11
THE OREGON BOARD OF ACCOUNTANCY IS MOVING! The Board office is moving to 200 Hawthorne Ave SE - Suite D450 Salem, Oregon 97301 Our move is scheduled for the week of May 18, 2020. Please do NOT fax your renewal application between May 19 – 29 as our machine will not receive faxes while the data lines are moved. As always, please feel free to call the Board office at 503-378-4181 or email [email protected] with any questions.

THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

  • Upload
    others

  • View
    6

  • Download
    0

Embed Size (px)

Citation preview

Page 1: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

THE OREGON BOARD OF ACCOUNTANCY IS MOVING!

The Board office is moving to

200 Hawthorne Ave SE - Suite D450 Salem, Oregon 97301

Our move is scheduled for the week of May 18, 2020.

Please do NOT fax your renewal application between May 19 – 29 as our machine will not receive faxes while the data lines are moved.

As always, please feel free to call the Board office at

503-378-4181 or email [email protected] with any questions.

jnadeau
Highlight
jnadeau
Highlight
Page 2: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

OREGON BOARD OF ACCOUNTANCY 2020-2022 RENEWAL PERIOD ENDS JUNE 30, 2020 INSTRUCTIONS FOR RENEWAL APPLICATION

Enclosed is your 2020-2022 Renewal Application for even-numbered licensees. If you hold a current active status license, you will be required to report 80 hours of CPE including 4 hours of ethics CPE. If you currently hold an inactive license, you will be required to report 32 hours of CPE. If renewing for the first time in Oregon, you may have pro-rated CPE and are required to report at least 4 hours of Oregon-specific ethics from an Oregon approved sponsor.

An electronic version of the renewal is posted on the Board’s website: www.oregon.gov/boa. All renewals must be received on or before June 30, 2020 in order to avoid a late fee. Proof of timely submission will be determined by the fax transmittal information or by the postmark issued by the USPS or other commercial carrier. All renewal applications received by fax on or after July 1, 2020 or received by mail postmarked on or after July 1, 2020 will be late and will be required to pay the late fee. The late fee is $255 for active, $50 for inactive and $50 for retired.

DO NOT E-MAIL YOUR RENEWAL APPLICATION

Verify and/or update both residence and business addresses. If you have a new employer and/or residence address, you must report the change on your renewal. Please note that Board rule requires licensees to report any change in address or employment within 30 days.

All licensees, regardless of your licensing status (active, inactive, retired or voluntary license lapse), must review and answer all background certification questions on the renewal. If there are unanswered questions, your renewal will not be processed. If you have a reporting requirement under this section, please attach a thorough explanation of the event(s). (page 4)

Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each year of the renewal period* (July 1, 2018- June 30, 2019 and July 1, 2019 – June 30, 2020). Failure to do so will result in the assessment of a 16-hour CPE penalty. Any carry-forward hours you have may be used toward the penalty hours, however carry-forward hours cannot be used toward the 24 hour annual requirement. If you failed to meet the minimum annual or total CPE requirement, you can report the additional 16 hours with your renewal to avoid a delay in renewing your license. *New licensees or licensees who recently reinstated may have a pro-rated annual requirement and/or total amount of CPE due.

If you recently reinstated your CPA or PA license or a municipal auditor license, any hours used to reinstate may not be used for the CPE required to renew your license(s).

All licensees, regardless of your licensing status (active, inactive, retired or voluntary license lapse), must complete all employment questions on the renewal. If there are unanswered questions, your renewal will not be processed. If you are performing attest or compilation services in Oregon or for Oregon clients, you are required to be employed by a firm that is registered in Oregon. If your circumstances do not fit into the categories listed, please explain under the “other” option. Failure to complete will delay your renewal application. (page 3)

Be sure to sign the renewal form. (page 4). If renewing to inactive (section A) or retired (section B) status or if you choose to let your license lapse (section C), you must also sign page 5 of the renewal application. All licensees are required to complete the renewal application in its entirety regardless of the status they are renewing under.

