Application forms and notices (afn) – gen


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dfsa

APPLICATION FORMS AND NOTICES (AFN) – GEN





(For DFSA use only)



Form GEN 2
Notification of appointment, resignation and termination of an Auditor



Name of Authorised Person



     





DFSA Reference Number



     





Firms are requested to contact the supervision department of the DFSA

(switchboard +971 (0)4 362 1500) before considering completing an application



Purpose of this form

This form must be submitted by an Authorised Person on the appointment, resignation and termination of its Auditor. It must be submitted immediately after the Authorised Person becomes aware of the appointment, resignation or termination. In some cases the DFSA may require additional information in order to complete the processing of this application. If this is necessary, the DFSA will contact the person identified in section 2 of this form.

Where an Authorised Person has re-appointed the same Auditor / Audit Principal, no notification is required.
Contents


Section

Title

1

Declaration

2

General information

3

Change of Auditor


Notes for completing this form


  • Defined terms are identified throughout this application form by the capitalization of the initial letter of a word or phrase and are defined in the Glossary module (GLO) of the DFSA’s Rulebook.




  • All sections of the form must be completed.




  • Questions must be answered fully and the use of abbreviations or acronyms should be avoided or defined.




  • Do not leave any questions blank. If a question is not applicable this should be indicated in the response section. Failure to answer questions or provide full responses will delay the progress of the application.




  • Answers must be typed, in electronic format, and the form must be signed by the Senior Executive Officer or Compliance Officer of the Authorised Person.




  • Please return the completed form to:


Dubai Financial Services Authority

Supervision Department

Level 13, The Gate Building

Dubai International Financial Centre

PO Box 75850

Dubai, UAE


  • Authorised Persons are advised to retain a copy of this form and all relevant attachments for their records.

SECTION 1 - DECLARATION


  1. I declare that, to the best of my knowledge and belief, having made due enquiry, the information given in this form is complete and correct. I understand that it is an offence under Article 66 of the Regulatory Law 2004 to provide to the DFSA any information which is false, misleading or deceptive or to conceal information where the concealment of such information is likely to mislead or deceive the DFSA.




  1. I confirm that I have the authority to make this application, to declare as specified above and sign this form for, or on behalf of, the Authorised Person.


Signature of Senior Executive Officer / Compliance Officer




Date

     




Name of Senior Executive Officer / Compliance Officer

     


SECTION 2 - GENERAL INFORMATION
About the Authorised Person


2.1

Name of Authorised Person

     




2.2

DFSA Reference Number


     




2.3

Authorised Person’s contact person for this notification

     




2.4

Contact telephone number

     




2.5

Contact e-mail

     


About the outgoing Auditor


2.6

Name of Auditor

     




2.7

DFSA Reference Number (if applicable)

     




2.8

Name of Audit Principal / audit partner signing the audit report

     




2.9

DFSA Reference Number (if applicable)

     


About the last audit


2.10

Details of financial year-end for which outgoing auditor issued its audit opinion

     










2.11

Date of the last Financial Statement Auditor’s Report

     











2.12

Date of the last Regulatory Returns Auditor’s Report

     











2.13

Date of the last Client Money Auditor’s Report (if applicable)

     











2.14

Date of the last Insurance Monies Auditor’s Report (if applicable)

     











2.15

Date of the last Safe Custody Auditor’s Report (if applicable)

     



About the incoming Auditor


2.16

Name of Auditor

     




2.17

DFSA Reference Number (if applicable)

     




2.18

Name of the responsible Audit Principal / audit partner

     




2.19

DFSA Reference Number (if applicable)

     


SECTION 3 – CHANGE OF AUDITOR



3.1

Please indicate the date (dd/mm/yyyy) on which this change is effective. (this is generally the date of the annual general meeting at which the appointment is made)

     




3.2

Please indicate the reason(s) for the change of Auditor.




3.2.1

Auditor no longer independent






3.2.2

Auditor not willing to be re-appointed / has resigned






3.2.3

Audit fee






3.2.4

Alignment with the Group Auditor






3.2.5

Auditor’s knowledge and competence






3.2.6

Other






3.2.7

Provide a full explanation of the reason(s) identified in 3.2.1 – 3.2.6


     



3.2.8

Has the outgoing Auditor submitted a notice in accordance with Article 102(4) of the Regulatory Law?



Yes  No  N/A 



3.2.9

Does the notice contain a statement in accordance with Article 102(4)(b) of the Regulatory Law? *



Yes  No  N/A 

* That is, that there are any circumstances connected with its ceasing to act that should be brought to the notice of members, unitholders or creditors
If Yes to 3.2.9, then please provide the copy to the DFSA.


of AFNGEN2 VER1/03-15

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