Individual Cpa Certificate Renewal - Minnesota Board Of Accountancy - 2018 Page 6
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79.
DESIGNATION AFFIDAVIT FOR
INACTIVE
RENEWALS
Complete only if you are electing to go inactive.
Please note:
Inactive is a status that requires annual renewal.
Read all statements and sign the affidavit below.
1. I am not required to have an active certificate in Minnesota;
2. I will not use the CPA designation in a way that may lead a person to believe that I hold an active
certificate in Minnesota;
3. I will place the word “inactive” adjacent to my CPA title;
4. I am not engaged and will not engage in the practice of public accounting in Minnesota without
obtaining an active certificate.
Affidavit: I swear or affirm that I have read the foregoing renewal application
and that the statements are true and complete.
Signature
Printed Name
Date
CPA Certificate Renewal Form—Page 5 of 6
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