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The Institute of Chartered Accountants of India


INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOV 2013
CANDIDATE DETAILS Name of Candidate : GANESH SINGH RAWAT DOB: 25/10/1993 Registration No : CRO0441641 Applied Date: 19/08/2013 Medium Opted : English Gender : Male E Mail : ganesh.singh1994@gmail.com Control No: 4609776 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 Exam Passed CPT MONTH & YEAR 07, 2012 Roll No. 198140

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 PAYMENT DETAILS Total Amount: 1600 INR Transaction Date: 19/08/2013 Bank Transaction No: EFI_CRO0441641_1098686346 Roll No. P1 P2 P3 P4 P5 P6 P7

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The Institute of Chartered Accountants of India


INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOV 2013

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 Intermediate (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 or an examination recognized as equivalent thereto by the Central Govt. and have registered for Intermediate (IPC) course / ATC on or 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 Intermediate (IPC) course/ATC under the Direct Entry Scheme, under Graduate/Post Graduate category and commenced articled training 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 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, 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 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, 2013. 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 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.

Name : Paste firmly with glue or adhessive like fevicol (Do not staple) a recent Signature of the candidate (Sign within the box with black pen) color photograph of size 3.5 X 4.5 cms

GANESH SINGH RAWAT


3/202-B,MALVIYA NAGAR JAIPUR RAJASTHAN, Pincode:302017 INDIA

Address : S/O MR.MOHAN SINGH RAWAT

(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 posting Name & Signature of the Member of ICAI/ Principal / Gazetted Officer with Membership NO.& Office seal

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The Institute of Chartered Accountants of India


INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION / ACCOUNTING TECHNICIAN EXAMINATION - NOV 2013

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. _____________________________