MONTANA BOARD OF PUBLIC ACCOUNTANTS

Transcription

1 MONTANA BOARD OF PUBLIC ACCOUNTANTS 301 South Park 4 th Floor PO Box Helena Mt Phone: E mail: dlibsdpac@mt.gov Website: APPLICATION FOR ORIGINAL LICENSE GENERAL INFORMATION The Application for Original License is for Montana exam candidates that have successfully passed the CPA exam and are applying for first time licensure; it is also for those that have been licensed in Montana previously and let their license terminate, and are not licensed in another jurisdiction. To obtain a License, you must have passed all sections of the exam and meet the education and experience requirements. An individual may not hold out as a CPA to the public without an active license. There is no residency requirement and a social security number is not required to obtain a license. If you do not have a social security number, you will need to complete the affidavit stating such and submit a notarized copy with your application. Individuals must have an active license to practice public accounting in Montana. See below for the definition of the practice of public accounting according to (10), MCA. "Practice of public accounting" means performing or offering to perform, by a person certified under , MCA; licensed under , MCA; or holding a practice privilege under , MCA for a client or potential client one or more types of services involving the use of accounting or auditing skills, including: (a) the issuance of reports or financial statements on which the public may rely; (b) one or more types of management advisory or consulting services; (c) the preparation of tax returns; or (d) furnishing advice on tax matters. All applications are reviewed by the Board at their regularly scheduled board meetings. A COMPLETED application must be received by the board 15 business days prior to a scheduled board meeting to be included on that meeting agenda. Please refer to our website for board meeting dates. The schedule of board meetings can be found under the Board Information/Board Meeting tab on the website. Applicants are responsible for providing all required documentation to the Board. Applications not completed within 12 months of applying are considered invalid and void. A new application and fee will be required in order to reapply.

2 LICENSE REQUIREMENTS 1. Application for Original License: Submit application and fee. You may not fax or scan and the application. We must receive either an online application or the original paper application. We must receive the following original supporting documents from the source, or from CPAES: Examination scores and results College or university transcripts (NIES evaluation document for foreign education) License verifications from other jurisdictions (If every held any professional license in a jurisdiction) Evidence of experience form 2. Professional Ethics: The AICPA Comprehensive Course: Complete the AICPA Comprehensive Ethics course. To order the self study course, go to The course is required whether you are applying for a certificate only or a permit to practice. 3. Verification: If you have ever held, or currently hold a professional license other than a CPA license, you must provide a license verification from all states where the professional license was/is held. 4. NASBA International Evaluation Services (NIES): An applicant with foreign qualifications will be required to have their foreign educational credentials evaluated in accordance with Montana s educational requirements by the NISE. The application form and pertinent information may be obtained from the NIES website at While the Board is not bound by the evaluation report, it is a guideline in determining if Montana s educational requirements have been met. 5. Education Requirement: A Montana exam applicant must meet the education requirement according to ARM Official transcripts must be provided from every university or college attended. 6. Experience Required For a License: An applicant applying for a License must submit the form entitled, "Evidence of Satisfaction of Experience Requirements" in accordance with ARM ARM provides that to be issued an initial License, an applicant must provide evidence of adequate accounting and auditing experience. Experience will be considered adequate by the Board if satisfactory evidence is presented of having performed accounting and auditing functions ordinarily required in the practice of public accounting. One year of actual work experience (2000 hours) is required. Experience must be attested to by a holder of an active license to practice public accounting in one of the 55 US jurisdictions unless you are using military experience. Experience must take place within the three (3) years prior to the date of this application. The US CPE must have a current license at the time of the attestation. The individual does not need to be a supervisor, but must be familiar with your work and able to attest that it meets professional standards.

3 MONTANA BOARD OF PUBLIC ACCOUNTANTS 301 South Park 4 th Floor PO Box Helena Mt Phone: E mail: dlibsdpac@mt.gov Website: APPLICATION FOR ORIGINAL LICENSE License Fee: $ FULL NAME: Last First Middle OTHER NAME(S) KNOWN BY: BUSINESS NAME: BUSINESS ADDRESS: HOME ADDRESS: Street or PO Box # City and State Zip Country Street or PO Box # City and State Zip Country The Board s primary method of communication with licensees is . Include your preferred address: E MAIL: CHECK ONE: MALE FEMALE TELEPHONE: Business Home/Cell (please indicate) Fax U.S. SOCIAL SECURITY NUMBER: FOREIGN ID NUMBER DATE OF BIRTH: LICENSE NAME: PLACE OF BIRTH (State your name as it should appear on the license if granted) City / State/Country EDUCATION: Name of University or College City, State, Country Dates Attended Degree Earned

