Revalidatio.pdf
Transcript of Revalidatio.pdf
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CMA BHAWAN, 12 SUDDER STREET, KOLKATA-700016
FORM OF APPLICATION FOR REVALIDATION
ToThe Secretary to the Council ofTHE INSTITUTE OF COST ACCOUNTANTS OF INDIACMA Bhawan, 12, Sudder Street, Kolkata - 700 016
APPLICATION NO. RV0000280REGISTRATION NO. 11021001606
Sir/Madam,
I beg to apply for Revalidation as a student of the Institute of Cost Accountants of India, The required particulars are furnished below:
Name in Full : THORAT PRAVIN LAXMANAddress : A-1,SHIVRATNA IMAGE DHYARI NARHG ROAD NEAR IARI CO OPP FOHIGH BILLSS
State : MAHARASHTRA City : PUNE Pin Code : 411041
Date of Birth : 25/06/1979
Email : [email protected] Mobile : 8983248638
Group : Group-IV Institute Name : WESTERN INDIA REGIONAL COUNCIL
Payment Details
Payment Mode Transaction/Instrument No Transaction/Instrument Date Drawn on/Bank Deposited Branch AmountDebit/Credit 94254107 05/08/2015 HDFC 1011
I hereby declare that particulars furnished above are correct and complete to the best of my knowledge.
Place : PUNE Signature:
Date : 02/05/2014
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