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REGISTRATION FORM READING ROOM FOR CA STUDENTS A unit of Guwahati Branch of EIRC of ICAI Near Railway Gate No. 6 A T Road Guwahati - 781009 Tel 91 361 2207660 Mobile 91 9707078491 E-mail icai. Guwahati gmail.com visit us at www. guwahati-icai. org To The Officer-in-Charge Reading Room for CA Students PHOTO Dear Sir Please grant me permission for using the reading room for the period from to. I have read the terms and conditions for the use of the facility and agree to abide by the same. Please fill in BLOCK Letters only 1 Name of CA Student 2 Student Regn No* 3 Whether Undergoing Articleship Yes If yes please fill 4 and 5 below. No 4 Name of Principal 5 Membership Number only in case of student undergoing Articleship 6 Name of Local Guardian 7 Mobile No of Guardian 8 Residential Address City PIN State Country 9 Contact Information Phone No Mobile No Alt. No* Email All fields are Mandatory. I am enclosing herewith a fee of 500/- by Cash/ Demand Draft / Local Cheque vide No* dated on in favour of Guwahati Branch of EIRC of ICAI payable at Guwahati being advance fee for the month of. I declare that the information provided above is true and correct. Yours faithfully Date Signature. I have read the terms and conditions for the use of the facility and agree to abide by the same. Please fill in BLOCK Letters only 1 Name of CA Student 2 Student Regn No* 3 Whether Undergoing Articleship Yes If yes please fill 4 and 5 below. No 4 Name of Principal 5 Membership Number only in case of student undergoing Articleship 6 Name of Local Guardian 7 Mobile No of Guardian 8 Residential Address City PIN State Country 9 Contact Information Phone No Mobile No Alt. No 4 Name of Principal 5 Membership Number only in case of student undergoing Articleship 6 Name of Local Guardian 7 Mobile No of Guardian 8 Residential Address City PIN State Country 9 Contact Information Phone No Mobile No Alt. No* Email All fields are Mandatory. I am enclosing herewith a fee of 500/- by Cash/ Demand Draft / Local Cheque vide No* dated on in favour of Guwahati Branch of EIRC of ICAI payable at Guwahati being advance fee for the month of. No* Email All fields are Mandatory. I am enclosing herewith a fee of 500/- by Cash/ Demand Draft / Local Cheque vide No* dated on in favour of Guwahati Branch of EIRC of ICAI payable at Guwahati being advance fee for the month of. I declare that the information provided above is true and correct. Yours faithfully Date Signature. I have read the terms and conditions for the use of the facility and agree to abide by the same. Please fill in BLOCK Letters only 1 Name of CA Student 2 Student Regn No* 3 Whether Undergoing Articleship Yes If yes please fill 4 and 5 below. No 4 Name of Principal 5 Membership Number only in case of student undergoing Articleship 6 Name of Local Guardian 7 Mobile No of Guardian 8 Residential Address City PIN State Country 9 Contact Information Phone No Mobile No Alt. No* Email All fields are Mandatory. I am enclosing herewith a fee of 500/- by Cash/ Demand Draft / Local Cheque vide No* dated on in favour of Guwahati Branch of EIRC of ICAI payable at Guwahati being advance fee for the month of.

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