INTERNAL AUDIT (Audit Project Title & No.

) AUDITOR ASSIGNMENT & INDEPENDENCE STATEMENT Government Auditing Standard 3.02 states: " In all matters relating to the audit work, the audit organization and the individual auditor, whether government or pu li!, must e "ree "rom personal, e#ternal, and organizational impairments to independen!e, and must avoid the appearan!e o" su!h impairments o" independen!e." International Standards "or the $ro"essional $ra!ti!e o" Internal Auditing Standard %%20 Individual & 'e!tivit( states: Internal auditors must have an impartial, un iased attitude and avoid an( !on"li!t o" interest. )( m( signature elow, I a!knowledge m( assignment to the a ove pro'e!t and pro"ess I know o" nothing that might impair m( independen!e and impartialit( on the pro'e!t. In C!"r#e Auditor$ St"%% Auditor$ Su&er'i(or$ A((i#n)ent Source$ D"te$ D"te$ D"te$

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Audit Director,( -eri%ic"tion o% Auditor,( A((i#n)ent & Inde&endence$ I have assigned the a ove sta"" and have determined the( are ade*uatel( skilled to work on the stated pro'e!t. I am not aware o" an(thing that might impair their independen!e and impartialit( on the pro'e!t.
201-Assignment.doc

INTERNAL AUDIT (Audit Project Title & No.) AUDITOR ASSIGNMENT & INDEPENDENCE STATEMENT

Audit +ire!tor Signature ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, +ate: ,,,,,,,,

201-Assignment.doc