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IRM Examination Application Form May - 2013
February, 07th 2013
                      The Institute of Chartered Accountants of India
           POST QUALIFICATION COURSE IN INSURANCE AND RISK MANAGEMENT
                                       Technical Examination, May, 2013
                               (Under Schedule 'G' of the Chartered Accountants Regulations, 1988)
                                   Last Date : 27th February, 2013 (Without late fee)
Cost of Application Form : Rs100/- 6th March, 2013 (With late fee of 500/-)
            NOTES FOR INFORMATION AND GUIDANCE OF APPLICANTS
                         Candidates are advised to carefully read, understand and follow the
                    instructions while filling in the Form and retain the same for future reference
(1) Dates of Examination          10th, 12th, 14th and 16th May, 2013
(2)   Timings of Examination             02.00 p.m. to 5.00 p.m. (IST)
(3)   Subject :                          1
      Module - I                         Principles and Practice of Insurance
      Module - II                        Technical Aspects of Insurance
      Module - III                       Risk Management and Reinsurance
      Module - IV                        Business Strategic Planning & Information Technology
(4)   Last date for receipt of              27th February, 2013 (Without late fee)
      application at the Institute's        6th March, 2013 (With late fee)
      Headquarters at New Delhi.         (Application received after 6th March, 2013 will not be entertained under any circumstances.
 



Therefore, candidates sending their application by Post must send the same at least 3-4 days in advance of the last date and avoid sending it on the last date for receipt of application forms). (5) Examination Fee 1000/- (Rupees One Thousand Only) without Late Fee (Note : Candidates are advised 1500/ (Rupees One Thousand Five Hundred Only) with Late Fee not to send any fee other than 100/- (Rupees One Hundred Only) extra if the examination form is downloaded examination fee along with the from Institute's website. Examination Application Form) (6) Mode of Payment of Fee The Examination Fee should be paid only by way of Demand Draft which may be of any Scheduled Bank. Drawn in favour of "The Secretary, The Institute of Chartered Accountants of India" and should be payable at New Delhi only. Candidates are advised to furnish the following details on the reverse of the Demand Draft in their own interest. Name IRM Registration No. Examination Application form No. Centre Opted (7) Filling up of Admit Card Candidates are required to fill in the relevant columns in the Admit Card and submit the same to the Examination Department alongwith the examination form. (8) Examination Centres 1. Agra 25. Bhilwara 49. Gwalior 73. Kumbakonam 97. Patna 121. Sri Ganganagar 2. Ahmedabad 26. Bhiwani 50. Hisar 74. Latur 98. Patiala 122. Surat 3. Ahmednagar 27. Bhopal 51. Hubli 75. Lucknow 99. Pimpri-Chinchwad 123. Surendranagar 4. Ajmer 28. Bhubaneswar 52. Hyderabad 76. Ludhiana 100. Pondicherry 124. Thane 5. Akola 29. Bhuj 53. Indore 77. Madurai 101. Pune 125. Thiruvananthapuram 6. Alappuzha 30. Bikaner 54. Jabalpur 78. Mangalore 102. Raipur 126. Thrissur 7. Aligarh 31. Bilaspur 55. Jaipur 79. Mapusa (Goa) 103. Rajamahendravaram 127. Tinsukia 8. Allahabad 32. Chandigarh 56. Jalandhar 80. Margao (Goa) 104. Rajkot 128. Tiruchirapalli 9. Alwar 33. Chennai 57. Jalgaon 81. Mathura 105. Ranchi 129. Tirupati 10. Ambala 34. Coimbatore 58. Jammu 82. Meerut 106. Ratlam 130. Tirupur 11. Amravati 35. Cuttack 59. Jamnagar 83. Moradabad 107. Rewari 131. Tuticorin 12. Amritsar 36. Dehradun 60. Jamshedpur 84. Mumbai 108. Rohtak 132. Udaipur 13. Anand 37. Delhi/New Delhi 61. Jind 85. Muzaffarnagar 109. Rourkela 133. Udupi 14. Asansol 38. Dhanbad 62. Jodhpur 86. Mysore 110. Saharanpur 134. Ujjain 15. Aurangabad 39. Durg 63. Kakinada 87. Nagpur 111. Salem 135. Vadodara 16. Bangalore 40. Ernakulam 64. Kanpur 88. Nanded 112. Sambalpur 136. Vapi 17. Bareilly 41. Erode 65. Karnal 89. Nashik 113. Sangli 137. Varanasi 18. Bathinda 42. Faridabad 66. Kishangarh 90. Navsari 114. Satara 138. Vellore 19. Beawar 43. Gandhidham 67. Kollam 91. Nellore 115. Shimla 139. Vijayawada 20. Belgaum 44. Ghaziabad 68. Kolhapur 92. Noida 116. Sikar 140. Visakhapatnam 21. Bellary 45. Gorakhpur 69. Kolkata 93. Palghat 117. Siliguri 141. Yamuna Nagar 22. Berhampore 46. Guntur 70.. Kota 94. Pali Marwar 118. Sirsa 23. Bharauch 47. Gurgaon 71. Kottayam 