Licensees must report all CPE taken between July 1, 2018 – June 30, 2020 in chronological (date) order. The CPE report must include the title of the course as listed on the certificate of completion. If the course is self-study, you must also include the 6-digit NASBA National Registry number associated with the sponsor.

Licensees may take unlimited technical CPE, however, there is a 16 hour limit for non-technical CPE courses for active renewals and an 8 hour limit for non-technical CPE for inactive renewals. Examples of non-technical subjects include (but are not limited to) interpersonal management skills, public relations, practice development, practice administration, marketing, personnel/HR, and

The Basics:

CPE:

Page 3: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

personal development. If non-technical hours are reported in excess of the allowed total, the additional hours will be deleted and may result in a CPE penalty if the deletion causes a shortage in total hours reported or a shortage in the 24 hour annual requirement. The maximum carryforward allowed for active licensees is 20 hours and the maximum carryforward allowed for inactive licensees is 8 hours.

Oregon now allows CPE courses to be taken in any credit increment and all CPE credits are calculated based on a 50-minute hour. For example, a 25 minute course earns .5 CPE credits, while a course that is 1 hour 20 minutes (80 minutes) would earn 1.6 CPE credits.

Ethics CPE: NEW REQUIREMENTS Effective July 1, 2020, all active and inactive licensees must report at least 4-hours of Oregon-specific ethics from a sponsor that is registered with the Board office, which means that this requirement will not affect your license renewal this period, but a reminder that the Oregon-specific ethics will be required on your next renewal cycle. A list of the registered sponsors can be found on the Board’s website www.oregon.gov/boa

The AICPA Ethics course required to obtain an initial license cannot be used toward the ethics requirement for renewal or toward the general CPE requirement.

The Board has updated reporting requirements effective January 1, 2020. OAR 801-030-0020(3)

Licensee must notify the Board within 45 days of resolution of any civil action against a licensee that relates to professional services and business operations involving an Oregon licensee or Oregon clients; initiation of any regulatory action against the licensee; resolution of any regulatory action against the licensee; any inquiry into the licensees conduct through a professional organization; or resolution of any professional organization inquiry.

Licensees must notify the Board within 10 days of initiation of any criminal investigation against the licensee or resolution of any criminal investigation against the licensee.

Firms must notify the Board within 45 days of resolution of any civil action against the Firm that relates to professional services, business operations or practices of the registered firm in Oregon; resolution of any civil action against any Oregon licensee affiliated with the firm that relates to professional services, business operations or practices of the registered firm in Oregon; initiation of any regulatory action against the firm; resolution of any regulatory action against the firm; initiation of any regulatory action against any Oregon licensee affiliated with the firm; resolution of any regulatory action against any Oregon licensee affiliated with the firm; any inquiry into an Oregon firms conduct through a professional organization; or resolution of any inquiry of an Oregon firm from a professional organization.

Firm must notify the Board within 10 days of initiation of any criminal investigation against the Firm; resolution of any criminal investigation against the Firm; or initiation of any criminal investigation against any of the following individuals affiliated with the firm: Oregon licensee, Oregon Partner, Oregon Owner.

Licensees and Firms must provide the following information to the Board when reporting any of the events above:

• Name of the regulatory agency, court or professional organization;• Title of matter;• Docket number if applicable;• Date of occurrence of the event;• Name of any legal representatives involved;• Statement of the facts; and• Copies of relevant documents, including but not limited to, regulatory notice, civil complaint, criminal charging document, and

any settlement documents.

REPORTING REQUIREMENTS:

Page 4: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Any of the following common errors may result in an incomplete application: Fees:

• Application received without the fee or with an incorrect fee (see fee schedule below)• Failure to include payment of Municipal Auditor Fee (if applicable)• Checks payable to an incorrect payee (i.e. OSCPA, AICPA, DOR, etc.)• Missing credit card information (i.e. amount, signature to authorize payment, expiration date or using a credit card other than

Visa or MasterCard)Address:

• Failure to include both employer and residence address• Failure to provide a physical address when a PO Box is used• Failure to choose which address to be used for mailings

CPE: • Failure to use the correct CPE format – CPE can be reported using excel or similar program, however, it must be in the

EXACT format provided by the Board on the renewal application and must include readable text (size and font). CPE coursesare to be reported in chronological (date) order.

