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The Institute of Chartered Accountants of India


INTERMEDIATE ( INTEGRATED PROFESSIONAL COMPETENCE ) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2017

CANDIDATE DETAILS
Name of Candidate : CHINTAPALLI MANIKANTA
DOB: 03/12/1994 Gender : Male
Registration No : SRO0422703 E Mail : manikantamani968@gmail.com
Applied Date: 14/08/2017 Control No: 2174649200
Medium Opted : English Landline No: -
Exam Applied : Intermediate (IPCE) Group-II
Examination Centre : VIJAYAWADA 2174649200
Center Code: 258
Mobile No : 9912026220
Father's Name: CHINTAPALLI LAKSHMI NARAYANA SARMA
Date of commencement of articleship
Conversion / Registration date of Intermediate(IPCC)/ATC: 01/03/2013
training: Nil
PIN : 1994 Differently Abled : NO
ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS (IF APPLICABLE)

Exam Passed MONTH & YEAR Roll No.

PARTIAL INTERMEDIATE (PASSED ON OR AFTER NOVEMBER 1994)/ PEE-II/ PCE/ I(IPC)E EXAMINATION PASSING DETAILS
Exam Passed MONTH & YEAR Roll No.
EXEMPTION SECURED IN I(IPC)E/ATE
Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7
PAYMENT DETAILS

Total Amount: 1500 INR Transaction Date: 14/08/2017 Bank Transaction No: EFI_SRO0422703_6122542652

DETAILS FOR DETERMINING ELIGIBILITY

(i) Registered For Intermediate (IPCC)/ATC on or before 01st March, 2017 based on having passed : CPT & 10+2 exam passed
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The Institute of Chartered Accountants of India


INTERMEDIATE ( INTEGRATED PROFESSIONAL COMPETENCE ) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2017

Registration No : SRO0422703 Control No: 2174649200

2174649200
DECLARATION
1. I CHINTAPALLI MANIKANTA son/daughter of CHINTAPALLI LAKSHMI NARAYANA SARMA request for permission to present myself at the Intermediate (IPC) /Accounting Technician Examination to be held in NOV 2017
by the Institute of Chartered Accountants of India and hold valid registration for appearing in Intermediate(IPC) Examination to be held in NOV 2017.
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 Intermediate(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, 2017 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 the Graduate/Post Graduate category and commenced articled training on or before 01st Feb, 2017 & completed/would be completing 9 months
of articled training (including 8 months of study course) as on 01st Nov, 2017 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 the Graduate/Post Graduate category and commenced articled training on or before
01st Feb, 2017 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st Nov, 2017 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, 2017 and completed or would be completing 8 months study course as on 01st Nov, 2017 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, 2017 as per article registration letter received from the Regional office.
9. I registered for Intermediate(IPC) through CPT route and appeared in the Intermediate(IPC) examination in one or both groups but did not pass any of the groups and converted to Intermediate(IPC) course under the Direct Entry
Scheme and commenced / would be commencing practical training on or before 31st Oct, 2017
10. 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 : CHINTAPALLI MANIKANTA


Address : S/O CHINTAPALLI LAKSHMI NARAYANA
SARMA
D NO 20-8-27/C NEW AYODHYA NAGAR,
RAMADASU ADI NARAYANA STREET
VIJAYAWADA
ANDHRA PRADESH, Pincode: 520003
INDIA
Signature of the candidate
(Sign within the box with black pen)

I do hereby certify that the photograph and signature appearing above are that of Mr./Ms CHINTAPALLI MANIKANTA. 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:
Name & Signature of the Member of ICAI/ Principal / Gazetted Officer
Important: Please do not fold this document while posting
with Membership NO.& Office seal