(Annexure-I)
Application for Empanelment as a Valuer
To
Affix Passport
size colour
Photograph and
sign across
Subject: Application for empanelment as a valuer
IBBI Registration No.(if applicable);
Registered under Sec 34AB of Wealth Tax Act 1957, if yes, Wealth Tax
Registration No:
Sir/ Madam,
I, being an individual/ proprietor/ partner/ director (strike off whichever is not
applicable), hereby apply for empanelment as a valuer for the following class(es) of
assets :-
(a) ________________
(b) ____________________
(c) ____________________
(d) ____________________
The details are as under:
A. DETAILS OF THE FIRM/ PARTNERSHIP ENTITY/ COMPANY (if applicable)
1. Name:
2. Registration Number/ LLP Number/CIN Number:
3. PAN No.:
4. GST No.
5. Address for Correspondence or registered office:
6. Permanent Address:
7. E-Mail Address
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8. Telephone No.:
Others:
B. PERSONAL DETAILS OF INDIVIDUAL/ PROPRIETOR/ EACH
PARTNER/DIRECTOR:
Title (Mr/Mrs/Ms):
1. Name:
2.
3.
4. Date of Birth:
5. Registration with CBDT under Wealth Tax Act, 1957 YES / No.
If yes, (Registration No. & Date, of Individual/ all the Partners (in case of
Partnership Firm)
6. PAN No.:
7. AADHAAR No.:
8. Passport No.:
9. GST No.
10. Address for Correspondence:
11. Permanent Address:
12. E-Mail Address:
13. Mobile No.
14. Others
C. EDUCATIONAL, PROFESSIONAL AND VALUATION EXAMINATION
QUALIFICATIONS:
1. Educational Qualifications
[Please provide educational qualifications from degree onwards for
Individual/ proprietor/ each partner/director]
Educational Year of Marks (percent.) Grade/ University/ Remarks, if
Qualification Passing Class College any
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2. Professional Qualifications for Individual/ proprietor/ each partner/director
Professional Institute/ Membership No. Date of enrolment Remarks, if
Qualification Professional any
Body/
registered
valuers
organisation
3 (a) Details of valuation examination passed (for Individual/ proprietor/ all
partners/directors who are registered valuers with RVO )
Date of examination Asset class, if any Marks secured Percentage
3 (b) Valuation Qualifications (for Individual/ proprietor/ all partners/directors
who are registered valuers with RVO)
Valuation specific Recognised Asset Membership Remarks, if any.
qualification/course Registered Valuers class No. in
Organisation Registered
Valuers
Organisation
Name Recognition
No
D. WORK EXPERIENCE (if applicable)
1. Are you presently in practice / employment? (Yes or No)
2. Number of years in practice or of work experience in the relevant profession or
in valuation (attach evidence in the form of reference letters/copies of valuation
reports/any other evidence):
3. If in practice, address for professional correspondence:
4. Number of years in employment (in years and months):
5. Experience Details
Sl. From To Employment / If employed, If in practice, Area of work
Date Date Practice Name of experience in
No.
Employer and the relevant
Designation profession/
valuation
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E. REGISTERED VALUERS ORGANISATION/ MEMBERSHIP OF
PROFESSIONAL BODIES
1. Please give details of the registered valuers organisation/ Professional bodies
of which you are a member. Please state your membership number.
F. ADDITIONAL INFORMATION:
1. Have you ever /or any of your partners/directors ever been convicted for an
offence? (Yes or No). If yes, please give details.
2. Are any criminal proceedings pending against you /or your partners/directors?
(Yes or No) If yes, please give details.
3. Are you or any of your/ your partners/directors undischarged bankrupt, or
have applied to be adjudged as a bankrupt? (Yes or No)
If yes, please give details.
4. Please provide any additional information that may be relevant for your
application.
G. ATTACHMENTS:
1. Copy of Certificate of Registration with IBBI
2. Copy of Certificate of Registration under Sec 34AB of Wealth Tax Act, 1957
(if applicable)
3. Copy of proof of membership with a registered valuers organization.
4. Copy of membership with Professional bodies
5. Reference Letter(s) as prescribed in Annexure-VIII
6. KYC documents for Individual/ Firm/ Partnership Firm/ Company and its
proprietor/ partners/directors.
7. Copies of documents in support of educational qualifications, professional
qualifications and valuation qualifications of Individual/ proprietor/
partners/directors.
8. Copies of documents demonstrating practice or work experience for relevant
period, if applicable
9. Copies of certificate of employment by the relevant employer(s), specifying
the period of such employment, if applicable.
10. Financial statements/ Income Tax Returns for the last three years.
11. Passport-size photograph(s) of Individual/ proprietor/ partners/directors.
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H. AFFIRMATIONS:
1. Copies of documents, as listed in section G of this application form have
been attached/ uploaded. The documents attached/ uploaded are
I undertake to furnish any additional information as and when called for.
2. I am not disqualified from being registered as a valuer under the Companies
(Registered Valuers and Valuation) Rules, 2017, (Please strike off if not
applicable).
3. This application and the information furnished by me along with this application
is true and complete. If found false, misleading or incorrect I will be fully
responsible for the consequences.
Place: Signature & Name of applicant
Date:
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