95. Panipat 119. Solapur 24. Bhavnagar 48. Guwahati 72. Kozhikode 96. Panvel 120. Sonepat (9) How the application form The application form together with Demand Draft for 1000/- or 1500/-, as the case may be, of should reach the Institute? any Scheduled Bank be sent by Speed Post / Registered Post Only in the special envelope attached to this Form to the Additional Secretary (Exams.), The Institute of Chartered Accountants of India, ICAI Bhawan, Indraprastha Marg, New Delhi-110 002. Candidates are advised to retain the receipt issued by Post Office till the receipt of Admit Card. Candidates are advised not to send the application through courier. Candidates should not submit / send the application forms to regional / branch offices of the Institute. (10) Eligibility Certificate A list of candidates eligible to appear for IRM Course Technical Examination May, 2013 will be hosted by the Committee on Banking, Insurance and Pension on the Website of the Institute www.icai.org Candidates who are not in receipt of Eligibility Certificate are advised, in their own interest, to pursue their case with the office of the Committee on Banking, Insurance and Pension, The Institute of Chartered Accountants of India, Indraprastha Marg, New Delhi - 110 002 so as to obtain Eligibility Certificate. Candidates may submit the Examination Application Form, pending receipt of Eligibility Certificate by them, in case, they have otherwise fulfilled the requisite eligibility criteria. Special Note: There will no change in the examination schedule even if any examination day is declared as a Public Holiday by Central Government or any State Government. (11) Admission to the IRM No. candidate shall be admitted to the IRM Technical Examination unless Technical Examination he / she obtains the Eligibility Certificate from the Committee on Banking, Insurance and Pension of the Institute. (12) Issue of Admit Card (a) A list of Candidates to whom the Admit Cards have been issued for the IRM Course Technical Examination will be hosted on the Institute's website www.icai.org. from 18th April, 2013. All correspondences in the above matter should be addressed to the Additional Secretary (Exams.) of the Institute at New Delhi quoting the following for prompt action. IRM Regn. No. Examination Application Form No. Receipt No. Issued (if any) Name of the Centre Opted Telephone No. Fax No. E-mail (b) In Case of any difficulty, Additional Secretary (Exams.), ICAI, C-1 Sector-1, Noida should be contacted on Fax No. 0120-3054841 and 3054843. Helpline Desk telephone Nos. 0120-3054851, 3054852, 3054853, 3054836 and 3054842 (13) Record of answer book tendered The Superintendents of Examination Centres are being advised to issue receipt at the Examination Centre. for the answer books handed over through the Invigilator in the Admit Card. Candidates are, therefore, advised to secure the signature of the Invigilator concerned while submitting their answer books and retain the Admit Card with themselves as record of receipt, at least till the declaration of result. (14) Requirement for passing the IRM A candidate for the Insurance and Risk Management Technical Examination Technical Examination shall be declared ordinarily to have passed the examination if he / she secures at one sitting a minimum of 40% marks in each of the papers and 50% marks in the aggregate of all the papers. (15) Issue of Statement of Marks Statement of Marks will be issued to all the candidates who appeared in IRM Technical Examination normally in two weeks' time from the date of declaration of result. (16) Check-list to ensure correctness of Candidates are requested to ensure that the Application is filled in correctly enclosures to the Application giving all the required details and the following enclosures are annexed securely. Demand Draft for ........................................ Application Form Admit Card with self attested photo Self-addressed Envelope for sending Admit Card. Self addressed envelope for sending statement of marks. Address Slip Copy of the membership Certificate. Before sending the application, candidates are requested to arrange serially the pages of application keeping the demand draft, admit card and envelopes on the Top of the Bunch. (17) Verification of answer book(s) After declaration of result, in accordance with Para 9(4) of Schedule-G to the Chartered Accountants Regulations, 1988, a candidate may, if he/she so desires, apply for verification of his/her answer book(s), necessarily in his/her own handwriting within one month from the date of