Calendar Year (e.g. 2017)

In accordance with the Audit Regulations, Ethical Standards and policies of the firm, all staff must complete and sign a statement of independence and of confidentiality as a condition of employment.
Any change in the circumstances described in this statement must be notified to a partner immediately.

Do you confirm that you do not hold any investments in an audit client of the firm?
Do you confirm that you have no beneficial interest in any shares in an audit client of the firm, whether directly, or as the beneficiary or trustee of a trust, or as the director of a trustee investment fund, or as an investor?
Do you confirm that you have not been employed by an audit client of the firm during the last two years. If so, give details?
Do you confirm that you are not aware of any circumstances including long association of personal/family relationships with a particular audit or solicitor client's staff which you consider might threaten or be thought to threaten your objectivity or independence?
My attention has been drawn to the need for integrity, objectivity and independence in my work and quality control procedures as detailed in GS Systems.
I have answered the above questions truthfully and honestly, to the best of my knowledge and belief.
Should any of the above circumstances change, I shall inform a partner immediately.

Date of completion

Thank You

You have completed this statement!

Thank you for taking the time to answer this statement .