Fillable North Carolina State Board of Certified Public Accountant (NC State Board of CPA Examiners)

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North Carolina State Board of Certified Public Accountant (NC State Board of CPA Examiners)

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The North Carolina State Board of Certified Public Accountant (NC State Board of CPA Examiners) form is 3 pages long and contains:

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REV. 11-2017
North Carolina State Board of Certified Public Accountant Examiners
1101 Oberlin Road Suite 104 • PO Box 12827 • Raleigh NC 27605
Phone 919-733-1423 • Fax 919-733-4209 • Web nccpaboard.gov
REGISTRATION OF A PARTNERSHIP
21 NCAC 08J .0108 requires all CPA firms to register with the Board and re-register annually in
accordance with NCGS 93-12(8)(a) and 21 NCAC 08J and 08K.
Pursuant to 21 NCAC 08N .0306(c), the firm’s name on letterhead, contracts, engagement letters, tax
returns, and all professional services reports must match exactly the firm’s name as registered with
the Board and the NC Department of Secretary of State (SOS).
To register a partnership, submit the following items to the Board:
• One copy of the proposed CPA firm letterhead;
• Completed “Registration of a Partnership;”
• Completed “Required Information;” and
• Check payable to the State Board of CPA Examiners for the proper fee.
There is no fee for registering a partnership CPA firm with offices in North Carolina only.
The fee for registering a partnership CPA firm with offices in North Carolina and at least one other
state is $10.00/per partner with a maximum fee of $2,500.00.
KEEP A COPY OF ALL DOCUMENTS FOR YOUR RECORDS.
REV. 11-2017
North Carolina State Board of Certified Public Accountant Examiners
1101 Oberlin Road Suite 104 • PO Box 12827 • Raleigh NC 27605
Phone 919-733-1423 • Fax 919-733-4209 • Web nccpaboard.gov
REGISTRATION OF A PARTNERSHIP
CPA Firm Name:
Name of Supervising CPA:
Supervising CPA’s Certificate No.:
Mailing Address:
City, State & ZIP:
Street Address:
City, State & ZIP:
Phone Number:
Fax Number:
Email Address:
Website Address:
Does the applicant partnership operate or maintain any other offices? N Y
If yes, provide the information requested above on an attached sheet for all other offices operated or
maintained by the applicant partnership.
I practiced and have ownership in (CPA firm name)
and wish to continue cancel that CPA firm’s registration (NOT including this registration).
Signature Date
Title
REV. 11-2017
REQUIRED INFORMATION
Registration of a Partnership
Resident Owners
Provide the name, address, phone number, and NC CPA certificate number of each CPA owner. Provide the name,
address, phone number, and social security number for each non-CPA owner. Attach additional sheet(s) if needed.
Name NC CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
Name NC CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
Name NC CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
Non-Resident Owners
Provide the name, address, phone number, and CPA certificate/license number (including jurisdiction) of each CPA
owner. Provide the name, address, phone number, and social security number for each non-CPA owner. Attach additional
sheet(s) if needed.
Name CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
Name CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
Name CPA No. or SSN:
Address
City, State & ZIP Phone No.
Percent of Ownership
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Completed 14 August 2020

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