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Group Name Exam Passed MM YYYY Roll No

Group I PE-II 11 2007 39333

Group II PE-II 11 2007 39333

Group Name MM YYYY Roll No Result

ONLINE FORM

The Institute of Chartered Accountants of India

FINAL EXAMINATION - MAY 2012

CANDIDATE DETAILS

Name of Candidate : JYOTI AGRAWAL

DOB : 05/12/1986 Gender : Female

Registration No : CRO0178363 Group Applied: Second

Applied Date : 06/02/2012 Control No: 8704580

Medium Opted : English Landline No: 0565 - 2460525

Examination Centre : Mathura E Mail : [email protected]

Mobile No : 9897402323 Old Article Registration Number :

Father's Name: DINESH KUMAR AGARWAL 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

LAST APPEARANCE DETAILS OF FINAL EXAM

PASSING DETAILS OF FINAL (IF APPLICABLE)

Group MM YYYY Roll No.

EXEMPTION DETAILS

Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7 P8

ELIGIBILITY CERTIFICATE DETAILS

Eligibility Certificate No. Dated:

PAYMENT DETAILS

Total Amount: 1250 INR Transaction Date: 06/02/2012 Bank Transaction No: EFF_CRO0178363_1378628186

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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.

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 : JYOTI AGRAWAL

Address : D/O SHRI DINESH KUMAR AGARWAL

30 TEACHERS COLONY STREET NO-

2

BAJARANG CHAURAHA MAHOLI

ROAD

MATHURA

UTTAR PRADESH

Pincode: 281001

INDIA

Date:Name and Signature of the

Principal with Membership No

Place:

(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




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:---------------------- Signature of the articled/audit assistant Signature of Principal/Member

Place:---------------------- 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:---------------------- Signature of the articled/audit assistant Signature of Principal/Member

Place:---------------------- Membership No--------------------------

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ONLINE FORM




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 31/2 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.



Date.-------------------------- Signature of the articled/audit assistant Signature of Principal/Member

Place:------------------------ 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.



Date.-------------------------- Signature of the articled/audit assistant Signature of Principal/Member

Place:------------------------ 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.

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