• Failure to submit the required number of CPE hours• Failure to provide the 6-digit NASBA Registry Number for self-study CPE• Reporting CPE taken outside the reporting period• Failure to take an Ethics Course• Failure for licensees renewing for the 1st time to take an Oregon-specific ethics course

Other: • Failure to complete all sections of the renewal form. Regardless of the status renewing to (active, inactive, voluntary lapse or

retired) the entire renewal must be completed• Failure to complete practice information on page 3 of the renewal• Failure to sign the renewal (page 4 and page 5 if applicable)• Failure to disclose 100% of services being performed by licensee• Failure to answer all background questions and submit required documentation

Failure to submit a complete renewal application may result in assessment of late fees, additional CPE required, significant delays in processing, or the lapse of your CPA/PA license.

FEES: ACTIVE $255 INACTIVE $50 RETIRED $50 MUNICIPAL $150 ACTIVE LATE FEE $255 INACTIVE LATE FEE $50 RETIRED LATE FEE $50 MUNICIPAL LATE FEE $150

*Late fees will be assessed for all renewals that are received by fax or postmarked on or after July 1, 2020. Late fees cannot bewaived.

Receipts for Payment – Receipts will not be provided between June 19 – July 14, 2020. If you would like a receipt forpayment, please make your request by email to [email protected] and a receipt will be emailed to you as soon as possible.

THE BOARD OFFICE IS MOVING THE WEEK OF MAY 18, 2020 The new address for the Board of Accountancy office is:

200 Hawthorne Ave SE Suite D450

Salem, Oregon 97301-5289

Incomplete applications will not be processed.

jnadeau
Highlight
Page 5: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

If you are interested in serving on the Board or a committee, please indicate so on page 1 of the renewal application.

The mission of the Board of Accountancy is to protect Oregon consumers by ensuring only qualified licensees practice public accountancy in accordance with established professional standards and promulgated rules. If you are interested in giving back to the profession, please consider the service opportunities listed below.

Board - The Board is responsible for licensing and regulating Certified Public Accountants, Public Accountants, and public accounting firms in Oregon and meets approximately 4 times per year in person at the Board office. The Board is currently recruiting an actively licensed CPA or PA to serve on the Board. If you are interested in Board service, please contact Kimberly Fast, Executive Director, by phone at 503-378-2280 or by email at [email protected] for more information.

Complaints Committee (BOACC) – The BOACC provides technical assistance to Board staff in the investigation of complaints received by the Board. The BOACC reviews investigation reports and makes recommendations to the Board. This committee meets approximately 4 times per year in person at the Board office.

Qualifications Committee (QC): This committee reviews experience requirements for individuals whose experience was gained in private industry or government settings. The QC reviews the experience as it relates to the seven core competencies and makes recommendations to the Board for approval or denial of an initial license. The QC meets approximately 4 times per year in person at the Board office.

Peer Review Oversight Committee (PROC): The PROC oversees and monitors approved peer review programs. The committee also reviews peer review reports submitted by firms and monitors results and actions taken by the peer review programs. This committee meets approximately 2-4 times per year in person at the Board office.

Laws and Rules Committee (LRC): This ad-hoc committee reviews current Board rules and statutes and makes recommendations to the Board. The LRC meets in person at the Board office as needed.

