Application For Minnesota Sole Proprietor Firm Permit - Minnesota Board Of Accountancy Page 4

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FIRM PEER REVIEW STATEMENT
1.
Did/will your firm do work under the following standards?
Current Year
Next Year
Statements on Auditing Standards (SAS)
Yes
No
Yes
No
Statements on Standards for Accounting and Review Services (SSARS)*
Yes
No
Yes
No
Statements on Standards for Attestation Engagements (SSAEs)
Yes
No
Yes
No
Generally Accepted Government Auditing Standards (the Yellow Book)
Yes
No
Yes
No
PCAOB Auditing Standards
Yes
No
Yes
No
* Excludes engagements done under SSARS No. 21, AR-C section 70
If you answered “No” to all items in question 1,
sign
the affidavit below, then
skip
to the
next
page.
I swear or affirm that during the past year my firm did not perform attest or compilation services and does not plan to do so in the
coming year. If the firm does engage in such practice, I will notify the Minnesota Board of Accountancy within 30 days. Therefore my
firm is exempt from peer review requirements. I further certify that this information is correct and understand that my deliberate
misrepresentation may result in disciplinary action against my certificate and/or the firm permit.
Signature
Printed Name
Date
If you answered “Yes” to any item in question 1 above,
complete questions 2-5
below.
Note: Under
MN Statute 326A.05 Subd. 8
and
MN Rule
1105.4600-5400, your firm is required
to undergo a peer review with respect to the nonpublic company practice.
If your firm is not currently participating in a peer review program, please see
MN Rule
1105.5100.
2.
Are you currently participating in a peer review program?
Yes
No
3.
Indicate the Report Acceptance Body (RAB) you are/will be working with:
AICPA
MAPA
MNCPA
Other (specify):
4.
What 12-month period will be reviewed during your initial required peer review?
/
to
/
(Beginning Month)
(Beginning Year)
(Ending Month)
(Ending Year)
5.
Affidavit:
I certify that the information provided above is complete and accurate.
Signature
Printed Name
Date
Application for Sole Proprietor Firm Permit——Page 3 of 5

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