MEMBERSHIP RENEWAL FORM Name: NRIC: Contribute to our ongoing ‘Go Green’ efforts by logging into http://www.icpas.org.sg to renew your subscription online. How To Qualify: Log into your ICPAS account  My Payments  My Payments List To ensure you are kept abreast of industry happenings, please update your particulars online through the Members’ Profile Update Portal by logging into your ICPAS account. Alternatively, your may complete the below form and fax back to us at 6438 9623. PAYMENT DETAILS Year 2010 subscription fee – Due Date: 31st January 2010 Please tick  the relevant box □ Provisional membership – local address (incl. GST) S$96.30 □ Provisional membership – overseas address S$90.00 □ Non-practising membership – local address (incl. GST) S$149.80 □ Non-practising membership – overseas address S$140.00 □ Practising membership – local address (incl. GST) S$492.20 □ Practising membership – overseas address S$460.00 □ Member-in-retirement – local address (incl. GST) S$53.50 □ Member-in-retirement – overseas address S$50.00 □ □ th 10 Edition ICPAS Members’ Handbook CD (incl. Prevailing GST) Voluntary contribution to Community Service Fund (min. S$12) S$10.70 TOTAL S$ PAYMENT METHOD □ Online – http://www.icpas.org.sg (Preferred payment method) □ Cheque No. ______________________ (payable to ICPAS) □ Credit Card Number: Amount: S$___________ __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ □ VISA  □ MasterCard  □ AMEX | Card Expiry Date: __ __ / __ __ | CVV Code: __ __ __ Cardholder’s Name: ____________________________________________________ Cardholder’s Signature: Amount: S$___________ PROFILE UPDATE 6 Raffles Quay, #23-00, Singapore 048580. Tel: 6532 5312 Fax: 6438 9623 Email: [email protected] MEMBERSHIP RENEWAL FORM New Contact Details Latest Employment Details Name: _____________________________________ Company: __________________________________ Home Address: ______________________________ Position: ___________________________________ ____________________________________________ Date Joined: ________________________________ Mailing Address: ____________________________ Phone (O): _____________ | Fax: _______________ ____________________________________________ Office Email: _______________________________ Phone (H): _____________ | Mobile: _____________ Personal Email: _____________________________ CPE DECLARATION □ □ I have fulfilled the CPE requirements of ICPAS for Y2009 I have NOT fulfilled the CPE requirements of ICPAS for Y2009 Signature / Date APPPLICATION FOR MEMBER –IN-RETIREMENT (Member must satisfy all the requirements below) In accordance with the ICPAS (Membership and Fees) Rules, I declare all of the following: a) I am 55 years old and above; and b) I am effectively retired; and c) I am *not gainfully employed. *”not gainfully employed” is defined as having an earned income of not more than S$24,000 per annum. I undertake to inform the Institute if I should subsequently resume gainful employment. The annual fee for member-in-retirement is $53.50+ ___________________________________ Signature /Date 6 Raffles Quay, #23-00, Singapore 048580. Tel: 6532 5312 Fax: 6438 9623 Email: [email protected]