declaration of result. The verification fee is 500/- payable by way of a demand draft drawn in favour of Secretary, The Institute of Chartered Accountants of India, payable at New Delhi. There is no standard application form for verification. Typewritten request will not be entertained. (18) Refund of fee The Fee once paid by a candidate shall not be refunded / adjusted under any circumstances except as provided in Sub Para (2) of Para 8 of schedule G of the CA Regulations 1988. No correspondence in this regard shall be entertained. PLEASE NOTE: a) Application should be complete in all respects, otherwise it is liable to be rejected. b) In the event of furnishing any incorrect information / misrepresentation, the admission shall become invalid. c) No correspondence in this regard shall be entertained. INSURANCE AND RISK MANAGEMENT Self Attested Passport Size Control No. Roll No. LATEST PHOTOGRAPH (to be affixed by the office) to be pasted here. POST QUALIFICATION COURSE IN (Please do not staple) Insurance and Risk Management Technical Examination, May, 2013 The Institute of Chartered Accountants of India (Please fill in the form carefully as per instructions overleaf) I. DEMAND DRAFT DETAILS D D MM YEAR 1) DATE (Specimen Signature of the Candidate) 2) AMOUNT (Rupees) Downloaded Form Without Late Fee With Late Fee 3) DRAWEE BANK 4) DEMAND DRAFT NO. 5) PAYABLE AT N EW D E L H I II. APPLICANT DETAILS (IN BLOCK LETTERS) 1) NAME (MR/MS.) : (as appearing on Certificate of Membership) 2) FATHER'S NAME (Shri) (as appearing on Certificate of Membership) Attach a photocopy of the membership certificate 3) CITY OF YOUR PROFESSIONAL ADDRESS (for use in Pass Certificate) 4) MEMBERSHIP NO. 5) GENDER MALE FEMALE 6) IRM REGISTRATION NO. D I R M / / 7) CENTRE OPTED D D MM YEAR 8) ELIGIBILITY CERT. NO. & DATE OF ISSUE 9) ADDRESS FOR COMMUNICATION (IN BLOCK LETTERS) CITY PIN STATE TEL. : STD CODE NUMBER MOBILE NO. 0 10) E-MAIL ADDRESS I request for permission to present myself for the Insurance and Risk Management Course Technical Examination to be held in May, 2013 conducted by the Institute of Chartered Accountants of India. I solemnly affirm that the above facts and information are complete and correct to the best of my knowledge and belief. I also undertake to abide by the Chartered Accountants Regulations, 1988 framed by the Council for the guidance of candidates appearing for the Insurance and Risk Management Technical Examination. Encls.: 1. Demand Draft. Yes No 2. Copy of evidence of membership. Yes No 3. Admit Card Proforma. Yes No 4. Envelope for Admit Card. Yes No (Full Signature of Candidate) 5. Envelope for Statement of Marks. Yes No 6. Address slip. Yes No Date.......................................... P.T.O. HOW TO FILL-IN FORM I. 1. Kindly write the date of issue of demand draft. 2. Write amount of fee paid. Please also ( ) the relevant box. (Fee is 1000/- without late fee and 1500/- with late fee. Please add 100/- if the form is downloaded from the Institute's website). 3. Write name of the Bank. 4. Write number of the Demand Draft. 5. Demand Draft should be drawn in favour of "The Secretary, The Institute of Chartered Accountants of India" and payable at New Delhi only. II. 1. Kindly write your name exactly as recorded in the Register of Members i.e. Membership Certificate.. 2. Write the name of your father exactly as appearing in the Membership Certificate. Married female members are to write Father's Name only. 3. Write the name of the place you belong to. The same will appear on the pass certificate issued to all the pass candidates. 4. Write your membership number. Kindly take special care to write your correct membership number. 5. Tick the appropriate box. 6. Supposing your registration number is DIRM/S/00718, Fill in like : D I R M / S / 0 0 7 1 8 7. Write the name of a city from amongst the list of centres as given in Col.8 of "Notes for Information and Guidance of Applicants: from where you wish to write the IRM Technical Examination. 8. Write the No. and Date of Eligibility Certificate, as recorded on the Eligibility Certificate issued to you by the Committee on Banking, Insurance and Pension. 