Renewal of External Examiner or Assistant Applications

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Approved Examiner Application

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This form is automatically submitted to the Law Society.

Accounting Practice Details

Name of the accounting practice.

Please provide the registered trading name of your practice

Trading name of the accounting practice (if different from the above name)

Please provide the registered trading name of your practice

ABN Number

What best describes the accounting practice

Registered Business Number

Please put N/A if not applicable

ACN #

Please put N/A if not applicable

What is the accounting practice's main email address

This email will be used to send a copy of this submitted application

What is the accounting practice's main telephone number

Postal Address

Suburb

State

Postcode

Applicant details

Year to which this application relates

Is this renewal for an external examiner or an assistant?

Please provide the name of the supervising examiner whom you will be assisting.

First Name of applicant

Surname of applicant

Has your position changed

What best describes your current position?

Has your work email altered since last year

Your current work email address

This email address will receive a copy of the submitted form

Has your direct telephone number altered since last year

What is your direct telephone number

Please identify which current Australian Association membership/s you hold

a member of the Institute of Chartered Accountants a member of the Institute of Public Accountants a member of CPA registered as an auditor under part 9.2 of the Corporations Act 2001 (Cth)

Membership number (for CPA Australia, ICA or IPA) or registered auditor number

Have you ever had a complaint upheld or disciplinary action undertaken by the above association/s

I authorise the Law Society to contact any professional association to which I belong, in order to verify current membership and any disciplinary action

Do you wish to provide any additional information concerning this application?

If required attach any documentation concerning this application

Declaration

Name of person submitting this renewal application

I, the person authorised to submit this renewal application CONFIRM TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION PROVIDED HEREIN IS TRUE AND CORRECT

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