Cpa Form 6r - Application For Public Accounting Firm Registration - New York State Education Department Page 2
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1
2Peer Review Information
PC
LLC
LLP
Partnership
Sole Proprietorship
1.
Authorized to conduct business as (check one):
2.
Identify the services the firm plans to perform:
Audits
Reviews
Attestation Engagements
Agreed Upon Procedures
a.) Attest Services:
Compilations
Taxes
Management Consulting
Financial Consulting
b.) Non-Attest Services:
Other _____________________________________________________________________________
Yes
No
3.
Has the firm completed and attached CPA Form 6PR? (All firms are required to do so.)
Once received and approved your firm's registration status will be available online at by clicking on the "Online Services"
link. Please contact the Department at opcorp@mail.nysed.gov if you have any questions about the firm registration process.
Affirmation (Note for PC’s: when signing, be sure to check the appropriate box)
I (We) the undersigned affirm under penalties of perjury that I am (we are) (a) certified public accountant(s) licensed to practice public
accountancy in New York, my (our) office and principal place of business being located at ________________________________________
________________________________that, to the best of my (our) knowledge, all statements made in this registration regarding the said
firm are true; that said firm has complied with all provisions of the laws of this State applicable there to including but not limited to the
provisions of Article 149 of the State Education Law, and all applicable provisions of the Rules of the Board for Regents and Regulations of
the Commissioner of Education; that the sole proprietor or each partner, member or shareholder in such firm is in good standing as a
certified public accountant of one or more of the states or political subdivisions of the United States; that no state or political subdivision of
the United States has revoked the certificate of the sole proprietor or each partner, member or shareholder of said firm; and that the sole
proprietor or each partner, member or shareholder of said firm engages within this State in the practice of public accountancy, is a certified
public accountant in good standing and is registered by the New York State Education Department or is otherwise authorized to practice in
this State and is in good standing as a certified public accountant in their state of principal place of business.
_________________________________________________________________________________ _____________________ ( ______ )
Signature of sole proprietor, partner, member or shareholder (PC’s only: president or vice president) CPA License number (State)
_____________________________________________________________________________
_________________________________
Print name
Date
_________________________________________________________________________________ _____________________ ( ______ )
PC’s Only, Second signature of secretary or assistant secretary
CPA License number (State)
_____________________________________________________________________________
_________________________________
Print name
Date
Mail this form with: 1)
a check or money order for the appropriate fee, made payable to the New York State Education
Department;
2)
the CPA Form 6PR;
3)
the CPA Form 6C and any additional owner list; and
4)
the certified copy of your formation document as follows: Certificate of Incorporation (domestic PC),
Articles of Organization (domestic LLC), Certificate of Registration (domestic LLP), Assumed Name
Certificate (Partnerships and Sole Proprietorships), Application for Authority (foreign PC and foreign LLC)
or Notice of Registration (foreign LLP).
To: The New York State Education Department, Office of the Professions, Division of Professional Licensing Services, Professional
Corporations Unit, 89 Washington Avenue, Albany, NY 12234.
Certified Public Accountant Form 6R, Page 2 of 2, Rev. 11/14
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