Cpa Sole Proprietor Firm Permit Renewal Application - Minnesota Board Of Accountancy - 2017

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Ph: 651-296-7938
oard of
Fax: 651-282-2644
85 East 7th Place, Suite 125
St. Paul, MN 55101-2143
Send this renewal and your check (made payable to MN Board of Accountancy)
to the address above
postmarked on or before December 31,
A $50 delinquency fee is required for renewals postmarked after that deadline.
Please Note: Firm permits cannot be renewed until the individual CPAs who are required by
Minnesota Rule 1105.4000.D to renew have already done so.
Complete and return these REQUIRED items:
and 2)
1. Firm Permit Renewal Application (pages
2. Firm Peer Review Statement (page 3)
3. Workers’ Compensation Liability Certificate of Compliance (page 4)
4. Payment of the firm permit renewal fee
Do NOT include individual renewal forms or payments with your firm permit renewal.
Annual Renewal Fee:
Firms with offices only in Minnesota:
Firms with one or more offices in another state:
Complete and return the following items if applicable:
1. Non-CPA Owner of Firm Statement Form (page 5)
Complete a form and include $45.00 fee for each Non-CPA Owner.
question 3 on page
2. List of firm locations (see
Dissolutions/Mergers: If your sole proprietor firm has dissolved or merged with a firm in the
past year, please notify the Board in writing.
Firm Name Changes:
Firms cannot renew under a new name until the Board has
approved the firm name change.
FIRST submit the
Sole Proprietor Firm Name Change
Request Form
found on the Board website. Once you receive approval from the Board, then you
may submit a renewal under the new name.
If you have questions regarding your application, please call the Board office at 651-296-7938.
Data Practices Act Warning
The data you furnish on this form will be used by the Board to process your application for licensure. You are not
legally required to provide this data; however, if you fail to do so, the Board may be unable to issue your license.
Until licensure is granted all application data, except name and designated address, are private data pursuant to
Minnesota Statutes section 13.41, subdivision 2 (2016). All data, except social security number and email address
become public record when licensure is granted pursuant to Minnesota Statutes section 13.41, subdivision 5 (2016).
CPA Sole Proprietor Firm Permit Renewal Form—INSTRUCTIONS


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