第３章 参考文献2 CAMICO加入申込書
Part Ⅳ:Scope of Practice（加入者の業務内容）
22. Firm's fiscal year end:________________________________________________
Based on your firm's fiscal year-end data,provide the following gross revenue figures:
| Last Year | Current Year(estimated) |
Next Year(projected) |
| $ | $ | $ |
23. Percentage of revenue from the Firm's largest client:_____________________________
If the Firm's total revenue from its largest client exceeds 20%, please list:type of industry, services performed and how the Firm maintains its independence on Narrative Response Sheet(Part Ⅶ,Page5).
24. What percentage of work is per diem for other CPA Firms?______________
If percentage is 20% or greater, describe on Narrative Response Sheet(Part Ⅶ,Page5) for whom the work is done, and what services are provided.
25. Approximately what percentage of the Firm's revenue is derived from the following areas.
Check the services that use engagement letters.
26. Has the Firm or any member of the Firm within the past five years:
Has the Firm or any member of the Firm within the past five years: a owned more than 20%,operated, or managed any entity(excluding the Firm), organization, corporation, or enterprise either for profit or not-for profit for whorm the Firm provides professional accounting services?
□Yes □No
b acted as a director, officer, or trustee for, or exercised any form of managerial contorol over any entity (excluding the Firm), trust, organization, corporation, or enterprise either for profit or not-for-profit?
□Yes □No
If yes to (a) or (b),please explain on Narrative Response Sheet(Part Ⅶ,Page 5).
c participated with clients in any investment or business? □Yes □No
If you answer "yes" the policy may may limit coverage, Consult your CAMICO representative for clarification of coverage.
2000 CAMICO Mutual Insurance Company
