2/18/23, 12:12 PM The Institute of Chartered Accountants of India - Application Form Print

Request ID : DPC23171068

Application for issue of Duplicate Pass Certificate

To
The Additional Secretary (Exams)
The Institute of Chartered Accountants of India
'ICAI Bhawan',
Post Box No. 7112, Indraprashta Marg,
New Delhi - 110002

Sub: Issue of duplicate pass certificate - Request ID : DPC23171068

Dear Sir

Kindly issue duplicate pass certificate as per details given below:

Applicant Type: ICAI Student
Name of the candidate: Puskar Raj Neupane

Contact no : Land line :    - Mobile : 8860949359

E-mail address : Puskarrn19@gmail.com

Address to which the duplicate pass certificate is to be sent
House 575, street 2, gururamdasnagar,mangalbajar
Laxminagar
India
DELHI - 110092

Student Registration No : FRO0009397 Old Student Registration No :     

Details of the duplicate pass certificate sought:

Examination Month and Year Group Passed Roll No

IPCE November-2018 GROUP I 637741

May-2019 GROUP II 363692

Details of Fees paid:

Transaction Reference No : EPP_23171068_7280765864
Amount : 240.00 INR                             GST(18%) Amount : 0.00 INR
Date : 18-02-2023                                    Total Amount : 240.00 INR
ICAI GSTIN: 09AAAAT7798M3ZF         
Signature of candidate
Encl: i) Affidavit in the prescribed format

https://icaiexam.icai.org/duplicate/registration_print.php?q=MzJmNDQ0MDM4YTkyMDdhMWE3OGVhOTE0ZDhlODM5Mjl8MTcxMDY4 1/3
2/18/23, 12:12 PM The Institute of Chartered Accountants of India - Application Form Print

Request ID : DPC23171068

https://icaiexam.icai.org/duplicate/registration_print.php?q=MzJmNDQ0MDM4YTkyMDdhMWE3OGVhOTE0ZDhlODM5Mjl8MTcxMDY4 2/3
2/18/23, 12:12 PM The Institute of Chartered Accountants of India - Application Form Print

https://icaiexam.icai.org/duplicate/registration_print.php?q=MzJmNDQ0MDM4YTkyMDdhMWE3OGVhOTE0ZDhlODM5Mjl8MTcxMDY4 3/3