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The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - MAY 2015

CANDIDATE DETAILS

Name of Candidate : YASH AJAYBHAI ACHARYA

DOB: 14/02/1996 Gender : Male

Registration No : WRO0489571 E Mail : ajay.acharya.128@gmail.com

Applied Date: 19/02/2015 Control No: 1154748983

Medium Opted : English Landline No: 0281 - 2459838

Exam Applied : Intermediate (IPCE) Both Groups

Examination Centre : Rajkot

Center Code: 143

Mobile No : 8758988959

Father's Name: AJAYBHAI

Conversion / Registration date of Intermediate(IPCC)/ATC: 18/02/2014 Revalidation Date: -

PIN :1234 Differently Abled :No

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

Exam Passed MONTH & YEAR Roll No.

CPT 12, 2013 119762

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: 1600 INR Transaction Date: 19/02/2015 Bank Transaction No: EFI_WRO0489571_1096015353
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The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - MAY 2015

Registration No : WRO0489571 Control No: 1154748983

DECLARATION BY THE STUDENT

1. I YASH AJAYBHAI ACHARYA son/daughter of AJAYBHAI request for permission to present myself at the Intermediate (IPC) /Accounting Technician Examination to
be held in MAY 2015 by the Institute of Chartered Accountants of India and hold valid registration for appearing in Intermediate(IPC) Examination to be held in MAY
2015.
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 or an examination recognized as equivalent thereto by the
Central Govt. and have registered for Intermediate (IPC) course / ATC on or before 01st September, 2014 as per 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 Intermediate (IPC) course/ATC under the Direct Entry Scheme, under the Graduate/Post Graduate category and commenced articled training on or
before 01st August, 2014 & completed/would be completing 9 months of articled training (including 8 months of study course) as on 01st May, 2015 as per article
registration letter received from the Regional office.
6. I converted to Intermediate (IPC) course /ATC from erstwhile Intermediate or CPT or PE-II or PCC or IPCC,under Direct Entry Scheme, under the Graduate/Post
Graduate category and commenced articled trainging on or before 01st August, 2014 & completed/would be completing 9 months of articled training (including 8 months
of study course) as on 01st May, 2015 as per article registration letter received from the Regional office.
7. I registered for Intermediate (IPC) course/ATC, under Direct Entry Scheme, having passed the Intermediate level examination of the Institute of Cost Accountants of
India/The Institute of Company Secretaries of India, on or before 01st September, 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, having passed the Intermediate
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, 2015 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.

Name : YASH AJAYBHAI ACHARYA

Address : KANKAI KRUPA

Paste firmly with glue or
6-13 JUNCTION PLOT
adhessive like fevicol RAJKOT
(Do not staple) a recent GUJARAT, Pincode:360001
color photograph of size INDIA
Signature of the candidate
3.5 X 4.5 cms
(Sign within the box with black pen)

I do hereby certify that the photograph affixed above is that of Mr./Ms YASH AJAYBHAI ACHARYA who 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:

Name & Signature of the Member of ICAI/ Principal / Gazetted Officer

Important: Please do not fold this document while posting
with Membership NO.& Office seal
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The Institute of Chartered Accountants of India

INTERMEDIATE (INTEGRATED PROFESSIONAL COMPETENCE) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - MAY 2015

Registration No : WRO0489571 Control No: 1154748983

DETAILS FOR DETERMINING ELIGIBILITY

(i) Registered For Intermediate (IPCC)/ATC on or before 01st September, 2014 based on having passed : CPT and 10+2 exam passed

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

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, 2014

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

under me as an articled assistant and completed or will be completing 9 months of articled training as 01st May, 2015.

Student Regn. No:___________________________

Date: ___________________________

Place: __________________________ Signature of the articled assistant Signature of Principal

ICAI membership No. _____________________________