Rev No Date
03 05.10.2021
Form:
Page 1 of 2
TSA-AC-F5
Training Details:
Training Program Title:
Location of Training:
Training Dates:
Personal Details:
First Name: Shubham
Address for Communication
City: Jalandhar
Contact Number
Email ID
Educational Qualification
Professional Qualification
Current Employment
If Self Employed / Own business
Current Job Profile
(In Brief)
Please Tick:
Self Sponsored
Note:
1. If Self Sponsored then kindly provide the below information
Personal PAN No:
2. If Company Sponsored then kindly provide the below details
Authorized Person’s First Name:
Company’s Name &Address
City:
Authorized Person’s Contact Number
Authorized Person’s Email ID
PAN No.: AABCT0716G
TAN No.: MUMT09385F
Maharashtra GSTIN :
27AABCT0716G1ZN
CIN No.: U74220MH1999PTC121330
PARTICIPANT
REGISTRATION FORM
Un Accredited Trainings
FSSC 22000 Ver. 6.0 Internal Auditor Training
Virtual
From: 19th Feb 2024 To: 20th Feb 2024
Middle Name: Kumar Last Name: Srivastava
13- Third floor, Bhagat singh colony, Shaheed Bhagat Singh Nagar,
Near Maqsudan Bypass, Jalandhar, Punjab
State: Punjab Pin Code: 144008
Off: Mobile: 6207882911
Shubhamsrvstv999@gmail.com
B.Tech in Food Technology
Designation: Corporate Quality Assurance Executive
Proprietor / Partner / CEO / Managing Director
Other ____________
To assure qualitative product manufactured at 3rd party factory.
Company Sponsored.
FYXPS1275M
Authorized Person’s Middle Name: Authorized Person’s Last Name:
State: Pin Code:
Off: Mobile:
Registered Office: Corporate Office: Email: info.in@tuvsud.com
TÜV SÜD South Asia Pvt. Ltd. TÜV SÜD South Asia Pvt. Ltd. https://www.tuvsud.com/en-in
TÜV SÜD House, Solitaire, 4th Floor,
Off Saki Vihar Road, ITI Road, Aundh,
Saki Naka, Andheri (East), Pune – 411007, India.
Mumbai – 400072, India.
 Rev No Date
03 05.10.2021 PARTICIPANT

Form: REGISTRATION FORM

Page 2 of 2
TSA-AC-F5
Un Accredited Trainings

Payment Details:

Mode of Payment: Online

(Online / Cheque / Demand Draft)
Bank Name State Bank Of India
Bank Branch Name
Amount Rs. 14160/-

Online Transaction No.

(If payment done online)
Online Transaction Date.
(If payment done online)
Cheque / DD No.
Cheque / DD Date.
TDS amount deducted
Note:
 Cheque / Demand Draft should be drawn in favour of TÜV SÜD South Asia,payable at the location of TÜV
SÜD office that is responsible for training.
 Participation fee is non refundable / non adjustable against any other training program conducted by TÜV SÜD South
Asia.
 Changes in nomination is acceptable but shall be communicated at least 3 days in advance.
 This workshop is non residential.

** Declaration:
To be confirmed by the participant only if the training program title mentioned above is IATF 16949:2016
Internal Auditor. (Tick below boxes to confirm)

I declare and confirm that I have the adequate pre-requisite knowledge on ISO 9001:2015 requirements
including core tools and I understand that this is a pre-requisite requirement to become a qualified internal
auditor for IATF 16949:2016

____________________
Participant’s Signature

If participant is sponsored by company, authorized person’s signature and company seal to be affixed below.

--------------------------------------------------------------------
Authorized person’s signature and company seal

PAN No.: AABCT0716G Registered Office: Corporate Office: Email: info.in@tuvsud.com

TAN No.: MUMT09385F
Maharashtra GSTIN :
27AABCT0716G1ZN
CIN No.: U74220MH1999PTC121330
TÜV SÜD South Asia Pvt. Ltd.
TÜV SÜD House,
Off Saki Vihar Road,
Saki Naka, Andheri (East),
Mumbai – 400072, India.
TÜV SÜD South Asia Pvt. Ltd. https://www.tuvsud.com/en-in
Solitaire, 4th Floor,
ITI Road, Aundh,
Pune – 411007, India.