LICENSING APPLICATION FORM



Form GEN1

Application for registration as an

auditor

| | |

|Name of applicant |      |

|Firms are requested to contact the supervision department of the DFSA |

|(+9714 362 1500) before considering completing an application. |

Purpose of this form

This form must be submitted by an audit firm wishing to apply for registration as an Auditor. An Auditor means a partnership or company that is registered by the DFSA to provide audit services to Authorised Firms and Authorised Market Institutions that are Domestic Firms or to Domestic Funds.

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 nominated contact identified in section 1.

Contents

This form consists of seven sections:

1. Audit firm details

2. Anti Money Laundering

3. Fit & proper questionnaire for AMLO

4. Fit & proper questionnaire for audit firm

5. Disclosure to DIFCA

6. Declaration

7. Payment of Fees

8. Attachments

Notes for completing this form

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

• All sections must be completed.

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

• Do not leave any questions blank – if a question is not applicable this should be indicated in the response section.

• Answers must be typed and the form must be signed by a Director/Partner and the Anti Money Laundering Officer (if different).

• Please ensure any supporting documentation is clearly labelled and securely attached.

1. AUDIT FIRM DETAILS

|1.1 |Full or proposed name of audit firm to be |      |

| |registered | |

|1.2 |Address of audit firm (include both office and|      |

| |postal address) | |

| |(Please indicate if current or proposed) | |

(Note: The office and postal addresses will be the addresses used for service of notices and correspondence. If the

audit firm does not have a U.A.E. address then it will be asked to supply a U.A.E. address where service can be effected)

|1.3 |Audit firm’s head office if applicant is a |      |

| |branch office | |

| | | |

|1.4 |Name of audit firm’s other branches and |      |

| |addresses | |

| | | |

|1.5 |Main telephone number of address in 1.2 |      |

| |(incl. country and area codes) | |

|1.6 |Main fax number of address in 1.2 |      |

| |(incl. country and area codes) | |

|1.7 |Website address (if applicable) |      |

|1.8 |Audit firm’s contact person for this |      |

| |application | |

| |Position/title |      |

| |Correspondence address |      |

| |(if different from 1.2 above) | |

| |Telephone number: |      |

| |Fax number |      |

| |E-mail address |      |

|1.9 |Please provide details of any adviser engaged by the audit firm to assist with the preparation and ongoing support of this |

| |application. |

| |Name of the adviser engaged by the audit firm |      |

| |Relevant contact person within the adviser |      |

| |Contact address |      |

| |Telephone/Fax number: |      |

| |E-mail address |      |

|1.10 |Legal nature of audit firm |      |

| |(Note: only companies, Limited Liability | |

| |Partnerships and General Partnership may | |

| |apply) | |

|1.11 |Date and place of incorporation /formation of |      |

| |the audit firm | |

Note: Please attach a copy of the applicant’s certificate of incorporation/company registration/partnership

agreement (as applicable). If in the process of being formed, please state “in formation”

|1.12 |Details of ownership of audit firm |      |

| |(if insufficient space please attach | |

| |additional sheets) | |

| | | |

| | | |

| | | |

| | | |

1.13 Background and history of audit firm (if insufficient space please attach additional sheets)

| |

|           |

14. Please detail the resources to be used to conduct DFSA audits (i.e. human and technological resources, including number of staff, partners, professional staff and other resources, as applicable). (If insufficient space please attach additional sheets)

| |

|           |

15. Please provide your firm’s approach to ensuring continuing professional development provided for employees including audit principals (if insufficient space please attach additional sheets)

| |

|           |

1.16 Please list the names and details of the Partners / Directors of the audit firm who will be the Audit Principals for audits of DFSA Authorised Firms and Authorised Market Institutions that are Domestic Firms or Domestic Funds. (Rule 8.9.3 of Gen requires that Audit Principals as a minimum hold a Recognised Professional Qualification; have at least 5 years of relevant audit experience of the last 7 years and be a current member in good standing of a Recognised Professional Body)

Audit Principal No.1

|Full Name: |      |

|Recognised Professional Qualifications: |      |

|Details of audit experience: |      |

|Recognised Professional Memberships: |      |

Audit Principal No.2

|Full Name: |      |

|Recognised Professional Qualifications: |      |

|Details of audit experience: |      |

|Recognised Professional Memberships: |      |

Audit Principal No.3

|Full Name: |      |

|Recognised Professional Qualifications: |      |

|Details of audit experience: |      |

|Recognised Professional Memberships: |      |

If insufficient space or more Audit Principals will be involved please attach a separate appendix or additional sheets as necessary.