9. Write your complete postal address, very clearly in Capital Letters for mailing Admit Card, Pass Certificate, Correspondence, if any. 10. Write your E-mail address for our records / use. 11. Write your Phone No. Enclosures : Please attach (i) demand draft (ii) copy of evidence of being a member of ICAI (iii) Admit card proforma (iv) Envelope for Admit Card (v) Envelope for Statement of Marks and (vi) Address Slips. Please tick in relevant boxes. Address Slip Address Slip (Please fill in Name & Address) (Please fill in Name & Address) THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA (Examination Department) ICAI Bhawan, Indraprastha Marg, New Delhi - 110 002 IRM LATEST ADMIT CARD (DUPLICATE) Roll No. PHOTO IRM TECHNICAL EXAMINATION-May, 2013 ONLY (To be filled in by the Candidate in BLOCK LETTERS) Candidate should affix Name of the Candidate ......................................................................................... self attested photograph which should be pasted in Membership No. ................................................................................................... this space and not merely I.R.M. Regn. No. .................................................................................................. stapled. Centre : City : ....................................................................................................... Specimen Signature of the Candidate .................................................................. Venue of the examination : (To be filled by the office) Additional Secretary (Exams.) The Institute of Chartered Accountants of India THE INSTITUTE OF CHARTERED ACCOUNTANTS OF INDIA (Examination Department) ICAI Bhawan, Indraprastha Marg, New Delhi - 110 002 IRM LATEST ADMIT CARD Roll No. PHOTO IRM TECHNICAL EXAMINATION-May, 2013 ONLY (To be filled in by the Candidate in BLOCK LETTERS) Candidate should affix Name of the Candidate ......................................................................................... self attested photograph which should be pasted in Membership No. ................................................................................................... this space and not merely I.R.M. Regn. No. .................................................................................................. stapled. Centre : City : ....................................................................................................... Specimen Signature of the Candidate .................................................................. Venue of the examination : (To be filled by the office) Additional Secretary (Exams.) The Institute of Chartered Accountants of India Record of Answer Books tendered at the examination centre Day & Date of Examination IRM Technical Name of the Signature of the Invigilator in Afternoon Session Examination Invigilator confirmation of receipt of (02.00 p.m. to 5.00 p.m.) (IST) Papers answer book Friday Module-I 10th May, 2013 Principles and Practice of Insurance Sunday Module-II 12th May, 2013 Technical Aspects of Insurance Tuesday Module-III 14th May, 2013 Risk Management and Reinsurance Thursday Module-IV 16th May, 2013 Business Strategic Planning & Information Technology Special Note: There will be no change in the examination schedule even if any examination day is declared as a Public Holiday by Central Government or any State Government. Record of Answer Books tendered at the examination centre Day & Date of Examination IRM Technical Name of the Signature of the Invigilator in Afternoon Session Examination Invigilator confirmation of receipt of (02.00 p.m. to 5.00 p.m.) (IST) Papers answer book Friday Module-I 10th May, 2013 Principles and Practice of Insurance Sunday Module-II 12th May, 2013 Technical Aspects of Insurance Tuesday Module-III 14th May, 2013 Risk Management and Reinsurance Thursday Module-IV 16th May, 2013 Business Strategic Planning & Information Technology Special Note: There will be no change in the examination schedule even if any examination day is declared as a Public Holiday by Central Government or any State Government. Statement of Marks SPEED POST Affix Stamp for 39/- or IRM as applicable for speed post from New Delhi to your place To Pin If undelivered please return to : THE ADDITIONAL SECRETARY (EXAMINATIONS) The Institute of Chartered Accountants of India ICAI Bhawan, Indraprashta Marg New Delhi - 110 002 SPEED POST Affix Stamp for 39/- Admit Card - Insurance and Risk Management Technical Examination or May, 2013 as applicable for speed post from New Delhi To to your place City Pin State THE ADDITIONAL SECRETARY (EXAMINATIONS) The Institute of Chartered Accountants of India ICAI Bhawan, Indraprashta Marg, New Delhi - 110 002 SPEED POST / REGISTERED To The Additional Secretary (Examinations) IRM The Institute of Chartered Accountants of India ICAI Bhawan Indraprastha Marg New Delhi - 110 002 From :
 
 
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