CRO0441641-IPC

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Exam Passed MONTH & YEAR Roll No.

CPT 07, 2012 198140

The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /

ACCOUNTING TECHNICIAN EXAMINATION - NOV 2013

CANDIDATE DETAILS

Name of Candidate : GANESH SINGH RAWATDOB: 25/10/1993 Gender : Male

Registration No : CRO0441641 E Mail : [email protected]

Applied Date: 19/08/2013 Control No: 4609776

Medium Opted : English Landline No: -

Exam Applied : Intermediate (IPCE) Both Groups

Examination Centre : Jaipur

Mobile No : 8561067299

Father's Name: MOHAN SINGH RAWAT

Registration date of Intermediate(IPCC)/ATC/Inter/PEE-II/PCC: 04/08/2012

PIN :1234 Differently Abled :No

ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS

PARTIAL INTERMEDIATE/ PEE-II/ PCE/ IPCE EXAMINATION PASSING DETAILS

Exam Passed MONTH & YEAR Roll No.

EXEMPTION DETAILS OF EXEMPTION SECURED IN ERSTWHILE PCE

Month & Year Roll No P1 P2 P3 P4 P5 P6

EXEMPTION DETAILS OF EXEMPTION SECURED IN IPCE/ATE

Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7

PAYMENT DETAILS

Total Amount: 1600 INR Transaction Date: 19/08/2013 Bank Transaction No: EFI_CRO0441641_1098686346

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Registration No : CRO0441641 Control No: 4609776

DECLARATION BY THE STUDENT

1. I GANESH SINGH RAWAT son/daughter of MOHAN SINGH RAWAT request for permission to present myself at the In termediate (IPC) /Accounting Technician

Examination to be held in NOV 2013 by the Institute of Chartered Accountants of India.

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;

3. I have passed the Common Proficiency Test (CPT) as well as Senior Secondary (10+2) Examination o r an examination recognized as equivalent the reto by the

Central Govt. and have registered for Intermediate (IPC) course / ATC on o r before 01st March, 2013; 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) /Accounting Technician Course (ATC) and have completed 8 months from the

date of registration in Intermediate /PE II/ PCC.

5. I registered for Inte rmediate (IPC) course/ATC under the Direct Entry Scheme, under Graduate/Post Graduate category and commenced articled training on or be fore

01st February, 2013 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st November, 2013

6. I converted to Intermediate (IPC) course /ATC from erstwhile Intermediate o r 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, 2013 & completed/would be completing 9 months of articled training (including 8

months of study course) as on 01st November, 2013

7. I registered for Inte rmediate (IPC) course/ATC, under Direct Entry Scheme, having passed the Inte rmediate level examination of the Institute of Cost Accountan ts of

India/The Institute of Company Secretaries of India, on or before 01st March, 2013.

8. I converted to Intermediate (IPC) course /ATC, from erstwhile Intermediate/CPT/PE-II/PCC or IPCC, under the Direct Entry Scheme, ha ving passed th e Inte rmediate

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 November, 2013.

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 : GANESH SINGH RAWAT

Address : S/O MR.MOHAN SINGH RAWAT

3/202-B,MALVIYA NAGAR

JAIPUR

RAJASTHAN, Pincode:302017

INDIA

(I do hereby certify that the photograph affixed above is that of Mr./Ms GANESH SINGH RAWAT) 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 postingName & Signature of the Member of ICAI/ Principal / Gazetted Officer

with Membership NO.& Office seal

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Registration No : CRO0441641 Control No: 4609776

DETAILS FOR DETERMINING ELIGIBILITY

(i) Registered For Intermediate (IPCC)/ATC on or before 01st March, 2013 based on having passed : CPT and 10+2 exam passed

CCT / ITT CERTIFICATE DETAILS

Certificate Name Certificate No. Dated

Orientation Completion Details

Completion Date :

**************************************************

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 1st February, 2013

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 November, 2013.

Student Regn. No:___________________________

Date: ___________________________

Place: __________________________ Signature of the articled assistant Signature of Principal

ICAI membership No. _____________________________

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CRO0441641-IPC