1 of 2
State of Florida
Department of Business and Professional Regulation
Board of Accountancy
Verification of Work Experience
Form # DBPR CPA 32
VERIFICATION OF WORK EXPERIENCE
INSTRUCTION TO APPLICANT: Please sign this statement, forward to verifying CPA for
completion and return to the Department of Business and Professional Regulation.
I hereby authorize my employers (past and present) to release to the Florida Board of Accountancy any
information, files and/or records as it may deem necessary in the processing of this verification of work
experience.
APPLICANT INFORMATION
Last Name
First
Middle
Street Address or P.O. Box
City
State
Zip Code (+4 optional)
Date
Signature
EMPLOYER INFORMATION
Name of employer __________________________________________________________________
Location of office in which applicant was employed ________________________________________
VERIFICATION PERIOD
3. FULL-TIME EMPLOYMENT: Date From: _______/_______/______
To: _______/_______/_______
Number weeks employed ______________________ Applicant still employed:
YES
NO
Average hours per week employed _____________________________
Total hours employed ________________________________________
4. PART-TIME EMPLOYMENT (Give complete details below. Attach additional statement if necessary.)
Date From: _______/_______/_______ To: _______/_______/_______
Number weeks employed _____________________________________
Average number hours per week employed _______________________
Total hours employed ________________________________________
DBPR CPA 32 CPA Work Experience
Eff. Date 07/01/2012
Incorporated by Rule: