1/1

###########
The Institute of Chartered Accountants of India
FOUNDATION EXAMINATION - MAY 2022

Name of Candidate : BHUVAN PRAJAPATI

Gender : MALE Foundation Reg. Date : 30/06/2021 Date of Birth : 13/07/2003
E Mail : bhuvanprajapati13@gmail.com Control No: 1221512723 Registration No:NRO0519680
Converted from CPT to Foundation: No
Center Selection
Mobile No : 8860922770 Landline No : - Region : NORTHERN REGION
Father's Name : RAKESH KUMAR Centre :DELHI / NEW DELHI - I
Centre State/UT :DELHI / NEW DELHI
Medium Opted : ENGLISH PIN :2003 Centre Code: 5007
1221512723
Concession Card No.: No
Address : A-609/1
SHASTRI NAGAR,
Details of Latest Previous appearances :
Exam: MM : YYYY : Roll No.:
NEW DELHI - 110052
DELHI , INDIA
ACADEMIC DETAILS OF QUALIFYING EXAMINATION (I.E., 12TH CLASS EXAMINATION) : ALREADY PASSED
Year : 2021 Roll Number : 26600474
Board of qualifying examination (i.e., 12th Class examination or equivalent) : CBSE
Payment Details Transaction Date: 24/02/2022 Amount: 1500 INR Bank Transaction No: EFFD_NRO0519680_7287553047
DECLARATION BY THE STUDENT
I BHUVAN PRAJAPATI Son/Daughter of RAKESH KUMAR hereby declare that I am registered in the Foundation Course on/before 01-January-2022 or have converted to Foundation
Course from CPT course on or before 13-03-2022 and have appeared / will be appearing in the 10+2 examination. I request for permission to appear at the Foundation examination conducted
by the Institute of Chartered Accountants of India scheduled to be held in May 2022. I hereby declare that the particulars stated in this application form are true to the best of my knowledge and
belief. I have read the Guidance Notes for candidates and satisfied myself that I am eligible to appear in ensuing Foundation Exam to be held in May, 2022 and I shall abide by the terms and
conditions contained therein. I understand that my admission to Foundation and result thereof shall be provisional and subject to verification of my fulfilling the eligibility requirements in terms
of the CA Regulations, 1988 and decision of the Council of ICAI. In the event of suppression or distortion of any fact made in this application form, I understand that I shall be denied the
opportunity to appear in Foundation Exam and if already admitted / appeared, my admission / result acquired shall be liable for outright cancellation. I also understand that the decision of the
Institute in this regard shall be final and binding upon me and I shall abide by the same

Date: _____________ Sign of Candidate: ______________________________ Sign of Parent / Guardian: ______________________________

Candidate's photograph
Paste firmly with glue or Paste firmly with glue or
adhessive like fevicol
adhessive like fevicol
Signature of the Candidate (Do not staple) a recent
(Do not staple) recent color
(Sign within the box with blue/black pen color photograph of size 3.5
photograph of size 3.5 X 4.5 only in the same style as signed in the X 4.5 cms
cms Foundation course Registration Form)

Dated : 24/02/2022
Photo to be attested by same person who is attesting this form NON ATTESTED PHOTO OF CANDIDATE

I ______________________________ do hereby certify that I have verified and satisfied that the candidate named above is registered for Foundation course with the Board of Studies of
the Institute on or before 01st January,2022 / Converted to Foundation from the CPT on or before 13-03-2022 and has already appeared in / will be appearing in 12th class examination and
is eligible as per regulation 25F (explained below) to appear in Foundation Exam. The particulars as furnished have been verified by me and found to be correct with reference to the
documents produced before me by the candidate.

Name and membership No.of the Member of ICAI /Head of

Date:
the Educational Institution /Gazzetted Officer with Seal

Place: Signature of Member of ICAI/Head of Educational Institution /Gazzetted Officer Tel No._________________________
Important: Please do not fold this document while posting

Explanation of Regulation 25 F:
1. The candidate should be registered with the Board of Studies of the Institute on or before 01st day of January 2022 for the examination to be held in the month May 2022 respectively or should have
converted from CPT to foundation on or before 13-03-2022; and
2. The candidate has already appeared / will be appearing in the Senior Secondary (10+2) examination conducted by an examining body constituted by law in India or an examination recognised by the Central
Government or the State Government as equivalent thereto for the purpose of admission to graduation course.