Fillable Experience Vericaon Form (Virginia Department of Motor Vehicles)

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Experience Vericaon Form (Virginia Department of Motor Vehicles)

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The Experience Vericaon Form (Virginia Department of Motor Vehicles) form is 2 pages long and contains:

  • 2 signatures
  • 11 check-boxes
  • 22 other fields

Country of origin: US
File type: PDF

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V
I R G I N I A B O A R D
OF ACCOUNTANCY
vboa
V
I R G I N I A B O A R D
OF ACCOUNTANCY
vboa
Experience Vericaon Form
V
I R G I N I A B O A R D
OF ACCOUNTANCY
vboa
Prior to applying for a CPA license, a person must have been employed in academia, a rm, government or
industry in any capacity involving the substanal use of accounng, nancial, tax or other skills that are relevant,
as determined by the Virginia Board of Accountancy. The Virginia individual CPA applicant must complete at least
2,080 work hours, or equivalent to one year of full-me employment. Whether other skills are relevant shall be
determined by the VBOA on a case-by-case basis. Self-employment does not meet the denion of experience.
Instrucons:
• Page 1 is to be completed by the applicant for licensure.
• Page 2 is to be completed by an Acve, licensed CPA (from any jurisdicon) who can verify the
applicant’s work experience. If necessary, aach addional pages.
The form can be submied by email at boa@boa.virginia.gov, fax to (804) 527-4409 or mail to the VBOA at 9960
Mayland Drive, Suite 402, Henrico, VA 23233. The VBOA is not responsible for sensive informaon sent
electronically.
CONTACT INFORMATION OF APPLICANT
Name: Organizaon:
Street address: City/State/ZIP:
Current job tle: Email address:
Phone number:
CERTIFICATION OF APPLICANT
The total number of hours I have worked at the organizaon(s) as cered by an Acve, licensed CPA (from any
jurisdicon):
Must have at least 2,080 work hours.
I cerfy that the informaon provided by an Acve, licensed CPA is accurate and true. My work
experience is in compliance with VBOA regulaon 18VAC5-22-100.
Signature: Date:
Updated December 2019 Page 1 of 2
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signature
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V
I R G I N I A B O A R D
OF ACCOUNTANCY
vboa
Experience Vericaon Form
This page only completed by a CPA.
Name: Organizaon:
CPA license number: Street address:
State/jurisdicon of licensure: City/State/ZIP:
Phone number: Email address:
WORK EXPERIENCE OF APPLICANT
Field of work experience (choose at least one):
Academia Government Public accounng
Industry Other eld:
Skill ulized (choose at least one):
Accounng Tax services Financial Other skill:
Organizaon: Dates employed:
Applicant job tle: Total hours worked:
(Must have at least 2,080 work hours)
CERTIFICATION OF CPA
I cerfy that the informaon I have provided to be accurate and true. The applicant’s work experience
is in compliance with VBOA regulaon 18VAC5-22-100.
Signature: Date:
Updated December 2019 Page 2 of 2
CONTACT INFORMATION OF CPA
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Experience Vericaon Form (Virginia Department of Motor Vehicles)

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Completed 22 February 2022

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