Helpful Links:

Verify Self-Study course registry information: https://www.nasbaregistry.org/sponsor-list Oregon Administrative Rules: http://www.oregon.gov/boa/Pages/adminrules.aspx

Page 6: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 1

OREGON BOARD OF ACCOUNTANCY 200 Hawthorne Ave SE, Ste D450, Salem, OR 97301-5289

PH (503) 378-4181 ▪ FAX (503) 378-3575 ▪ www.oregon.gov/BoA Renewal of CPA/PA License – DUE DATE: June 30, 2020 for EVEN-Numbered Licensees only

Active $255 Inactive $50 Retired $50 Muni $150

License #: Muni #:

Carryforward Hours: Ethics Hours Required:

Prorated Hours: Name & Mailing Address Alternate Address

Please use space below to update contact information

Check one box for official mailing address

Firm, Business or Employer name:

Business Address:

Business City State Zip Phone

Email Address:

Home Residence Address:

City State Zip Phone

Email Address:

Website Daytime Phone Fax

If you use a Tax Preparer’s Identification Number (PTIN), provide the number:

Are you interested in serving on the Board or a Committee? (check any that apply) Yes No

Board BOACC Qualifications (QC) Laws & Rules (LRC) Peer Review (PROC)

Clerk Date Proc SEQ Batch Last4

Page 7: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 2

CONTINUING EDUCATION REPORT (List programs in chronological order)

COURSE TITLE SPONSOR DATE Completed

*CPEType (see

below)

Live (L) or

Self-study (S)

NASBA National Registry # (self-

study only)

HOURS earned

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20 If you need additional space, attach a photocopy of this report with additional CPE courses. A PDF fillable form can be found on the Board website.

A computer generated form is acceptable only if it is produced in an identical format.

*CPE Type CALCULATE TOTAL CPE HOURS CLAIMED FOR EACH CPE TYPE HOURS

T All qualifying TECHNICAL CPE courses not otherwise described

E Ethics (4 hours required each renewal period; Oregon-specific course required for first renewal)

M Municipal Auditing (24 hours required for Municipal Auditors)

NT NON-TECHNICAL (limited to 16 hours Active/8 hours Inactive) see instructions for non-technical CPE categories

B CPE Course instructor, author of published books or articles, or discussion leader (may not exceed 50% of the total CPE requirement either separately or combined)

NL Nano-learning (may not exceed 10% of the total CPE requirement)

A MINIMUM OF 24 HOURS must be obtained in each year of the renewal period.

CPE Courses completed on or before June 30, but after the date you submit this renewal, may be included on the CPE report. If you are unable to attend or complete a course before June 30, or a course is cancelled, provide written notice to the Board describing the credits to be removed from your CPE report.

(calculate subtotals from this page and all attached pages) HOURS

Total CPE hours from 7/1/18 – 6/30/19:

Total CPE hours from 7/1/19 – 6/30/20:

Carryforward hours applied from last renewal period : (max 20 active/8 inactive)

TOTAL CPE HOURS REPORTED:

(STAFF USE ONLY)

Page 8: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 3

PRACTICE INFORMATION REQUIRED TO BE COMPLETED BY ALL LICENSEES

YOU MUST COMPLETE THIS SECTION

FULL TIME

PART TIME

Please indicate the types of engagements you performed from 7/1/2018 – 6/30/2020. If you work in Industry or you perform duties that are not listed, please use “other” to describe your duties that are not listed, for example CFO, Controller, Marketing, or HR.

Public Accounting Attest* %

Private Company/Industry Accountant Reviews (AR-C Sec 90)* %

Private Company - non-accounting Compilations (AR-C Sec 80)* %

Government Accountant/Auditor Preparation Engagements (AR-C Sec 70)* %

Academia (professor/assistant only) Municipal Audits %

Attorney Tax %

Unemployed Financial Planning %

Retired (no employment) Consulting %

Other (non-accounting), please describe Bookkeeping %

Internal Audit/Tax for private company %

CFO %

Controller %

Other (describe) %

TOTAL %

If you performed attest, review or compilation services in Oregon or for Oregon clients from 7/1/2018 - 6/30/2020, under which registered Oregon firm?

I do not perform engagements for Oregon clients and do not work for an Oregon public accounting firm.

