The Institute of Chartered Accountants of IndiaPOST QUALIFICATION COURSE IN INSURANCE AND RISK MANAGEMENT

Technical Examination, May, 2015(Under Regulation 204 of the Chartered Accountants Regulations, 1988)

Cost of Application Form : Rs. 100/-

thLast Date : 24 February, 2015 (Without late fee)rd3 March, 2015 (With late fee of Rs. 500/-)

NOTES FOR INFORMATION AND GUIDANCE OF APPLICANTS Candidates are advised to carefully read, understand and follow the

Dates of Examination (1)

1Principles and Practice of Insurance Technical Aspects of Insurance Risk Management and ReinsuranceBusiness Strategic Planning & Information Technology

th24 February, 2015 (Without late fee)rd3 March, 2015 (With late fee)

rd(Application received after 3 March, 2015 will not be entertained under any circumstances. Therefore, candidates sending their application by Post must send the same at least 3-4 days in advance of the last date and avoid sending it on the last date for receipt of application forms).

th th th th11 , 13 , 15 and 17 May, 2015

Timings of Examination (2) 2.00 p.m. to 5.00 p.m. (IST)

Subject : Module - IModule - IIModule - IIIModule - IV

Last date for receipt of application at the Institute'sHeadquarters at New Delhi.

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Rs. 1000/- (Rupees One Thousand Only) without Late Fee Rs. 1500/ (Rupees One Thousand Five Hundred Only) with Late Fee Rs. 100/- (Rupees One Hundred Only) extra if the examination form is downloaded

from Institute's website.

Examination Fee(Note : Candidates are advisednot to send any fee other than examination fee along with theExamination Application Form)

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The Examination Fee should be paid only by way of Demand Draft which may be of any Scheduled Bank.Drawn in favour of "The Secretary, The Institute of Chartered Accountants of India" and should be payable at New Delhi only.Candidates are advised to furnish the following details on the reverse of the Demand Draft in their own interest.

NameIRM Registration No.Examination Application form No.Centre Opted

Mode of Payment of Fee(6)

the Examination Department alongwith the examination form.Filling up of Admit Card (7)

The application form together with Demand Draft for Rs.1000/- or Rs.1500/-, as the case may be, of any Scheduled Bank be sent by Speed Post / Registered Post Only in the special envelope attached to this Form to the Deputy Secretary (Exams.), The Institute of Chartered Accountants of India, ICAI Bhawan, Indraprastha Marg, New Delhi-110 002.

Candidates are advised not to send the application through courier.

Institute.

How the application form should reach the Institute?

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A list of candidates eligible to appear for IRM Course Technical Examination May, 2015will be hosted by the Committee on Banking, Insurance and Pension on the Website of theInstitute www.icai.org

Institute of Chartered Accountants of India, Indraprastha Marg, New Delhi - 110 002 so as to

Candidates may submit the Examination Application Form, pending receipt of Eligibility

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Special Note: There will be no change in the examination schedule even if any examination day is declared as a Public Holiday by Central Government or any State Government.

Examination Centres (8) 1. Agra2. Ahmedabad3. Ahmednagar4. Ajmer5. Akola6. Alappuzha7. Aligarh8. Allahabad9. Alwar10. Ambala11. Amravati12. Amritsar13. Anand14. Anantapur15. Asansol16. Aurangabad17. Bangalore18. Bareilly19. Bathinda20. Beawar21. Belgaum22. Bellary23. Berhampore24. Bharatpur25. Bharuch26. Bhavnagar27. Bhilwara28. Bhiwandi29. Bhiwani

30. Bhopal31. Bhubaneswar32. Bhuj33. Bikaner34. Bilaspur35. Chandigarh36. Chennai37. Chittorgarh38. Coimbatore39. Cuttack40. Dehradun41. Delhi / New Delhi42. Dhanbad43. Dhule44. Durg45. Durgapur46. Ernakulam47. Erode48. Faridabad49. Fatehabad50. Gandhidham51. Gandhinagar52. Ghaziabad53. Gorakhpur54. Guntur55. Gurgaon56. Guwahati57. Gwalior58. Hisar

