2010 CPE Audit form
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2010 CPE Audit form

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MINNESOTA BOARD OF ACCOUNTANCY th 85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143 Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us CPE Audit Instructions for Fiscal Years (FY) 2007, 2008 & 2009 th.(The Board’s Fiscal Year is from July 1st to June 30 ) Complete the attached CPE reporting forms for fiscal years 2007, 2008 and 2009, and the FY10 carryback sheet, if applicable. You may make copies of the reporting forms as necessary. A “fillable” pdf version of the form is available online at www.boa.state.mn.us. Please see page 9 for detailed instructions. Important: You must complete the attached reporting forms. You are not allowed to supply your own form or write “see attached” in lieu of completing the forms. Supporting documentation must be provided for each course attended. Acceptable types of supporting documentation are: a certificate or other verification supplied by the CPE program sponsor, MNCPA transcripts, and college transcripts (for college courses). *Documentation for non-registry/non-approved coursework must consist of the following: (1) a certificate of attendance from the program sponsor containing the name and contact information of the sponsor, the title and description of the content of the program, the date of the program, the ...

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MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

CPE Audit Instructions for Fiscal Years (FY) 2007, 2008 & 2009
th.
(The Board’s Fiscal Year is from July 1st to June 30 )

Complete the attached CPE reporting forms for fiscal years 2007, 2008 and 2009, and the FY10 carryback sheet, if applicable. You may
make copies of the reporting forms as necessary. A “fillable” pdf version of the form is available online at www.boa.state.mn.us. Please
see page 9 for detailed instructions.
Important: You must complete the attached reporting forms. You are not allowed to supply your own form or write “see attached” in
lieu of completing the forms. Supporting documentation must be provided for each course attended. Acceptable types of supporting
documentation are: a certificate or other verification supplied by the CPE program sponsor, MNCPA transcripts, and college
transcripts (for college courses).
*Documentation for non-registry/non-approved coursework must consist of the following:
(1) a certificate of attendance from the program sponsor containing the name and contact information of the sponsor, the title and
description of the content of the program, the date of the program, the location of the program, and the number of CPE hours for which the
licensee attended;
(2) a copy of the detailed timed agenda for the program;
(3) a biography of the program developer and program presenter; and
(4) a statement by the licensee describing how the program contributes to the licensee's professional knowledge and competence.
*You will not receive credit for non-approved coursework if you do not submit the proper documentation.

Send copies of supporting documentation only; if you submit originals, they will not be returned to you. Please be sure to sign the
bottom of the summary page (page 2).

Mail your documents to: Minnesota Board of Accountancy
Attention: Bev Carey
th
85 E. 7 Place, Suite 125
St. Paul, MN 55101-2143



ALL FIELDS MUST BE COMPLETED; INCOMPLETE FORMS WILL BE RETURNED TO YOU!
Page 1 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

Minnesota CPE AUDIT Compliance Form for the Three Years Ended June 30, 2009


(See detailed instructions on page 9).
Fiscal Year ending June 30 Course hours from approved Self-study course hours from Course hours from non- Total (2)
sponsors (not including self- a NASBA Quality Assurance approved sponsors (not
study) (1) (3) Service sponsor (3) (7) including self-study)


2007
2008

2009

Deduct carryback hours included above which were used to satisfy hour requirements relating to the years ended June 30, 2006 and prior.

Add carryback hours earned after June 30, 2009 used to satisfy requirements for the three years ended June 30, 2009. (6)

Please read item number 6 on page 9.

Total for Three Years (4)
(Must equal at least 120 hours)







Your signature is required below.

I certify that all of the information on this form is accurate and understand that any misrepresentation could result in revocation of my certificate.

