Application For Minnesota Sole Proprietor Firm Permit - Minnesota Board Of Accountancy Page 3
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65.
List of Minnesota resident non-CPA owners:*
Provide the names of all non-CPA owners, partners, members, shareholders, directors and officers
of the firm who reside in Minnesota. Attach list, if necessary.
* Be sure to complete a
Non-CPA Owner of Firm Statement
(page 5) and enclose the $45.00 fee for each individual listed.
6.
Non-CPA owners—resident and nonresident combined—hold,
in
total, what percentage of:
Voting interest in the firm?
%
Financial interest in the firm?
%
7.
DESIGNATION AFFIDAVIT FOR
FIRM PERMIT APPLICATION
If a statement does not apply to your firm,
Read all statements and sign the affidavit below.
mark “N/A” in the box next to that statement.
q
1. I have an active Minnesota CPA certificate.
2. All attest and compilation services rendered by the firm in this state are under the
charge of a person holding a valid certificate with an active status or a person who has
been granted practice privileges under Minnesota Statute §326A.14 (2016).
3. The firm has an audit documentation retention and destruction policy that complies
with Minnesota Rules 1105.7850.F (2015).
4. The firm has verified that—if applicable—all Minnesota non-CPA owners have complet-
ed a Minnesota Non-CPA Owner of Firm Statement and registered with the Board.
5. All individual employees of the firm who have been granted practice privileges under
Minnesota Statute §326A.14 (2016), or who hold certificates and reside or practice in
this state and those persons specified in part 1105.4000.D (2015), who are responsible
for supervising attest or compilation services or who sign or authorize someone to sign
an accountant’s report on financial statements have met the competency requirements
set out in professional standards.
Affidavit: I swear or affirm that I have read the foregoing application
and that the statements are true and complete.
Printed Name of Sole Proprietor
Signature of Sole Proprietor
Date
Application for Sole Proprietor Firm Permit——Page 2 of 5
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