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The Institute of Chartered Accountants of India

INTERMEDIATE ( INTEGRATED PROFESSIONAL COMPETENCE ) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2020 (Old Syllabus)

CANDIDATE DETAILS
Name of Candidate : SHUBHAM SHRIRAM KULKARNI
DOB: 23/02/1998 Gender : Male
Registration No : WRO0568581 E Mail : rskulkarni.70@gmail.com
Applied Date: 14/08/2020 Control No: 2204728355
Medium Opted : English Landline No: 020 - 24376326
Exam Applied : Intermediate (IPC) Group-II
Examination Centre : PUNE - I Center Code: 1064 2204728355
Mobile No : 9921223460
Father's Name: SHRIRAM
Registration date of Intermediate(IPC)/ATC:
Date of commencement of articleship
Group I/ATC : 06/02/2017
training: Nil
Group II : 06/02/2017
PIN : 1998 Differently Abled : NO
ENTRANCE/ FOUNDATION/ PEE-I/ CPT PASSING PARTICULARS (IF APPLICABLE)

Exam Passed MONTH & YEAR Roll No.

CPT 12, 2016 111038

PARTIAL INTERMEDIATE (PASSED ON OR AFTER NOVEMBER 1994)/ ERSTWHILE INTERMEDIATE/ IPCE/ PEE-II/ PCE/
INTERMEDIATE(IPC) EXAMINATION PASSING DETAILS
Exam Passed MONTH & YEAR Roll No.
EXEMPTION SECURED IN INTERMEDIATE(IPC)/ATE
Month & Year Roll No. P1 P2 P3 P4 P5 P6 P7
PAYMENT DETAILS May 2020 Control No.:1204103568

Total Amount: 0 INR Transaction Date: 14/08/2020 Bank Transaction No: EFIO_WRO0568581_alredypaid

DETAILS FOR DETERMINING ELIGIBILITY

(i) Registered For Intermediate (IPC)/ATC on or before 01st March, 2020 based on having passed : CPT & 10+2 exam passed
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The Institute of Chartered Accountants of India

INTERMEDIATE ( INTEGRATED PROFESSIONAL COMPETENCE ) EXAMINATION /
ACCOUNTING TECHNICIAN EXAMINATION - NOVEMBER 2020

Registration No : WRO0568581 Control No: 2204728355

DECLARATION
1. I SHUBHAM SHRIRAM KULKARNI son/daughter of SHRIRAM request for permission to present myself at the Intermediate (IPC) /Accounting Technician Examination to be held in NOVEMBER 2020 by the Institute of
Chartered Accountants of India and hold valid registration for appearing in Intermediate(IPC) Examination to be held in NOVEMBER 2020.
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 Intermediate(IPC). or
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 March, 2020 ; 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). or
5. I registered for Intermediate (IPC) course/ATC under the Direct Entry Scheme, under the Graduate/Post Graduate category & completed/would be completing 9 months of articled training (including 8 months of study
course) as on 01st November, 2020. or
6. I converted to Intermediate (IPC) course /ATC from erstwhile Intermediate or PE-II or PCC or IPCE,under Direct Entry Scheme, under the Graduate/Post Graduate category & completed/would be completing 9 months
of articled training (including 8 months of study course) as on 01st November, 2020 . or
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 March, 2020 and completed or would be completing 8 months study course as on 01st November, 2020 .
8. I converted to Intermediate (IPC) course /ATC, from erstwhile Intermediate/PE-II/PCC or IPCE, 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 November, 2020. or
9. I registered for Intermediate(IPC) through CPT route and appeared in the Intermediate(IPC) examination in one or both groups but did not qualify both the Groups or either of the Groups and converted to
Intermediate(IPC) course under the Direct Entry Scheme and commenced / would be commencing practical training on or before 31st October, 2020
10. I have registered for the group(s) / level in which I wish to appear in NOV 2020.
11. 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 : SHUBHAM SHRIRAM KULKARNI

Address : 10 B SHANKAR APT BALAJI NAGAR
DHANKAWADI
PUNE
MAHARASHTRA, Pincode: 411043
INDIA

Signature of the candidate

(Sign within the box with black pen)

I do hereby certify that the photograph and signature appearing above are that of Mr./Ms SHUBHAM SHRIRAM KULKARNI. 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
Important: Please do not fold this document while posting
Officer with Membership NO.& Office seal