Check all engagement types you intend to perform in Oregon or for Oregon clients from 7/1/2020 – 6/30/2022:

Audits Agreed Upon Procedures ERISA Audits Broker-Dealer

Review Municipal Audits Compilations FDICIA

If you work full-time or part-time under a different business name, please provide the name and address of the business below (including any business that is not public accounting):

Enter the % of time for each area that applies. If none describe your work, please use “other” to explain. You may select multiple work types, but please provide date ranges if applicable.

Page 9: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 4

CERTIFICATION REQUIRED TO BE COMPLETED BY ALL LICENSEES

Please answer the following background questions regarding any jurisdiction by clearly marking your answers. Failure to answer all questions will result in an incomplete application.

YES NO 1 Have you ever been arrested, charged with or convicted of any criminal offense (excluding non-criminal traffic

violations) that you have not previously reported to the Board? 2 Have you ever been party to any legal proceedings related to professional services that you have not

previously reported to the Board? 3 Have you had any professional license suspended, revoked, restricted, disciplined in any way or been the

subject of any regulatory (including PCAOB) investigation or action that you have not previously reported to the Board?

4 Are you currently under investigation or do you have any pending actions by any regulatory agency?

If yes, did you previously report to the Board?

5 Do you have any pending action or investigation from a professional organization (AICPA, OAIA, OSCPA, PCAOB, etc)?

If yes, did you previously report to the Board?

6 Have you had any entity that issues a professional certification, license, or other credential initiate any regulatory action against you that you have not previously reported to the Board?

If YES response is related to a BOA matter, please note the Case or INQ number:

By signing below, I certify the truth and accuracy of all statements, answers and representations made in this renewal application and CPE report. This includes all supplementary statements. I also certify that all CPE

programs listed contribute directly to my professional competence as a licensee in the State of Oregon.

Failure to provide signature below will result in an incomplete application.

Signature Date

If you answered YES to any of the questions above and have not previously reported information to the Board, you must provide the following along with this application:

• Name of the regulatory agency, court or professional society;• Title of the matter;• Name of any Oregon licensees or Oregon clients involved;• Docket number, if applicable;• Date of occurrence of the event;• Name of any legal representatives involved;• A statement of the facts;• Copies of relevant documents, including but not limited to, regulatory notice, civil complaint, criminal charging document or

copies of legal documents indicating your compliance with any requirements imposed upon you; and• If a settlement was reached, provide the settlement agreement along with the final court order.

Reporting requirements for the questions above are not limited to responses in this application. Licensees are required to report within 45 days of the resolution of any civil action related to professional services involving an Oregon licensee or Oregon client. If you are reporting an ongoing matter, you must also report to the Board within 45 days of the conclusion of any civil or regulatory matter and within 10 days of the initiation of any criminal matter/investigation. OAR 801-030-0020(3)

Page 10: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 5

A TO RENEW AS INACTIVE STATUS / $50.00 TO RENEW AS INACTIVE STATUS, COMPLETE THIS SECTION and sign the certification on page 4:

I hereby apply for inactive status under ORS 673.220 and OAR 801-010-0120. I certify that:

• I hold a license issued under ORS 673.150 or 673.100 which is not suspended, revoked, expired, resigned, or lapsed;• I will not perform any attest, compilation or review services;• I will not prepare any tax returns as a preparer;• I do not practice any other forms of public accountancy as defined in OAR 801-005-0010(41);• I am not employed at a public accounting firm;• I will use the word “inactive” if I use the CPA or PA designation (OAR 801-010-0120).

Print Name

Signature (must also sign certification on page 4) Date

B TO APPLY OR RENEW AS RETIRED STATUS / $50.00 TO APPLY OR RENEW AS RETIRED STATUS, COMPLETE THIS SECTION and sign the certification on page 4:

I hereby apply for retired status under ORS 673.220 and OAR 801-005-0010(47). I certify that:

• I hold a license issued under ORS 673.150 or 673.100 which is not suspended, revoked, expired, resigned, or lapsed;• I will not perform any attest, compilation or review services;• I will not prepare any tax returns as a preparer if I have been compensated in any manner for my services;• I do not practice any other forms of public accountancy as defined in OAR 801-005-0010(41) for direct or indirect compensation;• I am not employed at a public accounting firm;• I will use the word “retired” if I use the CPA or PA designation (OAR 801-010-0120) or sign any documents related to non-compensated

services.