Name Certificate Number Date Daytime Phone Number Email Address Signature





Page 2 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us


Please give a breakdown of your CPE hours for each fiscal year in the following tables:

Fiscal Year 2007 (July 1, 2006 to June 30, 2007)
Course hours from Self-study course Course hours from
approved sponsors hours from a NASBA non-approved
(not including self- Quality Assurance sponsors (not
Type of credits study) (1) (3) Service sponsor (3) (7) including self-study) Totals
General *
Ethics (5)
Personal Development (7)
Teaching (7) NA
Writing (7)
*General Credits = Hours that do not fit into one of the other four categories – ethics, PD, teaching, writing
Total for fiscal year ending June 30, 2007


Fiscal Year 2008 (July 1, 2007 to June 30, 2008)
Course hours from Self-study course Course hours from
approved sponsors hours from a NASBA non-approved
(not including self- Quality Assurance sponsors (not
Type of credits study) (1) (3) Service sponsor (3) (7) including self-study) Totals
General *
Ethics (5)
Personal Development (7)
Teaching(7) NA
Writing (7)
*General Credits = Hours that do not fit into one of the other four categories – ethics, PD, teaching, writing
Total for fiscal year ending June 30, 2008

Page 3 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

Fiscal Year 2009 (July 1, 2008 to June 30, 2009)
Course hours from Self-study course Course hours from
approved sponsors hours from a NASBA non-approved
(not including self- Quality Assurance sponsors (not
Type of credits study) (1) (3) Service sponsor (3) (7) including self-study) Totals
General *
Ethics (5)
Personal Development (7)
Teaching(7) NA
Writing (7)
*General Credits = Hours that do not fit into one of the other four categories – ethics, PD, teaching, writing
Total for fiscal year ending June 30, 2009

















Page 4 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

CPE REPORTING FORM
FISCAL YEAR 2007 ONLY – July 1, 2006 to June 30, 2007
Course Title Course Sponsor name Sponsor location ID # - NASBA Completion date # of hours CPE type
(City, State) Registry (6 digits) earned (see legend
or QAS (3 digits) below)






# of course hours from NASBA CPE Registry # of self-study course hours # of course hours from Total for fiscal
year 2007
sponsors/other approved sponsors (not from a NASBA Quality non-approved sponsors
including self-study) Assurance Service (QAS) (not including self-
sponsor study)

CPE Type (Specify all “CPE Types” which apply for a course)
A – NASBA Registry/Other Approved Sponsor G - General S – Self-Study
CB – Hours carried back to a prior fiscal year (If CB, specify carry back year) N – Non-Approved/Non-Registry T - Teaching
E - Ethics P – Personal Development W - Writing

Page 5 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

CPE REPORTING FORM
FISCAL YEAR 2008 ONLY – July 1, 2007 to June 30, 2008
Course Title Course Sponsor name Sponsor location ID # - NASBA Completion date # of hours CPE type
(City, State) Registry (6 digits) earned (see legend
or QAS (3 digits) below)






# of course hours from NASBA CPE Registry # of self-study course hours # of course hours from Total for fiscal
year 2008
sponsors/other approved sponsors (not from a NASBA Quality non-approved sponsors
including self-study) Assurance Service (QAS) (not including self-
sponsor study)

CPE Type (Specify all “CPE Types” which apply for a course)
A – NASBA Registry/Other Approved Sponsor G - General S – Self-Study
CB – Hours carried back to a prior fiscal year (If CB, specify carry back year) N – Non-Approved/Non-Registry T - Teaching
E - Ethics P – Personal Development W - Writing


Page 6 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

CPE REPORTING FORM
FISCAL YEAR 2009 ONLY - July 1, 2008 to June 30, 2009
Course Title Course Sponsor name Sponsor location ID # - NASBA Completion date # of hours CPE type
(City, State) Registry (6 digits) earned (see legend
or QAS (3 digits) below)






# of course hours from NASBA CPE Registry # of self-study course hours # of course hours from Total for fiscal
year 2009
sponsors/other approved sponsors (not from a NASBA Quality non-approved sponsors
including self-study) Assurance Service (QAS) (not including self-
sponsor study)

CPE Type (Specify all “CPE Types” which apply for a course)
A – NASBA Registry/Other Approved Sponsor G - General S – Self-Study
CB – Hours carried back to a prior fiscal year (If CB, specify carry back year) N – Non-Approved/Non-Registry T - Teaching
E - Ethics P – Personal Development W - Writing


Page 7 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

CPE REPORTING FORM
ENTER FISCAL YEAR 2010 CARRYBACK COURSE DETAIL BELOW
CB to
Course Title Course Sponsor name Sponsor location ID # - NASBA Completion # of CPE type
which
(City, State) Registry (6 digits) date hours (see legend
FY?
or QAS (3 digits) earned below)