59. Hubli60. Hyderabad61. Ichalkaranji62. Indore63. Jabalpur64. Jaipur65. Jalandhar66. Jalgaon67. Jammu68. Jamnagar69. Jamshedpur70. Jhansi71. Jhunjhunu72. Jind73. Jodhpur74. Kaithal75. Kakinada76. Kannur77. Kanpur78. Karimnagar79. Karnal80. Kishangarh81. Kolhapur82. Kolkata83. Kollam84. Kota85. Kottayam86. Kozhikode87. Kumbakonam

88. Kurnool89. Latur90. Lucknow91. Ludhiana92. Madurai93. Mangalore94. Mapusa (Goa)95. Margao (Goa)96. Mathura97. Meerut98. Moradabad99. Mumbai100.Muzaffarnagar101.Mysore102.Nagpur103.Nanded104.Nashik105.Navi Mumbai106.Navsari107.Neemuch108.Nellore109.Noida110.Ongole111. Palghat112.Pali Marwar113.Panipat114.Panvel115.Patiala116.Patna

117.Pimpri-Chinchwad118.Pondicherry119.Pune120.Raipur121.Rajamahendravaram122.Rajkot123.Ranchi124.Ratlam125.Rewari126.Rohtak127.Rourkela128.Saharanpur129.Salem130.Sambalpur131.Sangli132.Sangrur133.Satara134.Shimla135.Sikar136.Siliguri137.Sirsa138.Sivakasi139.Solapur140.Sonepat141.Sri Ganganagar142.Srinagar143.Surat144.Surendranagar145.Thane

146.Thiruvananthapuram147.Thrissur148.Tinsukia149.Tiruchirapalli150.Tirunelveli151.Tirupati152.Tirupur153.Tuticorin154.Udaipur155.Udupi156.Ujjain157.Vadodara158.Vapi159.Varanasi160.Vasai161.Vellore162.Vijayawada163.Visakhapatnam164.Warangal165.Yamuna Nagar

Admission to the IRMTechnical Examination

(11) No. candidate shall be admitted to the IRM Technical Examination unless

Insurance and Pension of the Institute.

Issue of Admit Card(12) (a) A list of Candidates to whom the Admit Cards have been issued for the IRM Course Technical Examination will be hosted on the

th Institute's website www.icai.org. from 17 April, 2015.All correspondences in the above matter should be addressed to theDeputy Secretary (Exams.) of the Institute at New Delhi quotingthe following for prompt action.

IRM Regn. No.

Examination Application Form No.

Receipt No. Issued (if any)

Name of the Centre Opted

Telephone No.

Fax No.

E-mail

(b)C-1, Sector-1, Noida should be contacted on E-mail. : rpjuyal@icai.in

Helpline Desk telephone Nos. 0120-3054851, 3054852, 3054853, 3054854

Record of answer book tenderedat the Examination Centre.

(13) The Superintendents of Examination Centres are being advised to issue receipt for the answer books handed over through the Invigilator in the Admit Card.

Candidates are, therefore, advised to secure the signature of the Invigilator concerned while submitting their answer books and retain the Admit Card with themselves as record of receipt, at least till the declaration of result.

Requirement for passing the IRM Technical Examination

(14) A candidate for the Insurance and Risk Management Technical Examination shall be declared ordinarily to have passed the examination if he / she secures at one sitting a minimum of 40% marks in each of the papers and 50% marks in the aggregate of all the papers.

Issue of Statement of Marks (15) Statement of Marks will be issued to all the candidates who appeared in IRM Technical Examination normally in two weeks' time from the date of declaration of result.

Check-list to ensure correctness ofenclosures to the Application

(16)

giving all the required details and the following enclosures are annexed securely.

