CPA Ireland - Members - Members in Practice

	In the context of the amalgamation of CPA Ireland and Chartered Accountants Ireland, Chartered Accountants Ireland may register firms in which one or more principals are not members of Chartered Accountants Ireland if these individuals are granted affiliate status.
	The regulations relating to affiliates are set out in Chapter 7 of the Public Practice Regulations of Chartered Accountants Ireland. Affiliate status does not confer membership of Chartered Accountants Ireland. However, it does mean that an affiliate is bound by the same rules and regulations as govern a full member.
	Each affiliated partner that is not a member of Chartered Accountants Ireland, in a firm that was a CPA Authorised Firm prior to the amalgamation date, is required to submit a request for affiliate status, in accordance with the Public Practice Regulations of Chartered Accountants Ireland. Failure to do so will result in the cessation of the firm registration.
	If you have any queries on this matter, please contact Emer Kelly at emer.kelly@charteredaccountants.ie or Anais Jalet at anais.jalet@charteredaccountants.ie.
	In accordance with the Regulations of Chartered Accountants Ireland I hereby submit a request to be so approved as an affiliate of Chartered Accountants Ireland.
1. First name:
2. Last Name:
3. CPA Ireland’s affiliated partner number:
4. Date of Birth:
5. Phone Number:
6. Email Address:
7. Address:
8. Name of Firm:
9. Address of firm:
11. Are you a member of another Professional Accountancy Body?:	Yes No
If yes, please provide further information:
12. I confirm that there are no changes in circumstances which affect the information last provided to CPA Ireland in my latest annual return including my latest fit and proper declaration:	Yes No
	Declarations:
	1. I hereby apply for affiliate status of Chartered Accountants Ireland and in doing so make the following declarations
	I accept that by clicking “submit” below I will be accepting and confirming the following declarations.
	2. I agree to comply with the regulations and with all other obligations and liabilities of a member of Chartered Accountants Ireland and to be bound by the Charter, the Principal Bye-Laws, the Disciplinary Bye-laws and any other rules, regulations, codes and standards of Chartered Accountants Ireland to the extent that they apply to an affiliate.
	3. I agree to observe and uphold the Code of Ethics of Chartered Accountants Ireland.
	4. I agree to provide Chartered Accountants Ireland with all of the information that it requires.
	5. I understand that I shall not be entitled to call myself a chartered accountant and that affiliate status does not confer any rights, acknowledgements, status or designatory letters on an affiliate or entitle an affiliate to be publicly represented as having such.
	6. I acknowledge that, if accepted as an affiliate, I shall be subject to the disciplinary procedures of Chartered Accountants Ireland for any failure to comply with its Bye-laws or Regulations.
	7. I undertake that none of Chartered Accountants Ireland, its officers, staff, members of its Council or Committee, any agent of the Institute or the Committees or staff of the Investigation and Discipline Board or the Disciplinary Scheme can be held liable in damages for anything done or not done in dealing with any of the functions connected with the granting of affiliate status or enforcing the terms and conditions of the granting of affiliate status or the monitoring of compliance with those terms and in any respect, unless the act or omission is shown to have been in bad faith.
	8. I warrant that I have truthfully and fully answered the questions and hereby authorise Chartered Accountants Ireland to take up such references and make such enquires as are necessary to consider this application.
Date:	Today

Request to be registered as an Affiliate of Chartered Accountants Ireland