Individual Cpa Certificate Renewal - Minnesota Board Of Accountancy - 2018 Page 7
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710.
NOTIFICATION OF ELECTION TO BECOME
EXEMPT
FROM CERTIFICATE RENEWAL
Complete only if you are electing to go exempt.
Read all statements and sign the affidavit below.
1. I am not required to have an active certificate in Minnesota;
2. I am not engaged and will not engage in the practice of public accounting in Minnesota without
obtaining an active certificate;
3. I will not use the CPA designation in any manner or hold out in any manner (in accordance with the
provisions of Minnesota Rule 1105.3700 (2015)).
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 6 of 6
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