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Exam Passed MONTH & YEAR Roll No.

CPT 01, 2009 172277

The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /

ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2014

CANDIDATE DETAILS

Name of Candidate : SUNNY KUMARDOB: 28/08/1989 Gender : Male

Registration No : NRO0233125 E Mail : nitinbhatnagar2008@gmail.com

Applied Date: 18/08/2014 Control No: 4514078

Medium Opted : English Landline No: -

Exam Applied : Intermediate (IPCE) Group-I / ATE

Examination Centre : Delhi / New Delhi VIII

Center Code: 513

Mobile No : 9910656798

Father's Name: ANIL KUMAR

Conversion / Registration date of Intermediate(IPCC)/ATC: 27/01/2009 Revalidation Date: 27/01/2013

PIN :2808 Differently Abled :No

ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS (IF APPLICABLE)

PARTIAL INTERMEDIATE (PASSED ON OR AFTER NOVEMBER 1994)/ PEE-II/ PCE/ I(IPC)E EXAMINATION PASSING DETAILS

Exam Passed MONTH & YEAR Roll No.

EXEMPTION DETAILS OF EXEMPTION SECURED IN I(IPC)E/ATE

Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7

PAYMENT DETAILS

Total Amount: 1000 INR Transaction Date: 18/08/2014 Bank Transaction No: EFI_NRO0233125_1227104940

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The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /

ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2014

Registration No : NRO0233125 Control No: 4514078

DECLARATION BY THE STUDENT

1. I SUNNY KUMARson/daughter of ANIL KUMARrequest fo r permission to present myself at the Inte rmediate (IPC) /Accounting Technician Examination to be held in

NOVEMBER 2014 by the Institute of Chartered Accountants of India and hold valid registration for appearing in Intermediate(IPC) Examination to be held in

NOVEMBER 2014 .

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 IPCC.

3. I have passed the Common Proficiency Test (CPT) as well as Senior Secondary (10+2) Examination o r an examination recognized as equivalent the reto by the

Central Govt. and have registered for Intermediate (IPC) course / ATC on o r before 01st March, 2014 as pe r 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 Inte rmediate (IPC) course/ATC under the Direct Entry Scheme, under Graduate/Post Graduate category and commenced articled training on or be fore

01st February, 2014 & completed/would be completing 9 months of a rticled training (including 8 months of study course) as on 01st Nov, 201 4 as pe r article registration

letter received from the Regional office.

6. I converted to Intermediate (IPC) course /ATC from erstwhile Intermediate o r CPT or PE-II or PCC or IPCC,under Direct Entry Scheme, under Graduate /Post

Graduate category and commenced articled trainging on or before 01st February, 2014 & completed/would be completing 9 months of articled training (including 8

months of study course) as on 0 1st Nov, 2014 as per article registration letter received from the Regional o ffice.

7. I registered for Inte rmediate (IPC) course/ATC, under Direct Entry Scheme, having passed the Inte rmediate level examination of the Institute of Cost Accountan ts of

India/The Institute of Company Secretaries of India, on or before 01st March, 2014 and completed or would be completing 8 months study course 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, ha ving passed th e Inte rmediate

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 0 1st Nov, 2014 as per article registration letter received from the Regional office.

9. 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.

Signature of the candidate

(Sign within the box with black pen)

Paste firmly with glue or

adhessive like fevicol

(Do not staple) a recent

color photograph of size

3.5 X 4.5 cms

Name : SUNNY KUMAR

Address : RZ-C-116 DABRI EXTENTION EAST

NEAR MAMTA MEDICOS

NEW DELHI

DELHI, Pincode:110045

INDIA

I do hereby certify that the photograph affixed above is that of Mr./Ms SUNNY KUMARwho has signed in my presence.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:

Important: Please do not fold this document while postingName & Signature of the Member of ICAI/ Principal / Gazetted Officer

with Membership NO.& Office seal

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