Company Bankrupt - DOC by nhd16910

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									Declaration of Independence, Relevant Relationships and
                      Indemnities
This document MUST be completed for all formal insolvency appointments except for
appointments as Receiver, Receiver and Manager or some other form of Controller.


1.1       Declaration of Independence, Relevant Relationships and Indemnities
[company/bankrupt name]
[ACN / Estate number]

Independence
I, [name, firm] have undertaken a proper assessment of the risks to my independence prior to
accepting the appointment as [liquidator/administrator/trustee] of [company/bankrupt]. This
assessment identified no real or potential risks to my independence. I am not aware of any
reasons that would prevent me from accepting this appointment.


Relevant Relationships
Neither I, nor my firm, have, or have had within the preceding 24 months, any relationships
with the [company/bankrupt], an associate of the [company/bankrupt], a former insolvency
practitioner appointed to the [company/bankrupt] or any person or entity that has a charge on
the whole or substantially whole of the [company’s/bankrupt’s] property.
OR
I, or a member of my firm, have, or have had within the preceding 24 months, a relationship
with:


Name                   Nature of relationship           Reasons why not an Impediment or
                                                        Conflict


    Disclose here any relevant relationships with:
        the company/bankrupt;
        an associate of the company/bankrupt;
        a former Practitioner of the company/bankrupt; or
        a person who has a charge on the whole of substantially the whole of the
         company’s/bankrupt’s property.
There are no other prior professional or personal relationships that should be disclosed.


Prior Engagements with the Insolvent
Neither I, nor my Firm, have undertaken any prior engagements for [company/bankrupt].
OR
I, or a member of my Firm, have undertaken the following engagements for
[company/bankrupt] prior to the acceptance of this appointment:



1
Name                           Nature of engagement         Reasons why not an Impediment or
                                                            Conflict


    Disclose here:
        the nature of pre-appointment advice (if any);
        the nature of work carried out more than two years prior to the appointment (if any);
        the nature of any other work undertaken which fits within any of the exclusions
         included in the Code.
There are no other prior professional relationships or engagements that should be disclosed.


Indemnities
I have been provided with the following indemnities for the conduct of this
[liquidation/administration/bankruptcy]:


Name                             Nature of indemnity




    Disclose here:
        each indemnifier; and
        the extent and nature of each indemnity, other than statutory indemnities
This does not include statutory indemnities.
OR
I have not been indemnified in relation to this administration, other than any indemnities that I
may be entitled to under statute.


Dated:


.....................................................
(signed, Practitioner name)

NOTE:             If circumstances change, or new information is identified, I am required under the
                  IPA Code of Professional Practice to update this Declaration and provide a copy to
                  creditors with my next communication as well as table a copy of any replacement
                  declaration at the next meeting of the company’s creditors.




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