membership NO.& Office seal 2/3 The Institute of Chartered Accountants of India INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2014
Registration No : WRO0490344 Control No: 4628344 DETAILS FOR DETERMINING ELIGIBILITY (i) Registered For Intermediate (IPCC)/ATC on or before 01st March, 2014 based on having passed : CPT and 10+2 exam passed ************************************************** Certificate of service: For candidates who registered for/converted to Intermediate (IPC) course under the Direct Entry Scheme under the category graduates/post graduates and commenced articleship on or before 01st February, 2014 I _____________________________________ hereby certify that Mr/Ms _____________________________________ is presently serving under me as articled assistant and completed or will be completing 9 months of articled training as 01st Nov, 2014. Student Regn. No:___________________________ Date: ___________________________ Place: __________________________ Signature of the articled assistant Signature of Principal