If you have not previously applied for retired status, please indicate how you qualify:

I have held an active license in good standing, to practice public accountancy in Oregon for a combined period of not less than 20 years

I have reached 65 years of age Date of Birth: / / 19

Print Name

Signature (must also sign certification on page 4) Date

C DO NOT INTEND TO RENEW LICENSE / NO COST I DO NOT INTEND TO RENEW and understand by completing this section, along with the certification on page 4, that my license will LAPSE.

Lapsed licensees are still under the jurisdiction of the Board. I hereby apply for lapsed status under OAR 801-005-0010(28) and I certify that:

• I hold a license issued under ORS 673.150 or 673.100 which is not suspended, revoked, expired, resigned, or lapsed;• I will not perform any attest, reviews, or compilation services;• I am not employed at a public accounting firm and will not seek employment at a public accounting firm until I hold an active permit;• I will not prepare any tax returns as a preparer;• I do not practice any other forms of public accountancy as defined in OAR 801-005-0010(41).

Licensees whose license is in lapsed status are not permitted to hold themselves out as a CPA or PA. Licensees who continue to practice with a lapsed license are subject to civil penalties up to $5,000 per violation and other forms of discipline by the Board for holding out as a CPA or PA and for practicing without a valid license. Lapsed licenses will expire after 3 renewal periods.

My principal place of business is in another state as defined by OAR 801-005-0010(43) and I hold an active license in that jurisdiction.

Print Name .

Signature (must also sign certification on page 4) Date

Page 11: THE OREGON BOARD OF ACCOUNTANCY IS MOVING! Licensee... · Active licensees are required to report a minimum of 80 hours of CPE and report at least 24 hours of CPE taken within each

Questions? Please contact (503) 378-4181 or [email protected] 2020 CPA/PA Permit Renewal P a g e | 6

CREDIT/DEBIT CARD PAYMENT AUTHORIZATION FORM *** MUST ACCOMPANY PERMIT RENEWAL APPLICATION IF PAYING BY CREDIT CARD ***

LATE fees MUST be included with applications postmarked on or after July 1, 2020 or received by FAX on or after July 1, 2020. The postmark must be provided by a USPS or other commercial mail delivery provider. Mailing date stamped by a private postage meter will not be accepted to establish timely renewal. For your protection, email submissions will not be accepted.

ACTIVE $255 INACTIVE $50 RETIRED $50 MUNICIPAL $150 ACTIVE LATE FEE $255 INACTIVE LATE FEE $50 RETIRED LATE FEE $50 MUNICIPAL LATE FEE $150

VISA or MASTERCARD ONLY CARDHOLDER’S INFORMATION (please PRINT and provide ALL information)

Charge Amount: Visa Mastercard

Card Number: Expiration date:

Cardholder Name (as it appears on card):

Cardholder Billing Address:

House number / Street / Apartment number

City State Zip Code Daytime phone number

Cardholder’s Signature (unsigned credit card payments will not be processed) Date

If paying by CHECK

Make check payable to Oregon Board of Accountancy

Mail renewal form and check to:

Oregon Board of Accountancy Unit 05

PO Box 4395 Portland, OR 97208-4395

If paying by CREDIT CARD

You may mail or fax to

FAX: 503-378-3575

NEW MAILING ADDRESS: Oregon Board of Accountancy

200 Hawthorne Ave SE Ste D450

Salem, OR 97301-5289

For your privacy and protection, please DO NOT EMAIL renewal applications.

UNSIGNED CREDIT CARDS WILL NOT BE PROCESSED. IF PROPER PAYMENT IS NOT RECEIVED BY THE DUE DATE, YOUR RENEWAL APPLICATION MAY BE CONSIDERED LATE AND A LATE FEE MAY BE CHARGED.

jnadeau
Highlight
jnadeau
Highlight