Claim Form - audit fees
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Claim Form - audit fees

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Claim Form – Audit Fees ACCURACY OF INFORMATION. It is a condition of the Policy that all information provided is accurate. Any information found not to be true may lead to a claim being denied and the Policy being terminated. The insurer has the right to further investigate or audit any claim. INSTRUCTIONS. Please complete this form; attach relevant documents as listed below; ...

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Informations

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Claim Form – Audit Fees
ACCURACY OF INFORMATION.
It is a condition of the Policy that all information provided is
accurate. Any information found not to be true may lead to a claim being denied and the Policy
being terminated. The insurer has the right to further investigate or audit any claim.
INSTRUCTIONS.
Please complete this form; attach relevant documents as listed below; and
mail to InsureAust Pty Ltd, Locked Bag 2323 St Leonards NSW 1590 or fax to 02 9437 1728.
If the documentation can’t be provided please contact us on 02 8437 1633 to resolve.
Insured’s Name: _____________________________________________________
AEI Reference Number: ___________________________
Policy Number: _______________________
Contact person should we have any questions:
Name:
_________________________
Phone number:
(____) _________________________
Fax number:
(____)_________________________
Email address: ______________________________________________
If the entity being audited differs to the ‘Insured Name’ noted above, please list here and note
additional instructions at
#
under the heading ‘Documents Required’ below.
________________________________________________________________________
Is the Insured Name GST registered?
YES [ ]
NO [ ]
If ‘YES”, the ABN is: _______________________________________
What type of audit is being undertaken i.e., income tax, BAS, payroll, workers compensation?
________________________________________________________________________
Which financial years are being audited? ________________________________
What date were you first advised that an audit was to be undertaken? ______/____/_______
If you are reporting this claim more than 20 business days after the above date, please explain
why the delay.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Estimate of the final claim cost: $_________________
If all documents, as listed below, are not being provided to finalise this claim, approximately
when will final documentation be provided? ______/__________
Where attached, does the Tax Invoice represent ‘FINAL’ [ ] or ‘PROGRESS’ [ ] payment.
Insured Name’s Signature: _________________________________________
Date: ______/_______/________
DOCUMENTS REQUIRED TO COMPLETE THE CLAIM:
Please note that InsureAust Pty Ltd manages the insurance facility on behalf of the insurer.
Our role is to compile the required documents and submit to the insurer for consideration and
settlement.
We have no claims settlement authority.
Documents required:
This Claim Form.
A copy of the written notice from the relevant statutory authority advising that an audit is
to be undertaken.
#
It is possible that the entity being audited is a subsidiary or majority controlled entity of
the ‘Insured Name’ listed on this Claim Form. Please provide documentary proof
(preferably a copy of the relevant ASIC annual return) that substantiates the relationship
between the ‘Insured Name’ and the entity being audited.
Proof as to the actual date that the relevant return(s) being audited were submitted to the
relevant government authority.
The professional’s Tax Invoice sent to and signed by the insured as an
acknowledgement that the duties were undertaken.
(Please note that the amount of the
claim will reduce the remaining limit available for future claims.)
Where the amount of the Tax Invoice is greater than $500, we require a copy of the
professional’s ‘time sheets’ or ‘work in progress’ documents that support the activities as
highlighted on the professional’s Tax Invoice.
A copy of the final letter from the relevant statutory authority confirming that the audit has
been completed.
The insurer normally settles the professional fees being claimed to the relevant
professional noted on the Tax Invoice. If you have already paid the professional’s Tax
Invoice, please provide proof of payment.