Financial Reporting Regulations 2015

Schedule Form

r 9

Form Declaration that entity was inactive

Section 45(3), Financial Reporting Act 2013

The declaration in the format set out below must be made on behalf of the entity by 2 directors of the entity or, if the entity has only 1 director, by that director.

I, [name of director of entity], of [place, occupation], solemnly and sincerely declare that—

(a)

I am a director of [name of entity]; and

(b)

the incorporation or registration number of [name of entity] is [incorporation or registration number]; and

(c)

[name of entity] was an inactive entity (as defined in section 45(4) of the Financial Reporting Act 2013) in respect of the accounting period ending on [balance date].

And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957.

Signature:

Declared at [place] this [date] day of [month, year]

Signature of person authorised to take statutory declaration:

Michael Webster,
Clerk of the Executive Council.