What it is
Management of an issuer evaluates the effectiveness of internal control over financial reporting as of the fiscal year-end, with a suitable, recognized control framework, and evaluates each quarter any change in ICFR that has materially affected or is reasonably likely to materially affect it (Exchange Act Rule 13a-15(c) and (d)). This memo documents the basis for management’s conclusion.
It covers the framework, scope, risk assessment and key control identification, the evidence supporting the evaluation, the deficiencies and their classification using the Regulation S-X definitions, the conclusion, and changes in ICFR in the period. Other entities can adapt it for a lender or board need.
When to use it
- At year-end, to document management’s evaluation.
- When the audit committee asks for the basis of management’s conclusion.
- For a voluntary evaluation by a private company.
What’s inside
- Framework and scope
- Risk assessment and key controls
- Evidence table by area and the deficiency table
- Conclusion, changes in ICFR and sign-offs
Standard cited
This template follows SEC Rule 13a-15 / Reg S-X 1-02(a)(4). It is written in our own words, except for phrases the standard requires the document to contain, with [bracketed placeholders] for client details, amounts in USD and dates as MM/DD/YYYY. Check it against the current standard and your firm’s methodology before use.
Questions
Can management conclude ICFR was effective with a material weakness?
No. If there is one or more material weakness, management cannot conclude that ICFR was effective, and it describes each material weakness.
Who prepares the evaluation?
Management, with the participation of the principal executive and financial officers. The auditor’s procedures do not replace management’s own evaluation.
Related templates
- SOX 404 Scoping Memo
- ICFR Management Deficiency Aggregation Matrix
- Significant Accounts and Locations Scoping Matrix
- ICFR Deficiency Communication Memo to the Audit Committee
Last updated 11/05/2026. All free templates.