12/2016
North Carolina State Board of Certified Public Accountant Examiners
1101 Oberlin Road, Suite 104 • PO Box 12827 • Raleigh NC 27605
Phone 919-733-4222 • Fax 919-733-4209 • Web www.nccpaboard.gov
RECORD OF COMPLAINT
The Board investigates complaints filed against CPAs and CPA firms alleged to have violated North
Carolina General Statute 93 and/or the North Carolina Accountancy Act including the Rules of
Professional Ethics and Conduct. If the Board determines a CPA or CPA firm has violated the
statutes and/or rules, the Board may impose disciplinary action on the CPA or the CPA firm. The
Board does not intervene in fee disputes nor does the Board have authority to order monetary
damages. If you have these type problems, you should consult an attorney.
Fields marked with * are required. Please answer all questions as completely as possible.
*COMPLAINANT (your full name):
*Mailing Address:
*City: *State: *ZIP Code:
*Phone Number: Fax:
Email Address:
Do you prefer to correspond with the Board via _____ mail or _____ email?
*Are you represented by an attorney in this matter? ______ Yes _____ No
Attorney’s Name:
Mailing Address:
City: *State: *ZIP Code:
Phone Number: Fax:
Email Address:
*Is there a pending or completed lawsuit regarding your complaint? ______ Yes _____ No
*RESPONDENT (Name of CPA or CPA Firm):
*CPA Firm or Business Name:
*Mailing Address:
*City: *State: *ZIP Code:
*Phone Number: Fax:
Email Address:
CPA’s Certificate Number:
