INTERNAL AUDIT

(Audit Project Title & No.)

AUDITOR ASSIGNMENT & INDEPENDENCE STATEMENT

Government Auditing Standard 3.02 states:

" In all matters relating to the audit work, the audit organization and the individual
auditor, whether government or public, must be free from personal, external, and
organizational impairments to independence, and must avoid the appearance of such
impairments of independence."

International Standards for the Professional Practice of Internal Auditing Standard 1120
Individual Objectivity states:

Internal auditors must have an impartial, unbiased attitude and avoid any conflict of
interest.

By my signature below, I acknowledge my assignment to the above project and profess I know
of nothing that might impair my independence and impartiality on the project.

In-Charge Auditor: Date:

Staff Auditor: Date:

Supervisor: Date:

Assignment Source:

Audit Type:

Audit Objectives:

Audit Scope:

Special Instructions:

Start Date:

Estimated Audit Completion Date:

Audit Director’s Verification of Auditor’s Assignment & Independence:

I have assigned the above staff and have determined they are adequately skilled to work on the
stated project. I am not aware of anything that might impair their independence and impartiality
on the project.
201-Assignment.doc
 INTERNAL AUDIT
(Audit Project Title & No.)
AUDITOR ASSIGNMENT & INDEPENDENCE STATEMENT

Audit Director Signature ___________________________________________ Date: ________

201-Assignment.doc