4 PROFESSIONAL LICENSES: List all professional licenses you hold or have ever held. License verifications must be sent directly to Montana from each jurisdiction. Attach additional sheets if necessary. Jurisdiction License # License Type Date Issued Expiration Date License Status Requested State Verification YES YES YES NO NO NO Disciplinary Questions: Please read carefully and answer questions completely and truthfully, it may affect your license. If you answer yes to any question, please attach a detailed explanation and provide supporting documentation from the source. Please circle the appropriate response. 1. Have you ever had an application for a professional or occupational license refused or YES NO denied?. 2. Have you ever withdrawn an application for licensure prior to licensing agency s YES NO decision regarding your application? 3. Has a licensing agency initiated or completed disciplinary action against any YES NO professional or occupational license you held? If yes, please provide the agency documentation including the complaint, initiating documents, orders, final orders, stipulations, and consent and/or settlement agreements directly from the source. 4. Have you ever voluntarily surrendered, cancelled, forfeited, failed to renew a YES NO professional or occupational license in anticipation of or during an investigation or disciplinary proceeding or action? 5. Has a complaint ever been made against you with a professional or occupational YES NO licensing agency? 6. Have any civil proceeding been filed against you by a client, former client or YES NO employer/employee? 7. Do you have any criminal charges pending or have you ever pled guilty, forfeited bond, YES NO or been convicted for a crime (whether or not sentence was suspended or deferred), or have you pled no contest or had prosecution deferred whether or not an appeal is pending? You must report, but may omit documentation for (1) misdemeanor traffic violations resulting In fines of less than $100; and (2) charges or convictions prior to your 18 th birthday unless You were tried as an adult.

5 8. Have you ever been diagnosed with chemical dependency or another addiction, or have YES NO you participated in a chemical dependency or other addiction treatment program? If yes, Please attach a detailed explanation and provide documentation regarding evaluations, diagnosis, treatment recommendations and monitoring from the source. 9. Have you ever been diagnosed with a physical condition or mental health disorder YES NO Involving potential health risk to the public? 10. Have you ever been court martialed or discharged other than honorably from a branch YES NO of the armed service? AFFIDAVIT I authorize the release of information concerning my education, training, record, character, license history and competence to practice, by anyone who might possess such information, to the Montana Board of Public Accountants. I understand that I am responsible for providing all of the necessary documentation to demonstrate my qualifications for licensure and the Board is not responsible for obtaining the necessary documentation. I understand that if my application is not complete, including all documentation, within 12 months of filing the application it will be invalid and void. A new application and fee will be required in order to reapply. I hereby declare under penalty of perjury the information included in my application to be true and complete to the best of my knowledge. In signing this application, I am aware that a false statement or evasive answer to any question may lead to denial of my application or subsequent revocation of licensure on ethical grounds. I have read and will abide by the current licensure statutes and rules of the State of Montana governing the profession. I will abide by the current laws and rules that govern my practice. Legal Signature of Applicant Date

