Section Ac 401.04 - Renewal Forms(a) A licensee shall submit, by June 30 of a renewal year, the following on or with a Certification/Registration Renewal Application Form: (1) The applicant's certificate number as issued by the board upon initial certification;(2) The name of applicant, including any previous names under which the applicant held certification or registration;(3) The applicant's complete mailing address;(4) The applicant's complete business address;(5) The applicant's home and work telephone number;(6) The applicant's e-mail address;(7) A statement as to whether, since the original issuance of the certificate or the last renewal, which ever is later, the applicant's practice privileges before any governmental agency or tribunal in any jurisdiction was in any way sanctioned or altered, and if so, a complete explanation of all material facts;(8) A statement as to whether, since the original issuance of the certificate or the last renewal, which ever is later, the applicant was convicted of a felony or any offense involving dishonesty that has not been annulled by a court of competent jurisdiction, and if so, a complete explanation of all material facts;(9) A statement as to whether, since the original issuance of the certificate or the last renewal, which ever is later, the applicant has had a license denied, revoked, suspended, or in any way limited or sanctioned by any other state or jurisdiction, and if so, a complete explanation of all material facts;(10) The applicant's signature and date, attesting that the information contained in the application is true and correct to the best of the applicant's knowledge and belief.(b) A licensee shall submit the following on a Continuing Professional Education Activity Log: (1) The total number of hours of CPE claimed for each of the years covered by the expiring license, in the categories listed in Ac 403.02(c)(1) - (4);(2) The dates on which ethics CPE hours were earned, by category as listed in 403.02(c)(1) - (4);(3) The number of hours of CPE carried forward, if any, from the previous licensure period;(4) The total number of hours of CPE claimed; and(5) The total number of hours of CPE required, based upon proration for their licensure period.(c) If a licensee is among the 5% of the licensees randomly-selected for CPE compliance audit, the licensee shall submit the following on or with a Continuing Professional Education Reporting Form: (1) The name of each organization that sponsored each program;(2) The location of program;(3) Title of program or description of content;(4) The dates of the applicant's attendance at the program;(5) The number of hours claimed, by category, as having been completed by the applicant;(6) Documented proof of the hours claimed, as set forth in Ac 403.02(d) - (g); and(7) The applicant's signature, and date attesting that the information contained in the application is true and correct to the best of the applicant's knowledge and belief.(d) A firm shall submit, by June 30 of each even-numbered year a CPA Firm Permit Application Form as specified in Ac 301.11.N.H. Admin. Code § Ac 401.04
#6904, eff 12-4-98, EXPIRED: 12-4-06
New. #8810, INTERIM, eff 1-25-07, EXPIRED: 7-25-07
New. #9051, eff 12-27-07; amd by #10054, eff 1-1-12
Amended by Volume XXXV Number 01, Filed January 8, 2015, Proposed by #10746, Effective 1/1/2015, Expires1/1/2025.