FORM F002 ANNUAL FIRM LICENCE RENEWAL FORM (2023) Prevent Duplicate EntryForm Submission is restrictedYour return has been submitted successfully. Kindly check your email for more information.Step 1 of 8Dear Practitioner, Kindly read the following carefully before completing the 2023 Firm re-profiling and re-categorisation form 1. Completion of this form is mandatory for all firms. 2. After completing and submitting the form you will receive an email (in the primary email address you indicated on the form) 3. The email will indicate your Firm's category and the applicable fee and serves as the invoice to be used to pay your 2023 Firm licence renewal fees. 4. Please note that the deadline for submission of the completed form is 28th February 2023. 5. Firms which fail to meet the 28th February deadline will be sanctioned per ICA Act 2020, Act 1058. RENEWAL OF FIRM LICENCEDoes the firm intend to renew its licence for the year 2023?*YesNo Name of Firm*Firm's Licensed Number*Firm's Tax Payer Identification Number (TIN)*Name of Managing Partner/Practitioner*Email Address of Managing Partner/Practitioner*Telephone number of Managing Partner/Practitioner*Name of other Partners (Where Applicable)Email Addresses & Telephone numbers of other PartnersState the Reason/s for non-renewal*How will the existing clients be catted for?*Please note that you cannot sign any financial statements for the period of non-renewal of your firm's licence. The firm will be sanctioned per ICA Act 2020, (Act 1058) if it is found out that it has signed financial statements or conducted any business within the meaning of section 35 of Act 2020 (Act 1058) in the name of the firm. In any year that the firm wishes to renew its licence, the Institute should be formally notified in October, prior to the year of renewal.Declartion*I declare that the information provided above is true and complete to the best of my knowledgeSigned (Intitials):*Designation: (Managing Partner/Practitioner)*Name:*Date:* Please Provide Your Practice Firm DetailsName of Firm*Firm's Licensed Number*Firm's Tax Payer Identification Number (TIN)*Firm's Physical Locational Address*Firm's Digital/GPS Address*Firm's Email Address (Primary for receipt of invoice)*Firm's Email Address (Secondary)Firm's Active Telephone numbers: mobile*Firm's Active telephone numbers: landline (where applicable)Does the Firm have a Branch?*YesNoIf yes, please provide branch's postal, physical and digital/GPS address*Does the Firm has international affiliation/collaboration?*YesNoIf yes, please provide name of affiliate, country of residence, key contact*Attach a scanned copy of a valid Tax clearance certificate for the renewal of your practising licence* Upload% Completed0Attach Firm's Current Professional Indemnity Insurance* Upload% Completed0 DETAILS OF MANAGING PRACTITIONER / PARTNERSName of Managing Practitioner / Managing Partner*Email of Managing Practitioner / Managing Partner*Telephone Number of Managing Practitioner / Managing Partner*Total Number of Partners (Including the Managing Partner)Name of Partner 1Email Address Partner 1Phone Number Partner 1Name of Partner 2Email Address Partner 2Phone Number Partner 2Name of Partner 3Email Address Partner 3Phone Number Partner 3Name of Partner 4Email Address Partner 4Phone Number Partner 4Name of Partner 5Email Address Partner 5Phone Number Partner 5Please attach details of other partners if there are more Upload% Completed0 STAFFINGTotal Number of Staff*Number of Qualified Staff*Number of Non-Qualified Staff*Number of Permanent Staff*Number of Non-Permanent Staff* EARNINGS PROFILETotal Number of Clients*Number of Audit Client*Number of Non-Audit Clients*Number of Public Interest (PIE) Clients*Total Actual Firm Income/Revenue for 2021*Total Actual Audit Income for 2021 GHS*Total Actual Non-Audit Income for 2021 GHS*Total Firm Income/Revenue for 2022*Audit Income for 2022 GHS*Non-Audit Income for 2022 GHS*Annual Turnover*Category*Fee*Any Revelant Significant Change in the Practice (change in location, partnership structure, inactive/resigned/joined partners etc.)Attach Documentary Evidence of Change Where Appropirate Upload% Completed0Declaration*I declare that the information provided above is true and complete to the best of my knowledgeAny misrepresentation will be referred to the Disciplinary Committee of Council for the appropriate disciplinary measures to be taken against the firm Consent of Disclosure of Firm InformationI hereby agree and consent to the Institute of Chartered Accountants, Ghana to disclose or to provide my information to the public as a firm engaged in public prcatice of accountancy. I further agree that any duplication and any copy, photocopy, electronic data, or facsimile which have been made as a copy from this original consent declaration by means of photcopying, image scanning, or recording in whatever forms shall be deemed as evidence of my consent with the same effect as its original.In compliance with International Federation of Accountants (IFAC) Statement of Members Obligation (SMO) 1, I will avail my firm at all times for ICAG Quality Assurance Inspection.Signed (Initials):*Designation: (Managing Partner/Managing Practitioner)*Name:*Date:* Submit2023 FIRMS RE-PROFILING AND RE-CATEGORISATION FORMConfirm