1. The definitions in the Board's rules apply to this form. Italicized terms in the instructions to this form are defined in the Board's rules. See Rule 1001.
2. Any registered public accounting firm seeking to withdraw from registration with the Board must file this form with the Board.
3. In addition to these instructions, the Board's Rule 2107 governs applications for leave to withdraw from registration. Please read Rule 2107 and the instructions carefully before completing this form.
4. Unless otherwise directed by the Board, a registered public accounting firm seeking to withdraw from registration must submit this form to the Board electronically by completing the Web-based version of Form 1-WD. The date of such submission shall be deemed the date of Board receipt of the Form.
5. Pursuant to Rule 2107, any Form 1-WD filed with the Board shall be non-public. A registered public accounting firm may submit with Form 1-WD a request for Board notification in the event that the Board is requested by subpoena or other legal process to disclose the Form 1-WD. The Board will make reasonable attempts to honor any such request, although the Board will make public the fact that the firm has requested to withdraw from registration.
6. Information submitted as part of this form must be in the English language.
PART I – IDENTITY OF THE REGISTERED PUBLIC ACCOUNTING FIRM
Item 1.1 Name of the Firm Requesting Leave to Withdraw
State the legal name of the firm requesting leave to withdraw; if different, also state the name or names under which the firm (or any predecessor) issues audit reports, or has issued any audit report during the period of the firm's registration with the Board.
Item 1.2 Firm Contact Information
State the physical address (and, if different, mailing address) of the firm's headquarters office. State the telephone number and facsimile number of the firm's headquarters office.
Item 1.3 Primary Contact and Signatories
State the name, title, physical business address (and, if different, business mailing address), telephone number, facsimile number, and e-mail address of a partner or authorized officer of the firm who will serve as the firm's primary contact with the Board regarding this application. Provide the same information for every person whose signature appears in Part III or Part V of the form, if any of those persons are different from the primary contact.
PART II – DESCRIPTION OF ONGOING REGULATORY OR LAW ENFORCEMENT PROCEEDINGS
Item 2.1 Description of Ongoing Regulatory or Law Enforcement Proceedings
Identify all ongoing federal, state, or local investigative, disciplinary, regulatory, criminal, or other law enforcement proceedings that are known to the firm, including to any of the firm's partners or officers, and that address in whole or in part (1) conduct of the firm or (2) audit-related conduct of any of the firm's associated persons. For each such proceeding, state –
a. The identity of the federal, state, or local authority conducting the proceeding;
b. The caption or other identifying information of the proceeding;
c. The date that the firm or a partner or officer of the firm first became aware of the proceeding;
d. The firm's understanding of the current status of the proceeding; and
e. The conduct of the firm and the firm's associated persons that the proceeding addresses.
PART III – CERTIFICATION OF NONPARTICIPATION IN AUDITS
Item 3.1 Statement of Nonparticipation in Audits
Furnish a statement, dated and signed on behalf of the firm by an authorized partner or officer of the firm, in the following form –
On behalf of [name of firm], I certify that [name of firm] is not currently, and will not during the pendency of its request for leave to withdraw be, engaged in the preparation or issuance of, or playing a substantial role in the preparation or furnishing of, an audit report, other than to issue a consent to the use of an audit reportfor a prior period.
Note: Other than the insertion of the name of the firm the statement must be in the exact words contained in this instruction.
Part IV – REASONS FOR SEEKING LEAVE TO WITHDRAW (Optional)
Item 4.1 Description of Reasons for Seeking Leave to Withdraw
Describe, if you choose to do so, the reason or reasons that the firm seeks leave to withdraw from registration.
PART V – SIGNATURE OF FIRM SEEKING LEAVE TO WITHDRAW
Item 5.1 Signature of Authorized Partner or Officer
The request for leave to withdraw from registration must be signed on behalf of the firm by an authorized partner or officer of the firm. The signer must certify that he or she has reviewed the application; that the application is, based on the signer's knowledge, complete and does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statement made, in light of the circumstances under which such statements were made, not misleading, and that the signer is authorized to execute the application on behalf of the firm. The signature must be accompanied by the title of the signer and the date of the signature.
[Effective pursuant to SEC Release No. 34-49694, File No. PCAOB-2003-09 (May 13, 2004)]