DECLARATION FORM IN RELATION TO AUDITORS HAVING TO PERFORM THE WORK AT

CLIENT’S WORKPLACE / PREMISES

We hereby declare that:

S/n Items Remarks

[Please provide
details for ‘No’
and ‘NA’]
1) Work procedures cannot be performed from Assurance Partners LLP’s or Yes/No/NA
Assurance Partners LLP’s staff auditor’s (collectively as “auditor”) home /
work premises and such work procedures require the auditor to be at our
workplace or premises.
2) In addition, we confirm that and/or the following are in place at our
workplace or premises:
(i) Meetings at our workplace/premises should be conducted only if Yes/No/NA
online meetings are not possible. Meetings at our workplace/premises
should be strictly on appointment basis;
(ii) We do not have workers who are suspected and/or confirmed cases in Yes/No/NA
the last 14 days from the date of this declaration;
(iii) We have put in place Safe Management Measures; Yes/No/NA
(iv) We require all our employees to use TraceTogether App throughout Yes/No/NA
the entire duration of the journey to/from the workplace/premises;
(v) We require our employees to wear masks at all times in the Yes/No/NA
workplace/premises;
(vi) We will avoid physical meetings and interactions with the auditor Yes/No/NA
unless necessary. If such meetings / interactions are required, safe
distancing measures will be observed;
(vii) We have limited the number of our employees at our premises to the Yes/No/NA
extent required to perform the necessary tasks;
(viii) We have implemented team arrangements and have put in place Yes/No/NA
measures to avoid cross-deployment or interaction between
employees in different teams or worksites;
(ix) We have limited the time our employees spend at our premises and Yes/No/NA
our employees leave our premises immediately upon completion of
work procedures;
(x) We have ensured that our employees comply with the Safe Yes/No/NA
Management Measures that are in place at our premises;

1
 (xi) We do not allow employees who are unwell to work at our premises; Yes/No/NA
and
(xii) We have kept a log on the location of all our employees at all times. Yes/No/NA

_______________________
Signature

Name : __________
Designation : __________
Date : __________

For & on behalf of

Name of Company : _________