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Exam Passed MONTH & YEAR Roll No.

,

The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /

ACCOUNTING TECHNICIAN EXAMINATION - MAY 2014

CANDIDATE DETAILS

Name of Candidate : ARCHIT WATTSDOB: 30/05/1994 Gender : Male

Registration No : CRO0440172 E Mail : [email protected]

Applied Date: 01/03/2014 Control No: 4300711

Medium Opted : English Landline No: 0154 - 2480105

Exam Applied : Intermediate (IPCE) Both Groups

Examination Centre : Sriganganagar

Center Code: 446

Mobile No : 9509082399

Father's Name: ASEEM WATTS

Registration date of Intermediate(IPCC)/ATC/Inter/PEE-II/PCC: 06/08/2012 Revalidation Date: -

PIN :5099 Differently Abled :No

ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS

PARTIAL INTERMEDIATE/ PEE-II/ PCE/ IPCE EXAMINATION PASSING DETAILS

Exam Passed MONTH & YEAR Roll No.

EXEMPTION DETAILS OF EXEMPTION SECURED IN ERSTWHILE PCE

Month & Year Roll No P1 P2 P3 P4 P5 P6

EXEMPTION DETAILS OF EXEMPTION SECURED IN IPCE/ATE

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

PAYMENT DETAILS

Total Amount: 2100 INR Transaction Date: 01/03/2014 Bank Transaction No: EFI_CRO0440172_1310455008

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Registration No : CRO0440172 Control No: 4300711

DECLARATION BY THE STUDENT

1. I ARCHIT WATTSson/daughter of ASEEM WATTSrequest for pe rmission to present myself at the Inte rmediate (IPC) /Accounting Technician Examination to be held

in MAY 2014 by the Institute of Chartered Accountants of India.

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;

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 or before 01st September, 2013; 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) /Accounting Technician Course (ATC) and have completed 8 months from the

date of registration in Intermediate /PE II/ PCC.

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 August, 2013 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st May, 2014

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 August, 2013 & completed/would be completing 9 months of articled training (including 8 months

of study course) as on 01st May, 2014

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 September, 2013.

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 01st May, 2014.

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 : ARCHIT WATTS

Address : S/O MR.ASEEM WATTS

135-L BLOCK

SRIGANGANAGAR

RAJASTHAN, Pincode:335001

INDIA

I do hereby certify that the photograph affixed above is that of Mr./Ms ARCHIT WATTSwho 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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Registration No : CRO0440172 Control No: 4300711

DETAILS FOR DETERMINING ELIGIBILITY

(i) Registered For Intermediate (IPCC)/ATC on or before 01st September, 2013 based on having passed : CPT and 10+2 exam passed

CCT / ITT CERTIFICATE DETAILS

Certificate Name Certificate No. Dated

Orientation Completion Details

Completion Date :

**************************************************

Certificate of service:

For candidates who registered for/converted to Intermediate (IPC) course under the Direct Entry Scheme under the category

graduates/post graduates and commenced articleship on or before 01st August, 2013

I _____________________________________ hereby certify that Mr/Ms _____________________________________ is presently serving

under me as articled assistant and completed or will be completing 9 months of articled training as 01st May, 2014.

Student Regn. No:___________________________

Date: ___________________________

Place: __________________________ Signature of the articled assistant Signature of Principal

ICAI membership No. _____________________________

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