Form for Application to Vote by Post | ICAI Elections

Form for Application to Vote by Post | ICAI Elections : Last Date for Receipt of Application complete in all respect: 5th October, 2018

Form for Application to Vote by Post | ICAI Elections

The Institute of Chartered Accountants of India

Form of Application for permission to vote by post [See sub-rule (2) of Rule 28 of the Chartered Accountants (Election to the Council) Rules, 2006]

The Returning Officer, The Institute of Chartered Accountants of India, ICAI Bhawan, Indraprastha Marg, NEW DELHI 110002:

Sub: Elections 2018

Dear Sir, I hereby apply for permission to vote by post under sub-rule (2) of rule 28 of the Chartered Accountants (Election to the Council) Rules, 2006. I give below the following information/particulars for your perusal:-

1.	Full Name [As published in the List of Voters]
2.	Membership Number
3.	Serial Number in the List of Voters (If known)
4.	Address (As published in the List of Voters 2018 Copy available in the Headquarters of the Institute, its Regional Councils and Branches)
5.	Polling Booth Number allotted as per List of Voters - 2018
6.	Grounds on which permission to vote by post is being sought; i.e.   suffering from any permanent infirmity; or there has been a permanent change in address;   if so, whether you are in Service.   (Member in Service under the said Rules means, a member of the Institute who is employed in an organization not being a firm.)
7. (i)	Name and address of medical practitioner holding a position not below the rank of a Surgeon in Government Hospital together with full address of Government Hospital.
(ii)	(a) Name, designation and contact telephone/mobile number of the personnel authorized by the Organisation to issue proof of permanent change in address. (b) Full address of the organization
8.	(i) Nature of permanent infirmity:   (ii) Date from which suffering from permanent infirmity.   Or (i) Reason(s) for permanent change in the address, e.g. routine transfer, transfer on promotion, retirement, joining new organization and the like. (ii) Date on which permanent change in address took place (The date of permanent change should be a date after 1st April 2018) (iii) Details of changes i.e. new address

In support of my application, I enclose herewith Medical certificate confirming the above permanent infirmity issued by medical practitioner, namely, Dr. ___________________(who is not below the rank of a Surgeon in a Government Hospital). OR Proof of permanent change in address duly signed by authorized personnel of the organization in which I am employed. Place: Date:

Signature of the Member

VERIFICATION

I declare that the particulars given above are correct to the best of my knowledge and belief. I am aware that under sub-rule (4) of rule 28 of the said Rules, any misuse of the above concession or any mis-statement or false verification in this behalf shall attract disciplinary action against me under the Chartered Accountants Act, 1949 and the rules framed thereunder. Place: Date:

Signature of the Member

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