Ny Form 4B Certification Of Employer – Fill Out and Use This PDF

The University of the State of New York

The State Education Department

Office of the Professions

Division of Professional Licensing Services

www.op.nysed.gov

Instructions for Completing Verification of Experience by Supervisor Form 4B

NOTE: Send these instructions with the Form 4B to each supervisor.

Who can complete this form? A certified public accountant licensed in one of the U.S. jurisdictions who is properly licensed and registered or authorized to practice in the jurisdiction of their principal place of business. If a CPA supervisor was not properly licensed or registered or authorized to practice in the state where they practiced, the experience cannot be accepted. The CPA must have acted in a supervisory capacity to the applicant in the same employing organization.

What is acceptable experience? An applicant must present evidence, satisfactory to the State Board for Public Accountancy, of full-time experience providing accounting services or advice involving the use of accounting, attest, compilation, management advisory, financial advisory, tax or consulting skills under the supervision of a certified public accountant as indicated above. Acceptable experience may be earned in a public accounting firm, government, not-for-profit, private industry or an educational institution. Internships may not be accepted toward the experience requirement if it is used to meet the degree requirements or listed for academic credit on the transcript.

Full and part time experience. Full-time employment is considered to be a 5-day work week with 35-40 hours per week, excluding overtime. Acceptable part-time (no fewer than 20 hours per week) experience will be considered on the basis of one week of experience for every two weeks worked. Part-time experience requires supporting documentation that indicates the number of hours worked for each week during the duration. Supporting documentation may include time cards, billing reports, excel spreadsheets, etc. An average of part time work will not be accepted.

How much experience must be certified on Form(s) 4B?

●Initial license: 150 semester hour education requirements - must document at least 1 year of acceptable full-time experience (or the part-time equivalent as described above).

●Initial license: 120 semester hour education requirements - must document at least 2 years of acceptable full-time experience (or the part-time equivalent as described above) unless the applicant submits acceptable transcripts and is approved as meeting the 150 semester hour education requirements. See 150 semester hour requirement above.

●Endorsement of a CPA license issued in another state - must document 4 years of full time experience (or the part-time equivalent as described above) since the out-of-state license was issued and within the last 10 years. Applicants who hold a license issued by another state who cannot document 4 years of post-license acceptable experience are not eligible for licensure by endorsement and may be processed as an initial applicant for licensure. Do not list experience prior to the applicant's date of licensure listed in Section 1.

●Foreign Endorsement - must document 4 years of full time experience (or part-time equivalent as described above) since the foreign license was issued and within the last 10 years. The experience must be certified by a U.S. CPA as described above. Do not list experience prior to the applicant's date of licensure listed in Section I.

●Applicants for an initial license based on 15 years of experience in lieu of meeting the education requirements - must document at least 15 years of acceptable full time experience (or the part-time equivalent as described above).

Instructions for Completing Item 7, A-K

Indicate the applicant's service(s) performed during the attested experience.

A.Independent Audit: Includes experience where the applicant was involved:

1.in examining financial statements of clients where the application of generally accepted auditing standards has been employed for the purpose of expressing an opinion that the financial statements are presented in accordance with generally accepted accounting principles; or

2.in examining financial statements of clients when certain auditing procedures have been applied but a disclaimer is expressed, including Statements on Auditing Standards (SASs), Statements on Standards for Attestation Engagements (SSAEs), and Statements on Quality Control Standards (SQCSs).

The preparation of a client’s related income tax returns and management letters by the applicant who participated in the examination of the financial statements may also be included in this category. Involvement in the examination of the financial statement is mandatory for including these tax preparation and management letter activities in the audit category.

B.Compilations and Reviews: The independent preparation of financial statements from the books of account without audit, including compilations as defined by Statements on Standards for Accounting and Review Services (SSARS), and performing related services in which the applicant has demonstrated a knowledge of generally accepted accounting principles.

Certified Public Accountant Form 4BInst, Page 1 of 2, Rev. 9/20

Items 7 - 11: Applicant's work experience record to which I am attesting and acted in a supervisory capacity:

7.Type of services performed by the applicant:

A.* Independent Audit

B.* Compilations and Reviews

C. Internal, Management, or Government Audit

D. Forensic Accounting

E. Bookkeeping and Internal Financial Statement Preparation

F. Tax Preparation or Tax Advice

G. Management Advisory Services

H. Financial Advisory Services

I. Consulting

J. Teaching College Accounting

K Other Professional Services (describe in detail or attach additional sheets)

*A and B - restricted to registered public accounting firms only.

8.Applicant's Job Classification:

Full Time Part Time*

Full Time Part Time*

Full Time Part Time*

*Part time experience will not be accepted without supporting documentation. See instructions for acceptable supporting documentation.

Affirmation

Ideclare and affirm under penalty of perjury that the statements made in the foregoing application, including any attached statements, are true, complete and correct and that the experience and competency I am attesting to meets the definition and practice as a certified public accountant.

Return Directly to by mail: New York State Education Department, Office of the Professions, Division of Professional Licensing Services, CPA Unit, 89 Washington Avenue, Albany, NY 12234-1000, OR, Submit this form to the Department by E-mail at

DPLSExperience@nysed.gov.

Certified Public Accountant Form 4B, Page 2 of 2, Rev. 9/20