North Carolina State Board of Certified Public Accountant Examiners
1101 Oberlin Road Suite 104 • PO Box 12827 • Raleigh NC 27605
Phone 919-733-1422 • Fax 919-733-4209 • Web www.nccpaboard.gov
CERTIFICATE OF MORAL CHARACTER AND ELIGIBILITY - CPA CERTIFICATE APPLICANTS
TO BE COMPLETED BY APPLICANT:
Original CPA Certificate Applicant Reinstatement of CPA Certificate Reissuance of CPA Certificate
Full Name (First/Middle/Last/Suffix)
Mailing Address (Street or PO Box)
City, State, Zip Code
REMAINDER TO BE COMPLETED BY CPA SIGNING FORM (Please print legibly using blue or black ink.):
INSTRUCTIONS: NCGS 93-12(5) requires applicants for the CPA certificate to have good moral character. CPAs
completing this form are asked to evaluate and comment upon the applicant's character, conduct, social relations, and
adherence to general principles of right conduct. A CPA is expected to hold a high sense of duty to his/her fellow man and
to society in general because of the amount of trust and confidence that will be placed in him/her by clients and by the
citizens of this State and Nation.
Suggested references must be CPAs and may include, but are not restricted to, instructors/professors, employers, fellow
employees, fellow NCACPA chapter members, neighbors, and public officials. The Board will not accept references from
persons related by blood or marriage to the applicant. Persons signing moral character certificates are expected to have
known the applicant for a sufficient period of time to make an evaluation of his/her moral character and to be familiar with
the applicant's lifestyle outside of the classroom or workplace. Persons signing this form should do so only after careful
consideration, and only after reviewing the properly completed application package to determine that the applicant has
made all required disclosures.
NOTE: Persons completing this form who reside and/or work in North Carolina must be licensed by this Board to
use the CPA title. Completion of this form is considered to be use of the CPA title. Persons not licensed by this
Board and living outside of North Carolina who complete this form must be currently licensed by another board
I have personally known the applicant for years, months.
Describe in detail the opportunities you have had to evaluate the applicant (Attach additional page if needed).
Is the applicant of good moral character (i.e. has a personal history of honesty, fairness and respect for the rights of others
and for the laws of the State of North Carolina and this nation) and would be expected to conscientiously observe the high
professional responsibilities of a Certified Public Accountant? Y N If no, please explain (Attach additional
page if needed.):
Is the applicant entirely worthy of the trust placed in him/her by the State of North Carolina and the public as a Certified
Public Accountant? Y N If no, please explain (Attach additional page if needed.).