Request to Refund Course Fees Form - For (Either / Both) Parents Death Due To COVID-19
Important Instructions:
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1. All fields are mandatory
2. Death Certificate(s)/ Identity Proof to be Attested by one of the following:
-DCOs Heads/Regional Heads/Officer-in-charge of the Branch.
-Principal under whom such student is registered for Articleship
-Central Council Member / Regional Council Member / Managing Committee Member of the Branch.
Student Details - As per the SSP (Self Service Portal of ICAI)
Student Registration No. (SRN in SSP):
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Students Full Name (As per SSP):
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Date of Registration
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Applicable Date is 1st April 2020 (Onwards) (As per SSP): :
Select Course:
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--Select Course--
Foundation
Intermediate
Final
Mobile No. used for SSP Registration:
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Email ID used for SSP Registration:
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Father and Mother Details
Request Type:
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--Select Request Type--
FATHER
MOTHER
BOTH
Father's Name:
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Father's Date of Death:
As Mentioned in the Death Certificate:
Mother's Name:
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Mother's Date of Death:
As Mentioned in the Death Certificate
Bank Details for Refund
Name of the Account Holder:
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Bank Account No.:
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Bank Name:
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Bank IFSC Code:
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Account Type:
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--Select Account Type--
Savings
Current
Enclosure/Attachments
Upload Readable Death Certificate of Father in PDF/JPG:
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Upload Readable Death Certificates of Mother in PDF/JPG:
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Upload Readable Cancelled Cheque of the Bank Account Mentioned Above in PDF/JPG:
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Upload Readable Passing Certificate of Class X or XII in PDF/JPG:
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Upload Duly attested Identity Proof of Father / Mother in PDF/JPG:
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