APPLICATION FOR REINSTATEMENT OF MEMBERSHIP IMPORTANT NOTICE Please read the following notes before completing the application form: i. In accordance with the Institute (Membership and Fees) Rules, a former member who was removed from ISCA register due to non-payment will have to apply for reinstatement of membership on or before 31 December of the year of removal. A reinstatement fee of $107 (including GST) together with the annual subscription fee and a late payment fee of $32.10 (including GST) will be payable. The Council shall have the discretion to accept or refuse any application for reinstatement. Fee Amount including GST Reinstatement fee $107.00 Late payment fee $32.10 Outstanding annual subscription $149.80 per year (Associate) $299.60 per year (CA (Singapore)) ii. Goods & Services Tax (GST) will be applicable for members residing in Singapore. For zerorated GST to apply, members residing overseas must tick to declare that they are residing overseas at the point of payment. For non-declaration, standard rated GST will apply. iii. The Institute may request for any other supporting documents required to assess the application. iv. Please send the duly completed form and all necessary documents to [email protected] or 60 Cecil Street, ISCA House, Singapore 049709. 1. PERSONAL PARTICULARS Name: IC/Fin/Passport No: Nationality: Singapore PR: Mobile Phone: -Yes -No -NA Home Phone: Email: Home Address: Please tick if you are residing overseas: I declare that I am residing overseas Company: Position Company Email: Date Joined: __ __/__ __/__ __ Company Phone: Revised – 26 May 2015 2. CPE COMPLIANCE This section is applicable to CA (Singapore) only. All CA (Singapore), including Fellow but excluding Members-in-retirement, must attain at least 120 CPE hours per triennium, of which at least 20 are verifiable CPE hours including 2 hours of compulsory ethics per year. The CPE year is from 1 January to 31 December. Please tick the relevant box: I have complied with ISCA CPE requirements I have not complied with ISCA CPE requirements Please state reason: ______________________________________________________________________________ 3. CREDIT CARD AUTHORISATION I, hereby authorize ISCA to charge the amount stated below to my credit card. Credit Card: VISA MasterCard AMEX Credit Card No: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ CVV No.: __ __ __ __ Card Expiry Date: __ __ / __ __ (MM/YY) Cardholder’s Name: _______________________________________________________________________________ Cardholder Signature: _______________________________________ Amount: S$ ____________________ CVV is a security feature to help verify that an individual is in possession of the credit card. For Visa/Mastercard, it is the last 3 digits at the back of your card. For Amex, the 4-digit CVV number is printed on the front of the card above the card account number. 4. PREFERENCES Communication on Renewal Notice: IS Chartered Accountant Journal: Email only e-Journal only Letter Hardcopy Please note that the hardcopy letter and/or Journal will not be sent to you once you have selected the email and/or e-Journal only option. Revised – 26 May 2015 5. DECLARATION Please answer the following questions by ticking where appropriate. For any “Yes”, please provide details in the space below. Please attach a separate sheet if more space is required. (i) Have you ever been convicted of any criminal offence? (ii) Have you ever been adjudged a bankrupt or made any assignment for the benefit of your creditors? (iii) (iv) Have you ever been a subject of any investigation by governmental, statutory or professional in respect of any offence involving dishonesty or any complaint for professional misconduct? Have you been refused entry to any professional body or have your membership or registration with such body terminated or suspended? Yes No Yes No Yes No Yes No ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ISCA Privacy and Data Protection Policy The Institute seeks to collect and may use and/or disclose your personal data for matters relating to your membership and/or the conduct of the Institute’s business in accordance with the Personal Data Protection Act 2012. The Institute may from time to time use your personal data to inform you of related news, CPE activities, members’ benefits, goods, services, facilities and events. The Institute may also use your personal data for the conduct of statistical research and studies, and analyse the data collected to administer, develop and improve its services. By accepting membership with the Institute and/or participating in any events or activities organized by the Institute (including any purchases of goods and services from the Institute), you consent to the collection and use of your personal data in accordance with the ISCA Privacy and Data Protection Policy at http://corp.isca.org.sg/privacy-policy. You can withdraw your consent for certain future actions at any time at http://www.isca.org.sg/withdrawal-of-consent. I declare that I have read and understand the Singapore Qualification Programme (Singapore QP) Transitional Arrangements applicable to myself. I agree to be bound by the membership rules relating to the admission of Chartered Accountants of Singapore, as may be amended, modified or supplemented from time to time by the Institute. I understand that upon Council’s approval of my application, I shall observe and abide by the Rules of the Institute. By submitting this form, I agree with the above statements, unless stated otherwise, and my personal profile and information is true and complete to the best of knowledge and belief. Signature: ________________________________________________ Date: __________________________ Revised – 26 May 2015
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