SlAge:j yrs lsex: lUate

ffiT WTSTTRil MAHARf,SHTRA
TAIT PRAGTITIO
Pag
Taxes
e
1I
TBS' ASSOG IATIO]I
Yadav Vyapar Bhavan, Shivaji Road, 602, Shukrawar Peth,
Pune 411 002 Phone :O2O-2447 0237.
Not Less o Not More
For Office use only
Receipt No.
Date
Membership No.
Rs.-
Dues of lntroduce Member Yes / No
Accepted By the Managing Committee in the meeting held on
Signature
,APPLIC,ATION FOR MEMBERSHIP
1,'n"
Please Affix
:-ri,, l+Crctary,
The !\'estern Maharashtra Tax Practitioners,Associ ation,
Yadav Vyapar Bhavan, Shivaji Road,
6{!2, Shukrawar Peth, Pune 411 002.
Your Recent
Passport Size
Date:
Photograph
Dear Sin
. Being eligible to practice under the lncome Ta/ Sales Tax and Allied Laws. lAffe hereby apply for admission as a
member of THE WESTERN MAHARASHTRATAX PRACTITIONERS'ASSOCIATION with the f6lloi,vin-g particulars :
PERSONAL DETAILS
il
Full I'Jame: (Block Letters)
Surname
21
First Name
Middle Name
Office Address:
3j ltesrdential Address:
4l Phe'ne l!os,
:
(with STD Code)
Office
Fax
1)
:
2)
Mobile
5l E-mail
lD
Residence
:
:
1)
:
2)
{ilAddress fcr correspondence
:
(Please
Tick)
Office
Residence
7l Date of Birth
SlAge:j
1l EducationalLevel
yrs
:
B.Com
lsex:
lUate
Female
EDUCATIONAL QUALIFICATION
M.com.
C.A.:
:
Any Other
LL.B.
(Please Specifu)
\''*ar of Fassing the above Examination's:
2l Professional Level
:
Advocate
:
|
Cnmnanrrsanrofanr. I
|
C. A.
I ITP
:
S.T.P.:
nrr (-)fhor
I.C,W.A.
.
Dlaaca
Qaanifrr
DETAILS ABOUT PRACTICE
1l Date of Starting Practice:
2l I Practice in the following area
Excise
:,
:
lncome Tax
Auditing
Service Tax
VAT:
:
Custom
:
:
Any Other:
:
DETAILS OF PAYMENTS
Enclosed herewith please find a cheque / D.D. / Cash of
Vide Ch.
Dated
No.--
Rs.
( Rupees
Drawn on
Branch for the following.
Bank
Nlembership Fees (G.M. / L.M.)
Rs
Entrance Fees
Rs
Bulletin Fees
Rs
Total
Note
)
:
Rs
1l Cheque / Draft should be drawn in favour of "The Western Maharashtra Tax Practitioners Association"
ZiOut siation payment only by Demand Draft Payable at Pune.
INTRODUCED BY
Surname
( Name of the introducing WMTPA Member)
Address
:
ILM
L4ercb*rship [rlo. of W.M.T.P.A. GM
Ramark by Introducing Member (if any)
:
I i-ir*rei:y cieclare that no fees are outstanding with me.
Signature
VERIFICATION BY THE APPLICANT
do hereby declare that whatever stated herein above is true &
cir:-fect to the best of my knowledge and belief. I also undertake to abide by the rules Regulations and constitutions of the
/\ssociaticns as amended from time to time.
Thanking You,
Yours FaithfullY
Signature
(Applicants Name)
Er:ei. 1) Cash / Cheque t Draft as above 2) Xerox copies of educational qualifications.
3) Fractice Certificate Xerox copies - STP/lTPiAdvocate/C.A./Declaration with Affidavit etc.
MEMBERSHIP FEES
MEMBERSHIP FEES:
Life Member Rs 7500.00
Entrance Fees Rs 101.00
Bulletin Fees Rs 250.00
General Member Rs 1000.00 yearlY
VEenLV SERVTCE CHARGES FOR BULLETIN Rs. 25Ol- (For all Members)
STATUS OF MY MEMBERSHIP
in ease of Firm Membership the following person is nominated to represent the firm.
'i.; il4y Blood Group
: