Inactive status application form - Virginia Board of Accountancy

Certification of Applicant

Name*

First Last

Email*

License number*

Employment status*

Currently employed
Not employed
Retired

Additional information regarding your employment status*

Current job title*

Name of employer*

If employed, upload an official job description*

Accepted file types: doc, docx, ppt, pptx, txt, pdf, rtf, jpg, png, Max. file size: 2 MB.

Please include the original job description, documentation from Human Resources, etc.

Are you an owner or part owner of a CPA firm or other company/organization?*

Yes
No

Please name the company.*

Do you use your financial skills to volunteer?*

Yes
No

Please explain where you volunteer and what services you provide.*

Do you serve on any boards that include a financial aspect, either by the nature of the board (banking, investments, etc.) or by committee assignments?*

Yes
No

Please list the board or committee role(s):*

Certifications*

I certify that I am not currently providing services, including on a volunteer basis, as defined in § 54.1-4400, “Providing services to an employer” or “Providing services to the public.”

Certifications1

I certify that my current position does not require the use of accounting, financial, tax or other skills that are relevant, as determined by the VBOA.

Certifications3*

I certify that I will not provide accounting services to the public or to or on behalf of an employer with the Inactive status, which includes but is not limited to tax preparation (with or without compensation).

Certifications5*

I understand in order to begin providing services, I must request a change to Active status from the VBOA.

Certifications6*

I understand that I must comply with VBOA regulation to begin providing services. The requirements include obtaining at least 120 hours of CPE prior to providing the services, including a two hour VBOA-approved ethics course.

Certifications6*

I understand that the Inactive status exempts me from CPE requirements starting with the current calendar year. I certify that I am responsible for maintaining documentation of CPE from the four previous calendar years, per VBOA Policy #4.

Certifications6*

I understand that I must renew my CPA license on an annual basis regardless of whether my license is Inactive or Active.

Certifications6*

I certify all of the information submitted in this application is true and complete. I am aware that submitting false information or omitting pertinent or material information in connection with this application can result in disciplinary action.

Signature*

Please use your mouse, touchscreen or touchpad to sign inside the box.

Date*