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Refund of fee(18) The fee once paid by a candidate shall not be refunded / adjusted under any circumstances except where a candidate applies to the Deputy Secretary (Exams) for the transfer of fee to the next Examination only, on the ground that he/she was prevented from attending the Examination on account of circumstances beyond his/her control and provided that application to this effect is not received after fifteen days of the date of the Examination.

PLEASE NOTE:

a) Application should be complete in all respects, otherwise it is liable to be rejected.

b) In the event of furnishing any incorrect information / misrepresentation, the admission shall become invalid.

c) No correspondence in this regard shall be entertained.

Demand Draft for Rs........................................Application Form

Admit Card with self attested photo

Address Slip

Before sending the application, candidates are requested to arrange serially the pages of application keeping the demand draft and admit card on the Top of the Bunch.

3054836, 3054842, 4953742 and 4953751-754.

After declaration of result, a candidate may, if he/she so desires, apply for verification of his/her answer book(s), necessarily in his/her own handwriting within one month from the date of declaration of result. The verification fee is Rs. 500/-payable by way of a demand draft drawn in favour of Secrectary, The Institute of Chartered Accountants of India, payable at New Delhi. There is no standard application form for verification. Typewritten request will not be entertained.

In Case of any difficulty, Deputy Secretary (Exams.),

For any/all dispute(s) relating to IRM Technical Examination conducted by the Institute of Chartered Accountants of India, the Courts at Delhi shall have exclusive jurisdiction.

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INSURANCE AND RISK MANAGEMENT

Control No. Roll No.

Self AttestedPassport SizeLATEST PHOTOGRAPHto be pasted here.(Please do not staple)POST QUALIFICATION COURSE IN

Insurance and Risk Management Technical Examination, May, 2015

The Institute of Chartered Accountants of India

(Specimen Signature of the Candidate)

I. DEMAND DRAFT DETAILS

II. APPLICANT DETAILS (IN BLOCK LETTERS)

1) DATE

2) AMOUNT (Rupees)

3) DRAWEE BANK

4) DEMAND DRAFT NO.

5) PAYABLE AT

D D MM YEAR

Downloaded Form Without Late Fee With Late Fee

N E EW LD H I

1) NAME (MR/MS.) : (as appearing on

2) FATHER'S NAME (Shri)

of Membership) Attach a

3) CITY OF YOUR PROFESSIONAL ADDRESS

4) MEMBERSHIP NO.

6) IRM REGISTRATION NO.

7) CENTRE OPTED

5) GENDER MALE FEMALE

D I R M / /

8) ELIGIBILITY CERT. NO. & DATE OF ISSUE D D MM YEAR

ADDRESS FORCOMMUNICATION(IN BLOCK LETTERS)

I request for permission to present myself for the Insurance and Risk Management Course Technical Examination to be held in May, 2015 conducted by the Institute of Chartered Accountants of India. I solemnly affirm that the above facts and information are complete and correct to the best of my knowledge and belief. I also undertake to abide by the Chartered Accountants Regulations, 1988 framed by the Council for the guidance of candidates appearing for the Insurance and Risk Management Technical Examination.

(Full Signature of Candidate)

Date.......................................... P.T.O.

Encls.: 1.

2.

3.

Demand Draft.

Copy of evidence of membership.

Admit Card Proforma.

Yes No

Yes No

Yes No

10) E-MAIL ADDRESS

9)

CITY PIN

STATE

TEL. : STD CODE NUMBER

MOBILE NO.

4. Address slip. Yes No

0

I. 1. Kindly write the date of issue of demand draft.

2. Write amount of fee paid. Please also ( ) the relevant box. (Fee is Rs. 1000/- without

late fee and Rs. 1500/- with late fee. Please add Rs.100/- if the form is downloaded

from the Institute's website).

3. Write name of the Bank.

4. Write number of the Demand Draft.

5. Demand Draft should be drawn in favour of "The Secretary, The Institute of Chartered

Accountants of India" and payable at New Delhi only.

II. 1. Kindly write your name exactly as recorded in the Register of Members i.e.

Membership Certificate..

2. Write the name of your father exactly as appearing in the Membership Certificate.

Married female members are to write Father's Name only.

