Form Dbpr Cpa 32 - Verification Of Work Experience (Page 2 of 2) in pdf

Form Dbpr Cpa 32 - Verification Of Work Experience Page 2

2 of 2

INSTRUCTIONS TO VERIFYING CPA: Please complete and forward this Verification of Work

Experience form to the Department of Business and Professional Regulation, 1940 North Monroe

Street, Tallahassee, Florida 32399-0783.

I, the undersigned, state that the applicant named on this certification:

has had one year of work experience which included providing any type of service or advice involving

the use of accounting, attest, compilation, management advisory, financial advisory, tax, or consulting

skills. This experience was gained through employment in government, industry, academia, or public

practice and constituted a substantial part of the applicant’s duties.

has had at least five years of work experience, after licensure as a CPA or Canadian, Mexican, Irish,

Australian, New Zealand, or Hong Kong Chartered Accountant, which included providing any type of

service or advice involving the use of accounting, attest, compilation, management advisory, financial

advisory, tax, or consulting skills. This experience was gained through employment in government,

industry, academia, or public practice and constituted a substantial part of the applicant’s duties.

I state that these statements are true and correct and recognize that providing false information may

result in disciplinary action against my license or criminal penalties pursuant to sections 455.2275 and

837.06, Florida Statutes.

Verifying CPA’s Name ____________________________________________________________

CPA License Number ___________________

Date License to Practice Issued ______________

State in which certified __________________

Expiration Date of License __________________

________________

_______________________________________________________

DATE

SIGNATURE OF VERIFYING CPA

Is there any additional information concerning the good moral character or technical fitness of the

employee relative to his/her practice of public accounting that you feel the Board should be informed of?

____ Yes ____ No

(If "Yes", please attach written explanation.) Good moral character means a "personal history of honesty,

fairness, and respect for the rights of others and the laws of this state and nation."

DBPR CPA 32 CPA Work Experience

Eff. Date 07/01/2012

Incorporated by Rule:

Form Dbpr Cpa 32 - Verification Of Work Experience Page 2