FORM 1 Audit Oversight Board Application for registration as an individual auditor If there is insufficient space for any section of the form, you may add attachments and submit as part of this lodgment. 1. Applicant details Full name as per NRIC/Passport if not Malaysian Date of birth Residential address City State Postcode Country E-mail address Telephone number Fax number Handphone number NRIC number/passport number and country of issue if not Malaysian (delete where necessary) 2. Approved auditor status Are you currently an approved company auditor under section 8 of the Companies Act 1965? If yes, please state your Audit Licence number 3. Membership Are you a member of the Malaysian Institute of Accountants (MIA)? If yes, please state your MIA membership number
4. Principal place of practice Business name Audit Firm number issued by Suruhanjaya Syarikat Malaysia Address City State Postcode E-mail address Telephone number Fax number 5. Years of service How long have you been practising in this firm? 6. Previous employment history relating to your preparation of statutory audit reports in and outside Malaysia Name of employer and country if not in Malaysia Designation held Date held From/To Please add attachment if there is more than one previous employer 7. Client(s) State the name, audit and non-audit fees of the public-interest entity for which you have prepared statutory audit reports during the preceding two calendar years. (Please use Appendix A) For the purposes of this Part, audit and non-audit fees are those fees paid or payable to the audit firm and its affiliates in Malaysia in relation to the audited financial statements of a public-interest entity and its subsidiaries.
8. Fit and proper Disciplinary action (a) Have you been convicted of any offence, or are there any proceedings now pending which may lead to a conviction of any offence involving fraud or other dishonesty or violence whether in or outside Malaysia? (b) Have you had judgment involving findings of fraud or other dishonesty, violence, misrepresentation, breach of contract, breach of fiduciary duty or professional negligence given against you, as the case may be, in any civil proceedings, or are there any proceedings now pending that may lead to such a judgment, whether in or outside Malaysia? (c) Have you had any enforcement action taken against you or sanction imposed on you for any breaches of any laws administered by any regulatory bodies or professional body whether in or outside Malaysia relating to the financial statements of the public-interest entity? (d) Have you had any action taken against you for contravention of any provision made by or under any written law enacted for protecting members of the public against financial loss due to dishonesty, incompetence or malpractice in the provision of financial services or the management of companies or against financial loss due to the conduct of discharged or undischarged bankrupts?
(e) Have you had any form of disciplinary proceeding taken against you by any regulatory or professional body whether in or outside Malaysia relating to the financial statements of the public-interest entity? (f) Have you been engaged in or have been associated with any other business practices or otherwise conducted yourself in such a way as to cast doubt on your competence, soundness of judgment or professionalism? (g) Have you been involved in the audit of a public-interest entity or audit firm in or outside Malaysia which at the time of your involvement, the public-interest entity or audit firm (i) had been convicted of any offence, or are there any proceedings now pending which may lead to a conviction of any offence, involving fraud or other dishonesty? (ii) had judgment involving findings of fraud or other dishonesty, or misrepresentation, breach of contract, breach of fiduciary duty or professional negligence given against it in any civil proceedings, or
are there any proceedings now pending that may lead to such a judgment? (iii) contravened any written law for protecting members of the public against financial loss due to dishonesty, incompetence or malpractice by persons concerned in the provision of financial services, or the audit of a public-interest entity or against financial loss due to the conduct of discharged or undischarged bankrupts? (iv) had a receiver and/or manager been appointed in respect of any of the assets of the said public-interest entity or audit firm? (v) entered into a compromise or arrangement with creditors or members? (vi) had a petition presented in a court for its winding up?
(vii) been subjected to any form of disciplinary proceedings or action by any professional or regulatory body whether in or outside Malaysia? Financial status (h) Are you an undischarged bankrupt within or outside Malaysia? Auditing and ethical standards Do you adopt all recognised auditing and ethical standards in Malaysia in the performance of the audit of financial statements? If no, please give details Auditor status (i) Have your application for approval or renewal been refused or have you been previously suspended as an auditor under section 8 of the Companies Act 1965? (j) Are there any conditions attached to your approval as a company auditor under section 8 of the Companies Act 1965?
(k) Have you been refused or previously suspended from membership of the MIA or any recognised bodies of whether in or outside Malaysia Directorship (l) Do you hold any executive and/or non-executive directorship in any public-interest entity? 9. Referees Provide details of two persons who are making capability declarations in support of your application te: Persons that cannot be used as your capability declarant are your spouse and any other family member 1. Audit Licensing Number/MIA number/aob Registration Number (if applicable and delete where necessary) Name Address City State Postcode Country (if not Malaysia) E-mail address Telephone number
Fax number Occupation Nature of relationship 2. Audit Licensing Number/MIA number/aob Registration Number (if applicable and delete where necessary) Name Address City State Postcode Country (if not Malaysia) E-mail address Telephone number Fax number Occupation Nature of relationship 10. Other information Is there any other additional information relevant to your application which AOB should be made aware of?
11. Documents to be attached Attachments You must provide proof and evidence to support your application. Please refer to the AOB Handbook for Registration for further information on registration. 12. Declarations I hereby declare that all information provided in this application and its attachments are true and correct. Full name as per NRIC/Passport if not Malaysian Signature Date signed Lodgment Send completed and signed forms to: Securities Commission Malaysia 3, Persiaran Bukit Kiara 50490, Kuala Lumpur (Attention: Audit Oversight Board) This form is also available electronically at: www.sc.com.my
Appendix A Table 1: Audit and non-audit fees of audit reports prepared for public-interest entities and its subsidiaries for the preceding two (2) years. Date Publicinterest Entity Audit fees n-audit fees Firm attached with