Application for Empanelment of Concurrent Auditors
 
* Fields are Mandatory
   1. Centre Applied (In order of preference)
S No.: State District
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  2. Basic Details
a. Name of the Firm :*
b. Address Line1 :* c. Address Line2 :*
d. State:* e. District :*
f. City:* g. Pincode:*
 
  3. Contact Details
a. Landline(prefix with STD Code): b. Mobile :*
c. Fax(prefix with STD Code) : d. Email :*
 
  4. Other Details
a. Constitution Status as on Date :*
b. Date of Establishment of the firm/company(dd/mm/yyyy):*
c. Permanent Account Number of the firm :* (Pdf only. Maximum File Size 5MB only)
d. GST Registration number of the firm : (Pdf only. Maximum File Size 5MB only)
e. Registration number of the firm with ICAI :* (Pdf only. Maximum File Size 5MB only)
f. Date of Registration of the firm with ICAI (dd/mm/yyyy):*
g. Unique Code Number (Registered with RBI) :* (Pdf only. Maximum File Size 5MB only)
h. Date of Registration with RBI (dd/mm/yyyy):*
i. Category (Registered with RBI) :*
j. Number of Partners:
k. Number of the partners completed Certificate Course on Concurrent Audit of Banks:* (Pdf only. Maximum File Size 5MB only)
l. Number of partners with CISA/DISA qualification :* (Pdf only. Maximum File Size 5MB only)
m. Number of the partners who are Ex-Banker :
n. Number of partners/qualified staff with Forex Specialization / experience:
o. Number of partners/qualified staff with System / I.S Audit Specialization / experience:
p. Whether firm is empanelled information security auditing organization by CERT-In:
q. Whether any Partner having NISM awarded DOCE certificate (Valid & Inforce)
(Pdf only. Maximum File Size 5MB only)
 
  5. Information of Partners:
Name of Partner: Stationed At: Qualification: Membership No : Year of membership(yyyy): Contact No. Brief Profile (Past Exp):
 
  5.1. Whether any of the partner of the firm is related to staff or Director of the Bank.
  5.2.If so give details of such relationship:
 
  6. Whether the firm is having Branches.If yes, furnish details of each Branch Office hereunder :
 
  7. Audit experience of the firm:
  7.1. Concurrent Audit experience with Union Bank of India:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.2. Concurrent Audit experience with other Banks (other than Union Bank of India):
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.3 Central Statutory Audit experience with Banks:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
 
  7.4 Statutory Branch Audit experience with Banks:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.5 Income /Revenue Audit experience with Banks:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.6 System / IS. Audit experience with Banks:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.7 Foreign Exchange Audit experience with Banks:
Type of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.8 Stock Audit of Large Borrowers / Corporates of Banks:
Type of Audit: Name of Bank: Branch and Location: Name of borrower: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
  7.9 Detail of Bank Audit Assignments (including Concurrent Audit) on Hand:
Type of Audit: Nature of Audit: Name of Bank: Branch and Location: From Date(dd/mm/yyyy) (Cannot be greater than To Date): To Date(dd/mm/yyyy):
 
 
  8. Give details of Audit Staff Employed:
a. No. of Chartered Accountants:*
b. No. of Semi-qualified Chartered Accountants:*
c. No. of Article Clerks:*
d. No. of Ex Bankers:*
e. Other Assistants :*
g. Total :*
 
   9. Areas of specialization of the firm/partners in Bank audits (Forex Branch, Service Branch, Industrial Finance Branch [IFBs], Large Corporate Branch, Depository Participant Branch, Housing Finance Branch, NRI Branch, SME Branch, Collection & Payment Service Branch, Retail Hubs,Domain Audit,Gateway Audit etc.) Specify:
 
   10. Details of firm Income for FY 2024-25 (Rupees in lacs)
       Annual Revenue of the Firm
      Gross Income of the Firm
      Net Income of the Firm
 
11. Whether the firm or any partner/director have ever been debarred/de-empanelled by ICAI/RBI/Union Bank of India/any other bank during last five years:
a. If yes, give details:
12. Any other relevant details/ particulars of the firm
We, acknowledge and accept the Terms & Conditions applicable for Empanelment and further confirm that the details / information furnished above are/is true
and correct (if any detail furnished above is found incorrect later on, the Bank has right to terminate the assignment, given if any, without giving any notice).