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ONLINE FORM
The Institute of Chartered Accountants of India FINAL EXAMINATION - MAY 2012
CANDIDATE DETAILS Name of Candidate : JYOTI AGRAWAL DOB : 05/12/1986 Registration No : CRO0178363 Applied Date : 06/02/2012 Medium Opted : English Examination Centre : Mathura Mobile No : 9897402323 Father's Name: DINESH KUMAR AGARWAL Gender : Female Group Applied: Second Control No: 8704580 Landline No: 0565 - 2460525 E Mail : jyoti05.2011@gmail.com Old Article Registration Number : Date of Registration to Final : 28/08/2008 PIN: 2834

STATUS OF COMPLETION OF ARTICLE TRAINING CAT II - PE-II : Completed/Completing 3 years of articleship training (including excess leave, if any) as on 30th April, 2012

INTERMEDIATE / PE-II / PCE / IPCE PASSING DETAILS Group Name Group I Group II Exam Passed PE-II PE-II MM 11 11 YYYY 2007 2007 Roll No 39333 39333

LAST APPEARANCE DETAILS OF FINAL EXAM Group Name MM YYYY Roll No Result

PASSING DETAILS OF FINAL (IF APPLICABLE) Group EXEMPTION DETAILS Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7 P8 MM YYYY Roll No.

ELIGIBILITY CERTIFICATE DETAILS Eligibility Certificate No. PAYMENT DETAILS Total Amount: 1250 INR Transaction Date: 06/02/2012 Bank Transaction No: EFF_CRO0178363_1378628186 Dated:

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The Institute of Chartered Accountants of India

FINAL EXAMINATION - MAY 2012

Registration No : CRO0178363

Control No: 8704580

DECLARATION BY THE STUDENT I request for permission to present myself at the Final Examination to be held in MAY 2012 conducted by the Institute of Chartered Accountants of India. I declare the facts and information provided above 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 situation. Name Address Paste firmly with glue or adhessive like fevicol (Do not staple) a recent Signature of the candidate (Sign within the box with black pen) color photograph of size 3.5 X 4.5 cms : : JYOTI AGRAWAL D/O SHRI DINESH KUMAR AGARWAL 30 TEACHERS COLONY STREET NO2 BAJARANG CHAURAHA MAHOLI ROAD MATHURA UTTAR PRADESH Pincode: 281001 INDIA

Date: Place:

Name and Signature of the Principal with Membership No

(I do hereby certify that the photograph affixed above is that of Mr./Ms JYOTI AGRAWAL) 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) Enclosures: Certificate of service Important: Please do not fold this document while posting

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ONLINE FORM
The Institute of Chartered Accountants of India FINAL EXAMINATION - MAY 2012

Registration No : CRO0178363 Control No: 8704580

CERTIFICATE OF SERVICE 1. Article Ship Completion Declaration Old Article Reg No : New Unique Regn. No:

I -----------------------------------hereby declare that I have completed the prescribed period of 3 years / 3 1/2 Years of practical training (including excess leave, if any) on ------------------ as an Articled / Audit assistant. A certified true copy of the confirmation later dated ---------------issued by the Institute's office in this regards is enclosed Date: ---------------------Place :-------------------------------------------------Signature of the Candidate

2. For candidates who are presently in service and due to complete 3 years / 3 1/2 years of training (including excess leave if any) on or before 30th April, 2012. I -----------------------------------------------hereby certify that Shri/Ms----------------------------------------------is presently serving under me as an articled assistant /audit assistant and his/her due date of completion (including excess leave if any) will be -----------------------------------------------on or before 30th April, 2012,as per deed of articles. Old Article Regn.No.-------------------------New Unique Regn.No.-------------------------Date:---------------------Place:----------------------------------------------------------Signature of the articled/audit assistant ------------------------------Signature of Principal/Member ICAI Membership No---------------------

3 For candidates who are presently in service, serving the last twelve months of training as on 1st May, 2012 and due to complete 3 years / 3 1/2 years of training (including excess leave, if any)on or before 30th April, 2013. I ----------------------------------------------------hereby certify that Shri/Ms--------------------------------------------presently serving under me as an articled assistant/audit assistant, will be in service as on 1st May, 2012 serving the last twelve months of training and his/her due date of completion (including excess leave,if any)will be ---------------------------------------------i.e. on or before 30th April, 2013 as per deed of articles. Old Article Regn.No.-------------------------New Unique Regn.No.-------------------------Date:---------------------Place:----------------------------------------------------------Signature of the articled/audit assistant ------------------------------Signature of Principal/Member Membership No--------------------------

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ONLINE FORM
The Institute of Chartered Accountants of India FINAL EXAMINATION - MAY 2012

Registration No : CRO0178363

Control No: 8704580

CERTIFICATE OF SERVICE 4 For candidates who are presently in service, serving the last six months of training as on 1st May, 2012 and due to complete 3 1/2 years of training (including excess leave, if any) on or before 31st October, 2012. I ----------------------------------------------------hereby certify that Shri/Ms--------------------------------------------presently serving under me as an articled assistant/audit assistant, will be in service as on 1st May, 2012 serving the last six months of training and his/her due date of completion (including excess leave, if any)will be ---------------------------------------------i.e. on or before 31st October, 2012 as per deed of articles. Old Article Regn.No.-------------------------New Unique Regn.No.-------------------------Date.-------------------------Place:------------------------------------------------------------Signature of the articled/audit assistant ------------------------------Signature of Principal/Member ICAI Membership No--------------------------

5 For candidates who are presently in service, serving the last six months of training as on 1st May, 2012 and due to complete 3 years of training (including excess leave,if any)on or before 31st October, 2012. I ----------------------------------------------------hereby certify that Shri/Ms--------------------------------------------presently serving under me as an articled assistant/audit assistant, will be in service as on 1st May, 2012 serving the last six months of training and his/her due date of completion (including excess leave, if any)will be ---------------------------------------------i.e. on or before 31st October, 2012 as per deed of articles. Old Article Regn.No.-------------------------New Unique Regn.No.-------------------------Date.-------------------------Place:------------------------------------------------------------Signature of the articled/audit assistant ------------------------------Signature of Principal/Member ICAI Membership No--------------------------

ATTENTION STUDENTS
Candidates who have already completed 2 or 3 years of training and have taken termination due to any reason are advised, in their own interest to register their balance period of training with the Institute well before the commencement of examination i.e 1st May, 2012 so that they are in service as on 1st May, 2012 failing which admission to the examination will not be granted. A candidate who is otherwise eligible to appear in the Final Examination shall not be required to be in the service of articles/audit training on the first day of the month in which the final examination is held.However such relaxation shall be confined only to first of such permissible examination (i.e the Final Examination in which a student shall become eligble to appear in the Final Examination for the first time only but not thereafter), irrespective of whether he is from the stream of Professional Education Examination - II(PEE-II) or Professional Competence Examination (PCE) or Integrated Professional Competence Examination (IPCE) under the provisions of Regulation 29 C of the Chartered Accountants Regulations 1988.