1.17 Please provide details of professional indemnity insurance

Before registration, the audit firm will need to demonstrate that it holds adequate professional indemnity insurance covering, amongst other things, fraud committed by the audit firm’s employees.

Please attach a copy of the audit firm’s insurance certificate or cover note.

| |

|           |

9 Has the audit firm been inspected / assessed by an independent body or had a peer review in the last twelve months?

Yes No

If “YES”, please provide details below including a summary of the findings and copy of any findings.

| |

|           |

1.19 Do the audit firm’s systems, procedures and controls ensure compliance with the International Standards on Auditing (ISAs) as issued by IAASB of IFAC (or where applicable Auditing Standards for Islamic Financial Institutions as issued by AAOIFI)? (Please provide a copy of the firm’s systems, procedures and controls. If these are integrated into its internal IT systems then please provide a summary of how the systems, procedures and controls comply with the IASs or ASIFOs). The DFSA may wish to inspect the IT systems to verify compliance)

Yes No

If “No”, please provide details of where systems, procedures and controls do not comply.

| |

|           |

| |

1.20 Does the audit firm’s system of quality control operate to meet the requirements as set out under International Standard on Quality Control (ISQC) 1? (Please provide a copy of the firm’s current quality control policies and procedures. If the firm’s quality control policies and procedures are integrated into its internal IT systems please provide a summary of how the policies and procedures comply with International Standard on Quality Control (ISQC) 1. The DFSA may wish to inspect the IT systems to verify compliance)

Yes No

If “No”, please provide details of where system do not comply.

|           |

1.21 Does the audit firm have in place adequate systems, procedures and controls to ensure due compliance with the Code of Ethics for Professional Accountants issued by the Ethics Standards Board for Accountants (or where applicable the Code of Ethics for Accounting and Auditors for Islamic Financial Institutions issued by AAOIFI)? Please provide a copy of the firm’s current systems, procedures and controls.Note: If the firm’s systems, procedures and controls are integrated into its internal IT systems please provide a summary of how the systems, procedures and controls comply with the Code of Ethics. The DFSA may wish to inspect the IT systems to verify compliance]

Yes No

If “No”, please provide details of where systems, procedures and controls do not comply.

Registered Auditor status will only be granted to Auditors of DFSA regulated entities. Prior to registration as an Auditor, an audit firm may market services to regulated firms, but may not commence the provision of such services.

An audit firm shall not accept a mandate from a regulated entity to provide audit services within the DIFC (nor accept appointment to a tender panel for the provision of such services) until registered as an Auditor.

2. ANTI MONEY LAUNDERING

|2.1.1 |Please attach the audit firm's Anti Money Laundering (AML) policies, procedures, systems and controls. These must be specific to |

| |its DIFC activities and comply with the ASP AML Rules of the DFSA including an overview of the audit firm’s anti Money Laundering |

| |function, staffing levels, responsibilities and reporting lines. The audit firm’s procedures should include, amongst other things,|

| |arrangements to: |

| | |

| |ensure compliance with the UAE Law No.4 and any other relevant UAE federal laws; |

| |monitor for, detect and report suspicious customers and Transactions; Note: Audit firms should ensure the procedures comply with |

| |the requirement for Suspicious Transaction Reports (STRs) to be made in the required format to the Anti Money Laundering |

| |Suspicious Cases Unit (AMLSCU), and a copy provided to the DFSA. Details of the required format of the report and details for |

| |submission can be found on the DFSA website; |

| |establish and verify the identity of the customer and any other person on whose behalf the customer is acting, including that of |

| |the beneficial owner; unless exception applies (6.5) |

| |provide an audit trail of STRs; |

| |determine the duties and obligations of its Anti Money Laundering Officer (AMLO); |

| |review the effectiveness of its AML policies, procedures, systems and controls at least annually; |

| |respond to any request for information made by competent U.A.E. authorities or the DFSA; |

| |maintain AML relevant documents and records; |

| |ensure that it obtains and makes use of findings in relation to names of persons, groups, organisations or entities, or any other |

| |body where suspicion of Money laundering or terrorist financing exists; Be mindful of Government; regulatory and international |

| |findings |

| |assess its risks in relation to money laundering and to perform enhanced due diligence investigations for higher risk products, |

| |services and customers; |

| |determine whether a customer is a Politically Exposed Person (PEP); |

| |establish and maintain an AML training programme and awareness arrangements; and |

| |ensure compliance with any other obligation in the DFSA's ASP module. |

| | |

|2.1.2 |Does the audit firm apply similar or equivalent Anti Money Laundering (AML) policies, procedures, systems and controls mentioned |

| |in 2.1 for all its clients and activities outside the DIFC? |

| |Yes No |

| | |

| |If “No”, which Anti Money Laundering (AML) policies, procedures, systems and controls are not applied and in which jurisdiction? |

| | |

|      |

2.2 Anti Money Laundering Officer (AMLO)

|2.2.1 Family name/other names |      |

|2.2.2 Date of birth (DD/MM/YYYY) |      |

|2.2.3 Place of birth |      |

|2.2.4 Passport(s) number(s) |      |

| |      |

|2.2.5 Please state the country(ies) and place(s) of issue of|      |

|the applicant’s passport(s) | |

Please attach a copy of all passports held by the AMLO, including copies of any current visas.

