Application Form for the Appointment of an External Sharī‘ah Audit Office¹⁷

1. Name of Bank: _____________________
2. Appointment for financial year ending: ____________
3. Proposed date of Annual General Meeting: _________________
4. Particulars of the Audit Firm:

   Name
   Firm No.
   Address

5. Particulars of engagement and concurring partners.

   	Engagement Partner	Concurring Partner
   Name
   Audit License No.
   Contact No.
   E-mail

6. Engagement partner since [financial year]
7. New appointment or reappointment
8. If new appointment, please state reason(s) for change of auditor
9. Particulars of fees and non-audit services provided by the audit firm for the last two financial years.

   Type	Currency ($)		Nature of non-audit services
   Non-audit fee
   Audit fee
   Total

10. Additional information to be enclosed with application:
    • Extract of board minutes endorsing the proposed appointment/reappointment of the audit firm and confirming that the board is satisfied that the auditor has met the criteria for appointment as specified by ……
    • Statutory declaration by the engagement partner
    • List of public interest entities audited by the engagement partner in the last two years, prior to the date of statutory declaration

CEO Name
Signature
Date