# of course hours from NASBA CPE Registry # of self-study course hours # of course hours from Fiscal year 2010
hours carried back to
sponsors/other approved sponsors (not from a NASBA Quality non-approved sponsors
including self-study) Assurance Service (QAS) (not including self- a prior fiscal year
sponsor study)

CPE Type (Specify all “CPE Types” which apply for a course)
A – NASBA Registry/Other Approved Sponsor G - General S – Self-Study
CB – Hours carried back to a prior fiscal year (If CB, specify carry back year) N – Non-Approved/Non-Registry T - Teaching
E - Ethics P – Personal Development W - Writing


Page 8 of 9 MINNESOTA BOARD OF ACCOUNTANCY
th
85 East 7 Place, Suite 125 Phone: 651-296-7938 St. Paul, Minnesota 55101-2143
Fax: 651-282-2644 TTY: 800-627-3529 www.boa.state.mn.us

(1) The following are approved Sponsors:
• NASBA CPE Registry Sponsors for live credits only; all self-study coursework must be from a NASBA QAS provider.
• The Office of the Legislative Auditor or State Auditor provided a quality review has been conducted on those offices and an unmodified
report was received and filed with the Board.
• CPA firms who have had a system review level quality review completed in the last three years and an unmodified report received.
• Colleges and Universities whose academic programs qualify an applicant to sit for the CPA examination.
• CPE programs sponsored by the AICPA, MNCPA, MAPA.
(2) Total CPE hours must equal 20 or more for each year.
(3) Course hours in the approved categories must aggregate at least 72 hours for CPAs for the three years ended June 30, 2009.
(4) Three-year total must equal 120 hours or more for the three-years ended June 30, 2009.
(5) Ethics hours must total eight hours or more for the three years ended June 30, 2009 and for CPAs who were first licensed after July 1, 2006, the
eight hour ethics requirement is effective at the same time the 120 hour requirement is first effective in accordance with M.R. 1105.3000(k).
Ethics hours must be in accounting ethics or business ethics. CPAs are required to have eight hours of ethics in each three year rolling period.
(6) If you enter carryback hours here, you should notify the Board as soon as possible in order to reduce the amount of CPE late fees, which are
assessed based on months of noncompliance (MR 1105.3000 (G
)). A licensee not in compliance with this part on June 30 of each year shall be assessed
a late processing fee of $50 for the first month, or partial month, of noncompliance and $25 per month, or partial month, of noncompliance thereafter
until the date the licensee is in compliance with this part and provides documentation of compliance in writing to the board. Important - If you are
not in compliance with the CPE requirements by June 30th and you need to use "carryback" hours from the subsequent fiscal year(s), the CPE non-
compliance fees continue to accrue until the date you notify the Board in writing, not the date you complete the coursework. (You are required to
submit certificates of completion for carryback hours along with payment of the CPE non-compliance fees.)
(7) CPE hour limitations. The following hour limitations apply: A) At least 60 hours must be obtained from other than instructor preparation or
presentation; B) At least 60 hours must be obtained from other than the writing of articles, books, or CPE courses for publication; C) At least 24
hours must be obtained from other than self-study programs; and D) At least 96 hours must be obtained from programs in the subject area other than
personal development, as defined in the Statement on Standards for Continuing Professional Education (CPE) Programs.

Additional notes: YOU ARE REQUIRED TO COMPLETE ALL FIELDS; INCOMPLETE FORMS WILL BE RETURNED TO YOU!
• Course title– you may abbreviate the course title.
• e Sponsor name– self explanatory.
• Sponsor location – include only city and state. You may write “online” for self-study courses.
• NASBA Registry/QAS ID#– Registry numbers are 6 digits; QAS ID numbers are 3 digits. For courses completed through MNCPA,
MAPA, AICPA, qualifying colleges, enter NA; for courses completed through non-approved sponsors, enter Non-Approved.
• Completion date - enter your hours in chronological order.
• Number of hours – you are allowed to include partial credits in .25 increments only. You may not claim partial credits until the first full
hour has been completed.
• CPE Type - enter all CPE types that apply. (Example – a self-study ethics course sponsored by the AICPA would be listed as A, S, E.)
DO NOT enter letters not listed in the legend.
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