Print

Applicationformatforseekingcertifiedcopies/inspectionofevaluatedanswerbooks(Necessarilyinexaminee's
ownhandwriting)
TheDeputySecretary(Exams)
TheInstituteofCharteredAccountantsofIndia
Date:
ICAIBhawan,IndraprasthaMarg
NewDelhi110002.

DearSir
Iherebyapplyforthefollowing:
Nameofthecandidate:

Contactno:STDCode:LandlineNo: Mobile:Email:
Addressforcorrespondence:
StudentRegistrationNo:

Examination:CPT/Intermediate(IPC)/ATE/Units/Final/ISAAT/IRM/ITL&WTO/MAC/CMC/TMC

Month:Year:RollNo:
Particularsofanswerbooks,ofwhich,youwishtoseek(selectOne): CertifiedCopies Inspection

PaperNo. NameoftheSubject

DetailsofFeespaid(forOfflineApplication):DDNo:_________________________Date:____________

Drawnon:__________________ForRs.__________________

Declaration:
Iherebydeclareandaffirmthatthedetailsmentionedaboverelatetomeonlyandaretruetothebestofmyknowledge
andbelief.
IherebydeclarethatIhavereadandunderstoodthetermsandconditionsoftheschemeframedbytheICAIregarding
providinginspection/certifiedcopiesofevaluatedanswerbooksandthatIshallabidebytheminletterandspirit.
Iamseekinginspection/certifiedcopiesofmyevaluatedanswerbooksformyownacademicguidanceandshallnotuse
them,foranyotherpurpose.
Iunderstandthatthecertifiedcopiessoobtainedbymeshallbeformyexclusiveuse.Ishallbethesolecustodianofthe
copiesoftheevaluatedanswerbooksasandwhentheyaremadeavailabletomebytheInstituteandIshallnotunder
anycircumstancespartwiththecustody/possessionofthesameandshallnotusethesameforanyotherpurpose/s.

Date: Signatureofcandidate

Place: Name: