Chartered Accountants Regulatory Board Application for Registration in accordance with CARB’s Money Laundering Supervision Regulations This application form is issued by the Chartered Accountants Regulatory Board (“CARB”) on behalf of the Institute of Chartered Accountants in Ireland (the “Institute”) a competent authority under the Criminal Justice (Money Laundering and Terrorist Financing) Act 2010 (as amended) (the “Act”).
1.
Full Legal Name and Address of Applicant
Name: Address:
2.
Business Structure (Please tick the category which best describes the business)
3.
Sole Practitioner
Partnership
Limited Liability Partnership
Corporate Body
Principals1
Full name and any designatory letters
Date of birth
Chartered Accountants Ireland Membership Number (if applicable)
1 “Principal” as defined in the Money Laundering Supervision Regulations 2 The “Designated Accountancy Bodies” are: The Association of Chartered Certified Accountants (ACCA); The Institute of Certified Public Accountants (ICPAI); The Institute of Chartered Accountants in Ireland (ICAI); The Institute of Incorporated Public Accountants (IIPA); The Association of International Accountants (AIA); The Chartered Institute of Management Accountants (CIMA); The Chartered Institute of Public Finance and Accountancy (CIPFA); The Institute of Chartered Accountants in England and Wales (ICAEW); and The Institute of Chartered Accountants of Scotland (ICAS).
Designated Accountancy 2 Body (if any)
4.
Details of all owners who directly hold shares or other interests representing 25% or more of the voting or capital rights of the applicant entity including corporate bodies
Full name and any designatory letters
5.
Date of birth
Chartered Accountants Ireland Membership Number (if applicable)
Designated Accountancy Body (if any)
Money Laundering Compliance Principal3
Name: Telephone Number: Email Address:
6.
Type of Business
What type of business are you registering? Please tick all applicable boxes •
External Accountant other than book-keeping
•
Book-keeping
•
Tax adviser
•
Trust or Company Service Provider (TCSP)
7.
Fit and Proper Declarations (Appendix A) in respect of all Principals and all owners who directly hold shares or other interests representing 25% or more of the voting or capital rights of the applicant entity including corporate bodies
Please confirm that a Fit and Proper Declaration has been completed and retained in respect of each of the above.
Yes
No
Please confirm that any Fit and Proper issues which exist have been notified to CARB.
Yes
No
Yes
No
8.
Fee
Please confirm that the registration fee in the amount of €130 is attached.
9.
Application for Registration
I hereby apply for registration of the applicant as a Registered Designated Person under the Money Laundering Supervision Regulations of the Institute of Chartered Accountants in Ireland.
3 “Money Laundering Compliance Principal” as defined in the Money Laundering Supervision Regulations
10.
Declaration
To be completed by the Money Laundering Compliance Principal for and on behalf of the Registrable 4 Designated Person Note: an application shall not be complete unless an original signed declaration is submitted. Caution: If you have made a false or misleading statement on this application or in any supporting documentation, (including the withholding of relevant information), this may give rise to regulatory proceedings and/or liability to disciplinary action. CARB may check the accuracy of the information you have provided. I declare on behalf of the Registrable Designated Person: • • • • • •
• •
that the Applicant is a Registrable Designated person within the meaning of the Money Laundering Supervision Regulations; that the Registrable Designated Person has complied and will continue to comply with the Act; that the Registrable Designated Person agrees to comply with and be bound by the Money Laundering Supervision Regulations issued by CARB on behalf of the Institute as a competent authority under the Act; that the Registrable Designated Person agrees to comply with and be bound by the Disciplinary Bye-Laws, and the Money Laundering Supervision Regulations of the Institute; that the Registrable Designated Person will deal with CARB in an open and co-operative manner and will inform CARB promptly about any matter as may be required to be disclosed under the Money Laundering Supervision Regulations; that the Registrable Designated Person acknowledges that neither the Institute, CARB, their officers or staff, members of its Council or committees will be held liable in damages for anything done or not done in dealing with any of the functions connected with supervision under the Act or any regulations issued by CARB on behalf of the Institute in any respect unless the act or omission is shown to have been in bad faith; that the Registrable Designated Person is not currently supervised by another Competent Authority 5 with whom an agreement exists under Section 61 of the Act; and that Fit and Proper Declarations have been completed and retained in respect of all Principals and owners who directly hold shares or other interests representing 25% or more of the voting or capital rights of the applicant entity including corporate bodies.
I further declare: • • • •
that to the best of my knowledge all of the information given in this application form is correct and I will notify CARB as soon as possible in the event of any changes; that I have read and understood the caution above; that I am duly authorised by the Applicant and / or each of its Principals and owners who directly hold shares or other interests representing 25% or more of the voting or capital rights of the applicant entity including corporate bodies to make this application and to make these declarations on their behalf; and that I acknowledge, should any Fit and Proper issues arise in respect of this application, that CARB may refer the application to the Department of Justice and Equality for consideration.
Dated this
Signed by [INSERT NAME]
day of
20
for and on behalf of [INSERT NAME OF REGISTRABLE DESIGNATED PERSON]
Sign here: _________________________________________ MONEY LAUNDERING COMPLIANCE PRINCIPAL
4 “Registrable Designated Person” as defined in the Money Laundering Supervision Regulations 5 “Competent Authority” as defined in the Act
APPENDIX A FIT AND PROPER DECLARATION Financial integrity and reliability
YES
NO
1.
In the last ten years has a court, in Ireland, the United Kingdom or elsewhere, given any judgment against you about a debt?
2.
In the last ten years have you made any compromise arrangement with your creditors?
3.
Have you ever been declared bankrupt or been the subject of a bankruptcy court order in Ireland, the United Kingdom or elsewhere, or has a bankruptcy petition ever been served on you?
4.
Have you ever signed a trust deed for a creditor, made an assignment for the benefit of creditors, or made any arrangements for the payment of a composition to creditors?
YES
NO
Convictions or civil liabilities
Note: There is no need to mention offences which are spent for the purposes of the Rehabilitation of Offenders Act 1974 or offences committed before the age of 17 (unless committed in the last ten years) and road traffic offences that did not lead to a prison sentence. 5.
Have you at any time pleaded guilty to or been found guilty of any offence? If so, give details of the court which convicted you, the offence, the penalty imposed and date of conviction.
6.
In the last five years have you, in Ireland, the United Kingdom or elsewhere, been the subject of any civil action relating to your professional or business activities which has resulted in a finding against you by a court, or a settlement being agreed?
7.
Have you ever been disqualified by a court from being a director or from acting in the management or conduct of the affairs of any company?
YES
NO
Good reputation and character 8.
9.
Have you, in Ireland, the United Kingdom or elsewhere, ever been: •
Refused the right or been restricted in the right to carry on any trade, business or profession for which a specific licence, registration or other authority is required?
•
Investigated about allegations of misconduct or malpractice in connections with your professional activities which resulted in a formal complaint being proved but no disciplinary order being made?
•
The subject of disciplinary procedures by a professional body or employer resulting in a finding against you?
•
Refused entry to or excluded from membership of any profession or vocation?
•
Dismissed from any office (other than as auditor) or employment or requested to resign from any office, employment or partnership?
•
The subject of a court order at the instigation of any regulatory body, or any officially appointed enquiry concerned with the regulation of a financial, professional or other business activity?
•
Reprimanded, warned about future conduct, disciplined, or publicly criticised by any regulatory body, or any officially appointed enquiry concerned with the regulation of a financial, profession or other business activity?
Are you currently undergoing any investigation or disciplinary Procedures as described in 8 above?
11.
Completion Checklist
Before returning the completed registration form, please go through this checklist. (a) (b) (c) (d) (e) (f) (g)
Check that you have completed all questions. Ensure the form is signed. Ensure the fee is attached. Include additional sheets if there is inadequate space for any answer. Keep a copy of all the forms for your records. Ensure any Fit and Proper issues have been notified to CARB and that copies of the Fit and Proper Declarations have been retained. If you have any doubts or difficulties concerning the completion of this form, you should contact Chartered Accountants Regulatory Board for advice. This may avoid delays in processing the application.
Please return this form to: The Chartered Accountants Regulatory Board, The Linenhall, 32-38 Linenhall Street, Belfast, BT2 8BG Dublin Chartered Accountants Regulatory Board, CA House, 47-49 Pearse Street, Dublin 2 Phone: +353 1 637 7336 Fax: +353 1 637 7369 Email:
[email protected]
Website: www.carb.ie
Belfast Chartered Accountants Regulatory Board, The Linenhall, 32-38 Linenhall Street, Belfast, BT2 2BG Phone: +44 9043 5858 Fax: +44 9031 9320 Email:
[email protected]
Website: www.carb.ie
