Individual Cpa Certificate Renewal Application - Minnesota Board Of Accountancy - 2016

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M
B
a
Ph: 651-296-7938
innesota
oard of
ccountancy
Fax: 651-282-2644
85 East 7th Place, Suite 125
St. Paul, MN 55101-2143
2016 INDIVIDUAL CPA CERTIFICATE RENEWAL
INSTRUCTIONS
Individuals who MUST RENEW by December 31, 2015:
• All CPAs whose last name begins with A-P
• CPAs who were issued a new certificate in 2015
• Any CPA who renewed after January 1, 2014
Complete the applicable pages and send with your check (made payable to MN Board of
Accountancy) to the address above
postmarked on or before December 31,
2015.
A $50 delinquency fee is required for renewals postmarked after that deadline.
Active certificate remaining Active: Complete pages
1, 2,
3
and 4.
Inactive certificate remaining Inactive: Complete pages
1, 2
and 5.
Active certificate changing to Inactive
1, 2
and 5.
Complete pages
You are required to report your CPE for the 3-year period ending June 30, 2015,
before you can change to the inactive status. If you have not already reported your
3
and 4.
CPE using the Board’s Online Services, also complete pages
Inactive certificate changing to Active
1
and 2.
Complete pages
In addition to the above, you must also complete the
CPE Reporting Form for Status
Change to Active
on the Board website (do not use pages 3 and 4 of this form).
Changing to Exempt
1, 2,
and 6.
Complete pages
If your previous status was Inactive, you do not need to report CPE.
If your previous status was Active, you are required to report your CPE for the
3-year period ending June 30, 2015, before you can change to exempt status. If you
have not already reported your CPE using the Board’s Online Services, complete
3
and 4.
pages
Changing from Exempt to Active
Do not use this form. Use the
Status Change Request Form
on the Board website.
Surrender certificate
1
and 2.
Complete pages
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 (2014). 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 (2014).
CPA Certificate Renewal Form—INSTRUCTIONS

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