6 THIS FORM ONLY BE USED FOR PERSONS/APPLICANTS/LICENSEES WHO DO NOT HAVE A SOCIAL SECURITY NUMBER STATE OF MONTANA BOARD OF PUBLIC ACCOUNTANTS REQUEST FOR EXEMPTION FROM SOCIAL SECURITY NUMBER REQUIREMENT Montana Code Annotated requires applicants for a Montana professional or occupational practice license to provide a United States Social Security Number (SSN). However, pursuant to Policy Interpretation Question (PIQ) number issued by the U.S. Dept. of Health and Human Services in 1999, the State of Montana, Department of Labor & Industry, Business Standards Division (BSD) may issue a license to an applicant who does not have a SSN if the applicant submits this form truthfully attesting that he or she has not been assigned a SSN. If a person (who has been issued a Montana practice license without a SSN) is later assigned a SSN, the person must report the SSN to the licensing board or program within BSD as a prior condition for renewal of licensure. If a person has already been issued a Montana practice license without having submitted a SSN or this affidavit at the time of original application, the person will be required to provide a SSN or this affidavit as a prior condition of renewal. All persons who do not have a SSN and who are applying for a new practice license from BSD or renewing an existing practice license must have filed a copy of this form with the BSD licensing board or program. The form need only be filed once for each license. THIS FORM MAY ONLY BE USED FOR PERSONS/APPLICANTS/LICENSEES WHO DO NOT HAVE A SOCIAL SECURITY NUMBER. If such a person has ever been issued a SSN, the person MUST provide it as a condition of licensing. A practice license will not be renewed or issued to a person who refuses to provide their SSN. 1. Name: Last /Family First Middle 2. Mailing Address: Street City State/Province Zip/Postal Code 3. Check one: I am applying for Montana license as a Public Accountant. I currently hold a Montana license as a Public Accountant. License #:. 4. I certify that I have not been assigned a U.S. Social Security Number. Yes No An answer of No to this question # 4 will result in a denial of your license application or renewal unless you provide the SSN. If you already have a SSN, you do not need to use this form. Instead, you must provide the SSN. 5. If a SSN is assigned to you after the date of this affidavit, do you agree to immediately report the SSN to the State of Montana, Department of Labor & Industry, Business Standards Division? Yes No An answer of No to this question # 5 will result in a denial of your license application or renewal.

7 AFFIDAVIT I, being first sworn, depose and affirm or state under penalty of perjury/falsification under the laws of Montana that that the information contained herein is true and correct to the best of my knowledge. I understand that under Montana law, providing false information is grounds for denial, suspension, or revocation of a professional or occupational license, certificate or permit and is also grounds for criminal prosecution. Signature: Date: This form must be notarized below. SUBSCRIBED AND SWORN TO before me before this day of, 20. Notary Public for the State of SEAL My commission Expires:

8 EXPERIENCE INSTRUCTIONS If you currently hold a certificate by the Montana Board of Public Accountants and are applying for an initial license, please include your Montana certificate number on the front of the form. ARM provides that to be issued an initial license, an applicant must provide evidence of adequate accounting and auditing experience. Experience will be considered adequate by the Board if satisfactory evidence is presented of having performed accounting and auditing functions ordinarily required in the practice of public accounting. One year of actual work experience (2000 hours) is required. Experience must be attested to by a holder of an active license to practice public accounting in one of the 55 Board jurisdictions unless you are using military experience. The US CPA attesting to your experience does not need to be a supervisor, but must be familiar with your work and able to attest that it meets professional standards. Experience must take place within three (3) years prior to the date of this application. However, individuals applying for licensure transfer according to ARM (3) must report four (4) years of experience in the practice of public accounting within the ten (10) years immediately preceding this application in order for the education requirement to be waived. Or, if applying using military experience and no U.S. CPA can attest to the experience, the applicant s commanding officer must provide sufficient information on the duties and responsibilities of the applicant for the Board to evaluate to determine if the applicant meets the 2000 hour experience requirement.

9 MONTANA BOARD OF PUBLIC ACCOUNTANTS 301 South Park PO Box Helena Mt Phone: E mail: dlibsdpac@mt.gov Website: EVIDENCE OF SATISFACTION OF EXPERIENCE REQUIREMENTS FORM FULL NAME: Last First Middle MONTANA CERTIFICATE # (IF PREVIOUSLY HELD): OTHER NAME(S) KNOWN BY: EMPLOYER NAME: EMPLOYER ADDRESS: Street or PO Box # City and State Zip Country POSITION TITLE OF APPLICANT: TYPE OF ACCOUNTING EMPLOYMENT: PUBLIC GOVERNMENTAL PRIVATE INDUSTRY ACADEMIC PERIOD OF EMPLOYMENT: Only list employment within the previous 3 years (4 of the past 10 years if applying under ARM (3). See Experience instructions.) FULL TIME: FROM TO TOTAL HOURS: MONTH/DAY/YEAR MONTH/DAY/YEAR PART TIME: FROM TO TOTAL HOURS: MONTH/DAY/YEAR MONTH/DAY/YEAR ATTESTATION NAME PHONE NO POSITION RELATIONSHIP TO APPLICANT NATURE AND LEVEL OF WORK PERFORMED BY APPLICANT (ATTACH ADDITIONAL SIGNED SHEETS AS NECESSARY): I hold an active license (# ) to practice public accounting in the State of, which expires on. I certify under penalty of perjury that I have reviewed the applicant s work, this completed form and any attachments, and that the information is correct. SIGNATURE DATE