Individual Cpa Certificate Renewal Application - Minnesota Board Of Accountancy - 2016 Page 5
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7Continuing Professional Education Report
If you have not already reported your CPE through the Board’s
Online
Services, complete this form.
FISCAL YEAR 2013 (Hours completed July 1, 2012 to June 30, 2013)
Self-Study Course
Course Hours from
Hours from a NASBA
Course Hours from
Non-Approved
Quality Assurance
Approved Sponsors
Sponsors
Type of Credits
Service Sponsor
Total
(Not including self-study)
(Not including self-study)
General
Ethics
Personal Development
Teaching
N/A
Writing
Total for fiscal year ending June 30, 2013
FISCAL YEAR 2014 (Hours completed July 1, 2013 to June 30, 2014)
Self-Study Course
Course Hours from
Hours from a NASBA
Course Hours from
Non-Approved
Quality Assurance
Approved Sponsors
Sponsors
Type of Credits
Service Sponsor
Total
(Not including self-study)
(Not including self-study)
General
Ethics
Personal Development
Teaching
N/A
Writing
Total for fiscal year ending June 30, 2014
FISCAL YEAR 2015 (Hours completed July 1, 2014 to June 30, 2015)
Self-Study Course
Course Hours from
Hours from a
Course Hours from
Non-Approved
NASBA-Approved
Approved Sponsors
Sponsors
Type of Credits
Self-Study Sponsor
Total
(Not including self-study)
(Not including self-study)
General
Ethics
Personal Development
Teaching
N/A
Writing
Total for fiscal year ending June 30, 2015
Carryback hours used to satisfy the minimum requirements
(Include copies of certificates of completion and CPE Non-Compliance fee, if not already submitted.)
Grand Total for Three Years
(Must meet minimum requirement of 120 hours)
CPA Certificate Renewal Form—Page 4 of 6
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