'ICSI House', C-36, SECTOR-62, NOIDA - 201309

Website: www.icsi.edu, E-mail: info@icsi.edu

Call Center Helpline Numbers- 0120-6204999, 3314111
ICSI Academic Helpline Number: 0120-6267777

ONLINE STUDENT IDENTITY CARD

Registration Number 440983101/05/2021

Valid Upto 30/04/2026

Name of the Student siddhesh uttam nagarkar

Date of Birth 22/02/2000

Father's/Husband's/Spouse's Name uttam nagarkar

Signature of Student

for The Institute of Company

Address 3A/303 VINAYAK DARSHAN CENTRAL PARK Secretaries of India
ROAD
NALLASOPARA
MAHARASHTRA Pincode :401203

(Signature of the issuing authority)

Contact No. 917276773648 Print Date : 17/12/2021

Please validate the Online/Downloaded Student Identity Card by any of the following authorities with his/her Signature and Photo & Signature of Student attested
Seal/Rubber Stamp carrying name, professional membership no., Designation and official address of the attesting authority
: Member of the institute, with ACS/FCS No., Officers of the Institute, Gazetted Officer of the Central or State Government;
Manager of a Nationalized Bank; Princial of a recognized School/Collage Signature & Seal/Rubber stamp carring name,
Professional Membership No, Designation and Official
address of the authority.

Undertaking by the Student

1. I hereby declare that the particulars furnished above are true to the best of my knowledge and belief and if at any time it has come to the notice of the Institute that
the said particulars were untrue, I agree to my registration being cancelled without any obligation on the part of the Institute to refund any fee paid by me to the
Institute without prejudice to the right of the Institute to take any further action as deemed fit and appropriate.
2. I shall as a registered student conduct myself in a manner befitting the ideals and standards of the profession of Company Secretaries generally and as specified
by the Council from time to time and shall abide by bye-laws or other standing orders as may be framed by the Council and made applicable from time to time.