| |      |

|2.2.6 Job title/level within the firm | |

Please attach a detailed job description clearly outlining the AMLO’s role and responsibilities within the firm and attach details of the AMLO’s employment record for the previous 10 years highlighting any experience relevant to the role of AMLO.

|2.2.7 |Residential address |      |

|2.2.8 |Dates resident at above address (from/to) |      |

|2.2.9 |Previous address if less than 3 |      |

| |years at above address | |

| | | |

|2.2.10 |Contact details |Telephone |      |

| |Fax |      |

|E-mail |      |

|2.2.11 |What steps will be taken by the audit firm to ensure that the AMLO will be fully aware of his or her duties and be able to carry|

| |out these duties effectively? Please provide details. |

|      |

|2.2.12 |Do another jurisdiction's laws or Regulations prevent or inhibit the audit firm from complying with the U.A.E. Law No.4 or the |

| |DFSA Rules? |

| |Yes | |No | | |

|If Yes, please give full details |

|      |

Note: Should such an event arise in the future audit firms are obliged to notify DFSA in writing promptly

3. FIT & PROPER QUESTIONNAIRE FOR AMLO

|3.1 |Please complete the following questionnaire in relation to the proposed AMLO |

| |Answers must be provided to every question. |

| |Has the applicant AMLO: |Yes |No |

|(i) |been convicted or found guilty by any court of competent jurisdiction in respect of any offence, | | |

| |other than a minor road traffic offence? | | |

|(ii) |ever been the subject of disciplinary procedures by a government body or agency or any self | | |

| |Regulatory organisation or other professional body? | | |

|(iii) |contravened any provision of Financial Services legislation or of Rules, Regulations, statements or| | |

| |principle or codes of practice made under or by a Financial Services Regulator or other supervisory| | |

| |body? | | |

|(iv) |been refused or restricted the right to carry on a trade, business or profession requiring a | | |

| |licence, registration or other authority? | | |

|(v) |been dismissed or requested to resign from any office of employment? | | |

|(vi) |been concerned either individually or with the management of a Body Corporate who or which has been| | |

| |or is currently the subject of an investigation into a allegation of misconduct or malpractice? | | |

|(vii) |received an adverse finding in a civil action by any court of competent jurisdiction of fraud, | | |

| |misfeasance, or other misconduct, whether in connection with the formation or management of a | | |

| |corporation or otherwise? | | |

|(viii) |received an adverse finding in an agreed settlement in a civil action by any court or tribunal of | | |

| |competent jurisdiction resulting in an award against an individual in excess of $10,000 or awards | | |

| |that total more than $10,000? | | |

|(ix) |been the subject of an order of disqualification as a Director or otherwise to act in the | | |

| |management or conduct of the affairs of a corporation by a Court of competent jurisdiction or | | |

| |Regulator? | | |

|(x) |been a Director, or Partner or concerned in the management of a company or Partnership which has | | |

| |gone into insolvent liquidation whilst the individual was connected with that company, Partnership | | |

| |or within one year of such a connection? | | |

|(xi) |been the subject of complaint in connection with a Financial Service or Accounting Service which | | |

| |relates to his integrity, competence or financial soundness? | | |

|(xii) |been censured, disciplined, publicly criticised by or the subject of a court order at the | | |

| |instigation of a Financial Services Regulator or any officially appointed inquiry? | | |

If you have answered Yes to any questions, please provide appropriate details of the matter below.

