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Application Format Chartered Engineer Certificate 01

This document is an application format for a Chartered Engineer Certificate from The Institution of Engineers (India). It requests factual information including previous receipt of a Chartered Engineer Certificate, payment of 11800 rupees for an Indian resident or 56250 rupees for a non-resident by NEFT/IMPS/DD, and confirmation of entitlement as a life member who has paid composite subscription dues. It collects applicant name, address, membership details, bank transfer details and scans of payment receipt for processing the certificate application.

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211 views

Application Format Chartered Engineer Certificate 01

This document is an application format for a Chartered Engineer Certificate from The Institution of Engineers (India). It requests factual information including previous receipt of a Chartered Engineer Certificate, payment of 11800 rupees for an Indian resident or 56250 rupees for a non-resident by NEFT/IMPS/DD, and confirmation of entitlement as a life member who has paid composite subscription dues. It collects applicant name, address, membership details, bank transfer details and scans of payment receipt for processing the certificate application.

Uploaded by

Campus Connect
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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APPLICATION FORMAT FOR CHARTERED ENGINEER CERTIFICATE

The Director (Membership) For Office Use Only


The Institution of Engineers (India)
8 Gokhale Road
Kolkata 700 020

Dear Sir,
You are requested to consider my application for issuing Chartered Engineered Certificate. I give below the
following factual information.
I had applied for a Chartered Engineers Certificate earlier and received the same. Please find the enclose
photocopy of the Certificate. Therefore an amount ` 11800 (` 56250 for members residing is abroad) is being paid by
NEFT/IMPS/Demand Draft (DD) details given below.
I hereby confirm that I am entitled for Chartered Engineer Certificate as I have compounded by annual subscription for
life/made full payment of the Composite Subscription as Clause 69(vi) of the Bye-Laws of The Institution of Engineers
(India)

My Membership Grade and Number is AM/M/F

Full Name (Block Letters) : ............................................................................................................................................

*Address (Block Letters) : .............................................................................................................................................

.............................................................................................................................................

. ......................................................................................... Pi n :

Phone/Mobile No. .............................. E-mail : ........................................................................

Bank details for NEFT/IMPS payment


Name of Beneficiary : The Institution of Engineers (India)
Address of Beneficiary : 8 Gokhale Road, Kolkata 700020
Name & Address of Bank : IDBI Bank, Siddha Point, Ground floor, 101 Park Street, Kolkata 700016
IFS Code : IBKL0000012
Bank Account No. : 012104000094674
After the payment is made kindly e-mail the scan copy of the receipt of the payment along with the application form at
[email protected] for further needful action.
Transaction date : D D M M Y Y
Transaction ID/UTR No./Payment Reference No. :- ________________________________________
Note:- In case of NEFT/Online Net Banking Transfer to IEI Account, please enclose the transaction slip generated.

NO NEED TO SEND ANY HARD COPY, IF THE PAYMENT MADE THROUGH NEFT/IMPS

________________________________________
Full Signature with Date

I am enclosing the scan image of bank transaction slip of ` 11800 (` 56250 for members residing in abroad).

*The Certificate will be sent to the address as recorded in our database. For any change in the address, please
login to our website to update your address or apply for the same.

Form No. MEMB/10


Rev. 08/13062018

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