FCIM220060 - Where CDF offer is made 30 June 2014 onwards: appendices: appendix 6 - CDF report adoption certificate

Sample form - do not use

TO: HM REVENUE & CUSTOMS

On …………………… I accepted HM Revenue and Customs offer to enter into the Contractual Disclosure Facility and submitted my Outline Disclosure on *……………………/the same day (* delete as appropriate).

I confirm that I have seen Code of Practice 9, which incorporates the HMRC Investigation of Fraud Statement and that I have read and understood this.

I have also read and examined the Report dated ………………… prepared on my instructions by ……………………… ………………………………………and adopt it as my full disclosure in accordance with the HMRC Investigation of Fraud Statement and practice outlined in Code of Practice 9.

I certify that, to the best of my knowledge and belief:

a. the statements, figures and schedules in the Report are true and correct

b. the Report incorporates a complete statement of my assets and liabilities as at………………………………………

c. the Report incorporates a complete schedule of bank accounts operated by me from……………………………to…………………………………………

d. the Report incorporates a complete schedule of credit and debit cards operated by me from…………………………………………to…………………………………………..

e. the Report includes all facts which have any reference to all taxes and duties to which I am or have been liable and which I have caused to be evaded, both for my own benefit or that of others including any corporate entities

f. the Report, together with returns already made to HMRC, contains a full disclosure of all taxed and duties due to HMRC for the period from…………………………………to…………………………………… for the following persons and entities …………………………………………………………………………………………

Signed…………………………………………………

Address…………………………………………………………………………………………………………………………

Date………………………………………………………

FALSE STATEMENTS MAY RESULT IN A CRIMINAL INVESTIGATION WITH A VIEW TO PROSECUTION