Audit Management Service – Client Acceptance Form Audit Services Pty Ltd – NSW ­ 06/03/02646 What is included. External professional fees incurred (up to the ‘Shared Level’ selected) to manage any audit initiated by a Local, State or Commonwealth Government agency that arises during the ‘Period’. External professional fees incurred must be ‘fair & reasonable’ for the type of audit being conducted. ‘You’ will be liable for any professional fees incurred over the ‘Shared Level’ selected. The ‘Period’ is the 12 month period from the date Audit Services Pty Ltd receives this ‘Client Acceptance Form’ and payment of the ‘AMS Fee’ in their office. At the end of 12 months, Audit Services Pty Ltd will invite renewal of this service. ‘You’ means all names listed under ‘Step 1’ below. What isn’t included. Where (1) a return has been prepared or lodged recklessly or fraudulently; (2) a return is lodged more than 3 months outside the prescribed date; (3) you or your representative(s) are aware of circumstances that would likely lead to an audit occurring; (4) any verbal or written advice or notice of a pending audit has already been received by you or your representative(s); (5) any activity that involves the maintenance of any operating licenses, memberships, registrations, workplace practices, regulatory or industry processes and the like; (6) education, training, implementation etc., due to a change in government or industry policies, regulations and by­laws; (7) you have knowingly or deliberately breached any policies, regulations or by­laws governing your business or industry occupation; (8) an audit relates to the deduction, rebate or claim for tax or duty relief arising out of a mass marketed product or scheme unless the product or scheme has received prior written approval from the relevant government authority; (9) any amended assessments, fines, penalties or the like are imposed by a government agency; (10) costs are incurred for any legal proceedings initially taken against you or instituted by you; and (11) you have entered into any form of bankruptcy, administration, receivership, liquidation, insolvency (voluntary or otherwise), winding up or a similar process. STEP 1. List the names of Individuals, Trusts, Superfunds, Operating or other entities (entities must have common majority ownership) to be included in the ‘Audit Management Service’. >>> PLEASE PRINT CLEARLY & SEPARATE THE NAMES WITH A COMMA. <<< _______________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________ STEP 2. Select the ‘Shared Level’ of professional fees required to be covered under the ‘Audit Management Service’. (The ‘Shared Level’ selected should ensure sufficient professional fees coverage in the event of being exposed to more than one audit or a multi year audit. Most ‘Individuals’& ‘Self Employed’ select $5,000 or $10,000 and Small­ Medium Sized Business $15,000, $20,000 or $25,000. Also note that where multiple names are listed, the ‘Shared Level’ selected is shared by all and is the maximum amount during the subscription period.) Shared Level $5,000 $25,000 AMS Fee Shared Level AMS Fee Shared Level $210 $10,000* $400 $15,000^ $865 $30,000 $1,125 $35,000 (* Maximum ‘Level’ for any ‘Individual’ and ^ for any ‘Self Employed’ listed.) STEP 3. Selected ‘Option’: _______ Fee amount: $_______ Signature: _________________________________________ AMS Fee $555 $1,345 Shared Level $20,000 $50,000 AMS Fee $645 $2,395 EFT Reference: ______________________ (St George Bank BSB: 332027 Acct: 552229946 Name: Audit Services P/L Trust Account) Date: ______/_______/________ Contact number: (____) ____________________ Your postal address: __________________________________________________________________________________________________ For more prompt communication, an email address: __________________________________________________________________________________________________ STEP 4. Mail this form, with payment for the ‘Fee amount’, to Audit Services Pty Ltd Locked Bag 2323 St Leonards NSW 1590. Our ABN is 93 108 815 194. STEP 5. If introduced to Audit Assist by the Belrose Terry Hills Soccer Club, please ‘tick’ this box [ ]