The Tennessee In 1324 form is an affidavit used by licensed accountants in Tennessee who wish to change their status from active to inactive. This form must be notarized and serves to officially notify the Tennessee State Board of Accountancy of the licensee's decision to surrender their right to practice public accountancy. Completing this form is essential for those who have not engaged in accounting services for a specified period.
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The Tennessee In 1324 form serves as a crucial document for licensed public accountants who wish to transition from active to inactive status. This form is designed specifically for individuals who have decided to surrender their right to practice public accountancy, thereby indicating a significant change in their professional engagement. By completing the form, licensees affirm that they have not engaged in any public accounting services, including auditing or financial consulting, for a specified period. This declaration is essential, as it ensures compliance with the regulations set forth by the Tennessee State Board of Accountancy. The form also outlines the responsibilities that remain for the licensee, such as the requirement to renew their permanent certificate biennially and the need to complete continuing professional education (CPE) hours if they wish to reactivate their license in the future. Additionally, it highlights the importance of understanding the legal implications of maintaining an inactive status, including the limitations on the use of professional titles and the potential for disciplinary action if the rules are violated. Notarization of the form adds an extra layer of authenticity, ensuring that the information provided is verified and legally binding.
State of Tennessee
Department of Commerce and Insurance Tennessee State Board of Accountancy 500 James Robertson Parkway Nashville, TN 37243
6157412550 or 8884536150 (Fax 6155328800)
AFFIDAVIT FOR CPE EXEMPTION AND INACTIVE CPA/PA STATUS
(Must Be Notarized)
By: ______________________________________________________________________________________
(Licensee's Full Name and Address print or type)
after being duly sworn, deposes and says:
I, _________________________________________, hereby advise the Tennessee State Board of Accountancy that
I wish to surrender my right to practice public accountancy and change my certificate from 'Active' to 'Inactive' status.
I warrant and affirm that I have not performed or offered to perform for the public, individually or as an employee in a firm, one or more kinds of services involving the use of accounting or auditing skills, including the issuance of reports on financial statements, nor have I performed or offered to perform for the public one or more kinds of management advisory, financial advisory or consulting services nor have I performed or offered to perform for the public services including preparation of tax returns or the furnishing of advice on tax matters since___________________ (date must
precede period for which you are seeking exemption.)
I understand that by doing so I give up the right to use the title of certified public accountant or licensed public accountant without including 'Inactive' adjacent to the use of the title which includes the abbreviations CPA, PA and the word 'Accountant.' I understand that by making this election I can not perform or offer to perform for the public any of the services listed in the previous paragraph. I further certify that I have read and understand the Law and Rules of the Board of Accountancy.
I understand that I must continue to renew my permanent certificate on a regular biennial basis and pay the renewal fees assessed by the Board of Accountancy. I further understand that in order to return to active status, I must complete eighty (80) hours of technical CPE during the 24 month period preceding the date I request reactivation of my license.
Additionally, I understand that violation of Tennessee Code Annotated, Title 62, Chapter 1 and/or the rules and policies of the Tennessee State Board of Accountancy relating to improperly performing services for the public and/or using my credential in the State of Tennessee is cause for disciplinary action by the Tennessee State Board of Accountancy.
____________________________________________________
___________________
_______________
Affiant Signature
Certificate Number
Date of Signature
________________________________________________________________________________
Street Address
City State
Zip
Sworn and subscribed Before Me this _________ day of ________________, 20_____.
_______________________________
Notary signature
Notary Public: My Commission Expires: _________________________ (Seal)
IN 1324 (06/3/2009)
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