Alabama State Board of Public Accountancy

Experience Form - To be completed by the person verifying experience (Verifying Agent)

Permits to engage in the practice of public accounting shall be issued by the Board to a holder of a CPA certificate issued under the laws of this state to a person who shall have furnished evidence satisfactory to the Board of one year of experience in public accountant or its equivalent. Public accounting shall mean full‐time employment by a public accounting firm as a staff accountant and supervised by a practicing CPA or registered PA holding a valid permit to practice in this or any other state.
The following shall be deemed the equivalent of one year of experience in public accounting: two years’ full‐time employment in the accounting field in industry, business, government, or college teaching; or any combination of the above. Such experience must be properly supervised, have sufficient quality and depth, meet one of the criteria for the duration of that qualifying experience. Please read Accounting Rule 30-X-5-.06 for details of each area of experience.
If the Applicant/CPA has more than one employer verifying experience, please use a separate form for each.

1. APPLICANT/CPA CONTACT INFORMATION

Full Name:	You must enter a name.	AL CPA Cert#:
Preferred Phone:	You must enter a phone number.	Email:	You must enter an email address. Invalid email address format.

2. EMPLOYER INFORMATION, APPLICANT/CPA EXPERIENCE INFORMATION & VERIFYING AGENT INFORMATION:

If verifying 1 year of public accounting experience, the Verifying Agent must be a CPA that is active and in good standing in the State of Alabama or another state*.

Employer Name:

Is this a CPA firm?

YesNo

Address:

Employment time period:
to Full-time or Part-time? NOTE: Full-time experience must be 30 hours a week, or more, not an average.

Job Title:

Internship?

YesNo

Brief description of experience:
(1500 character maximum)

Agent Name:

Agent CPA Cert # and Issuing State (if applicable):
N/A

Agent Job Title:

Agent Phone:

Agent Email:

Digital Signature:

I acknowledge my signature indicates I understand that this written declaration has the same legal effect as an oath or affirmation. I certify under penalty of perjury that all representations made on this form are true and accurate to the best of my knowledge and belief.

(Typing your full name into the box below constitues your digital signature.)

Date: 4/20/2024

Attachments:

Before you choose your file attachments below, be sure all of the files are in the same folder location. Select all of the files at the same time (hold the SHIFT key to highlight them all). You cannot select them in separate actions. Once the multiple files are selected, the file selector should look like the example image to the right. After a second or two, you can see all of the file names by hovering your mouse pointer over the file selector.

Please check the "I am not a robot" box to continue:

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