EAST DELHI C.A. CPE STUDY CIRCLE OF NIRC OF ICAI Head Office: 413, Vikas Deep, Laxmi Nagar District Centre, Delhi – 110092, Tel.: 011- 22437235(O), 011-22430486 (O) 9311075092 (M) Tel: 9873286967 (M), 9582101001 (M) Email:
[email protected], W: www.eastdelhistudycircle.com
MEMBERSHIP FORM: (CALENDER YEAR - 2017) Receipt No (For Office Purpose Only)
Serial No. Please Affix Passport Photograph
(For Office Purpose Only)
Name of the Member Name of the Company/ Firm Firm Reg Number & Year of Establishment(as per ICAI)(If any) Membership No Address Mobile Telephone E-mail Address Date Of Birth Whatsapp Update (Yes/No) Number of partners Mode of payment
(Details as per separate sheet attached)
CASH Cheque / DD No.
CHEQUE PAYMENT
Issue Date
BANK TRANSFER
Drawing Bank
Amount (Rs.)
Area Of Interest
Date : MEMBERSHIP FEES : (CALENDER YEAR - 2017) -Individual Rs.3,000/= -Firm Rs.5,500/= (Two Partners) Rs.8,000/= (Three Partners) Rs.10,000/= (Four Partners) Rs.12,000/= (Five Partners) Rs.15,000/= (Six or more Partners)
Signature
Note: ALL CORRESPONDENCE WILL BE DONE AT THE ADDRESS PROVIDED ABOVE ONLY Note: PLEASE ISSUE CHEQUE IN FAVOUR OF "EAST DELHI CA CPE STUDY CIRCLE"