3. Write the name of the place you belong to. The same will appear on the pass

certificate issued to all the pass candidates.

4. Write your membership number. Kindly take special care to write your correct

membership number.

5. Tick the appropriate box.

6. Supposing your registration number is DIRM/S/00718, Fill in like :

7. Write the name of a city from amongst the list of centres as given in Col.8 of "Notes

for Information and Guidance of Applicants: from where you wish to write the IRM

Technical Examination.

8. Write the No. and Date of Eligibility Certificate, as recorded on the Eligibility

Certificate issued to you by the Committee on Banking, Insurance and Pension.

9. Write your complete postal address, very clearly in Capital Letters for mailing Admit

Card, Pass Certificate, Correspondence, if any.

10. Write your E-mail address for our records / use.

11. Write your Phone No. also under your address in column No.9

Enclosures : Please attach (i) demand draft (ii) copy of evidence of being a member of ICAI

(iii) Admit card proforma (iv) Address Slips.

Please tick in relevant boxes.

HOW TO FILL-IN FORM

D I R M / S / 0 0 7 1 8

Address Slip (Please fill in Name & Address)

Address Slip (Please fill in Name & Address)

THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA (Examination Department)

ICAI Bhawan, Indraprastha Marg, New Delhi - 110 002 IRMADMIT CARD (DUPLICATE) IRM TECHNICAL EXAMINATION - MAY, 2015

Roll No.

Name of the Candidate .........................................................................................

Membership No. ...................................................................................................

I.R.M. Regn. No. ..................................................................................................

Centre : City : .......................................................................................................

Specimen Signature of the Candidate ..................................................................

Venue of the examination :

self attested photograph

which should be pasted in

this space and not merely

stapled.

LATEST PHOTOONLY

Deputy Secretary (Exams.)The Institute of Chartered Accountants of India

THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA (Examination Department)

ICAI Bhawan, Indraprastha Marg, New Delhi - 110 002 IRMADMIT CARD IRM TECHNICAL EXAMINATION-MAY, 2015

Roll No.

Name of the Candidate .........................................................................................

Membership No. ...................................................................................................

I.R.M. Regn. No. ..................................................................................................

Centre : City : .......................................................................................................

Specimen Signature of the Candidate ..................................................................

Venue of the examination :

self attested photograph

which should be pasted in

this space and not merely

stapled.

LATEST PHOTOONLY

Deputy Secretary (Exams.)The Institute of Chartered Accountants of India

Record of Answer Books tendered at the examination centre

Day & Date of ExaminationAfternoon Session (2.00 p.m. to 5.00 p.m.) (IST)

IRM TechnicalExaminationPapers

Name of theInvigilator

Signature of the Invigilator inconfirmation of receipt ofanswer book

Module-IPrinciples and Practiceof Insurance

Module-IITechnical Aspects ofInsurance

Module-IIIRisk Management andReinsurance

Module-IVBusiness StrategicPlanning & InformationTechnology

Special Note: There will be no change in the examination schedule even if any examination day is declared as a PublicHoliday by Central Government or any State Government.

Mondayth11 May, 2015

Wednesdayth13 May, 2015

Friday 15 May, 2015th

Sundayth17 May, 2015

Record of Answer Books tendered at the examination centre

Day & Date of ExaminationAfternoon Session (2.00 p.m. to 5.00 p.m.) (IST)

IRM TechnicalExaminationPapers

Name of theInvigilator

Signature of the Invigilator inconfirmation of receipt ofanswer book

Module-IPrinciples and Practiceof Insurance

Module-IITechnical Aspects ofInsurance

Module-IIIRisk Management andReinsurance

Module-IVBusiness StrategicPlanning & InformationTechnology

Special Note: There will be no change in the examination schedule even if any examination day is declared as a PublicHoliday by Central Government or any State Government.

Mondayth11 May, 2015

Wednesdayth13 May, 2015

Friday 15 May, 2015th

Sundayth17 May, 2015

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