|      |

4. FIT & PROPER QUESTIONNAIRE FOR AUDIT FIRM

|4.1 |Please complete the following questionnaire in relation to the audit firm |

| |Answers must be provided to every question. |

| |Has the audit firm: |Yes |No |

|(i) |been convicted or found guilty by any Court of competent jurisdiction in respect of any offence? | | |

|(ii) |ever been the subject of disciplinary procedures by a government body or agency or any self | | |

| |Regulatory organisation or other professional body? | | |

|(iii) |contravened any provision of Financial Services legislation or of Rules, Regulations, statements or| | |

| |principle or codes of practice made under or by a self regulatory body, Financial Services | | |

| |Regulator or other supervisory body? | | |

|(iv) |been refused or restricted the right to carry on a trade, business or profession requiring a | | |

| |licence, registration or other authority? | | |

|(v) |received an adverse finding in an agreed settlement in a civil action by any Court or tribunal of | | |

| |competent jurisdiction resulting in an award against or payment in excess of $10,000 or awards that| | |

| |total more than $10,000? | | |

|(vi) |been censured, disciplined, publicly criticised by or the subject of a Court order at the | | |

| |instigation of a Financial Services Regulator or any officially appointed inquiry? | | |

If you have answered Yes to any questions, please provide appropriate details of the matter below.

|      |

5. Disclosure of information to the Dubai International Financial Centre Authority (DIFCA)

The provision of certain information by the DFSA to the DIFCA under the following consent will assist the DIFCA in exercising its functions and powers. It is not mandatory to provide consent and should you not wish to provide consent, we ask that you consider keeping the DIFCA informed of the progress of your application.

I consent / I do not consent to disclosure of the following information by the DFSA to DIFCA:

1. The fact of the filing of this application, together with the name of the applicant;

2. The fact (if applicable) that this application is still being reviewed by the DFSA; and

3. The outcome of this application. An outcome may include a decision by the DFSA to approve this application, in principle or otherwise, or to reject the application or the withdrawal of the application.

6. DECLARATION

6.1 Declaration by the audit firm (senior partner or equivalent)

6.1.1 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.

6.1.2 I declare my understanding that the DFSA may request more detailed information (including but not limited to, personal, educational, employment and financial information) should it be deemed necessary to adequately assess the fitness and propriety of the firm or any person connected to the firm. I consent to the DFSA contacting any previous employers, educational institutions, professional organisations or any other organisation, to verify any information contained in this form.

6.1.3 I declare that the firm, the Audit Principals and its Employees are fit and proper to perform the audit services.

6.1.4 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 applicant. I also confirm that I have the authority to give the consent specified above.

6.1.5 For the purposes of complying with DIFC Data Protection Law 2007, I understand that any Personal Data provided to the DFSA will be used to discharge its regulatory functions under the Regulatory Law 2004 and other relevant legislation and may be disclosed to third parties for those purposes.

|      | | |

|Name of a Director/Partner | | |

|      | | |

| | |  /  /   |

|Signature of a Director/Partner | |Date |

|      | | |

| | | |

|Name of the AMLO if different from above | | |

|      | | |

| | |  /  /   |

Signature of the AMLO if not signed above Date

7. Fees

Applications will not be processed until the relevant fee is paid in full to the DFSA. Details of the application fees are contained in the Fees module of the DFSA Rulebook.

Please make the payment by Bank transfer in US Dollars to the account listed below. Cheques or bank drafts will not be accepted.

|Account name |Dubai Financial Services Authority |

|Account number |020-683751-100 |

|IBAN |AE080200000020683751100 |

|Bank details |HSBC Bank Middle East |

| |PO Box 66 |

| |Dubai, UAE |

|Swift code |BBMEAEAD |

|Reference to be quoted |Application fee – [applicant name] |

8. ATTACHMENTS

|Section |Document |Attached? |

|1.10 |Certificate of Incorporation/Company Registration/Partnership Agreement |Y N N/A |

|1.7 |Professional Indemnity Insurance Certificate | Y N N/A |

|1.18 |Copy of findings |Y N N/A |

|1.19 |Copy of systems, procedures and controls in relation to International Auditing Standards /|Y N N/A |

| |Auditing Standards for Islamic Financial Institutions | |

|1.20 |Copy of quality control policies and procedures |Y N N/A |

|1.21 |Copy of systems, procedures and controls in relation to Code of Ethics |Y N N/A |

|2.1 |Anti Money Laundering procedures |Y N N/A |

|2.2.5 |Copy(ies) of passport(s) |Y N N/A |

|2.2.6 |AMLO job description |Y N N/A |

|2.2.6 |AMLO employment details for the last 10 years |Y N N/A |

|3 |Fit & Proper questionnaire – AMLO |Y N N/A |

|4 |Fit & Proper questionnaire – Audit Firm |Y N N/A |

|Other |Please list |Y N N/A |

| | |Y N N/A |

Please return completed form to:

DUBAI FINANCIAL SERVICES AUTHORITY

SUPERVISION DEPARTMENT

LEVEL 13, THE GATE BUILDING

DUBAI INTERNATIONAL FINANCIAL CENTRE

PO BOX 75850

DUBAI, UAE

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(For DFSA use only)

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