application for a certified public accountant (cpa ......certified public accountant (cpa)...

PAB 3 of 5 Revision date: 11/07/2013

New Mexico Regulation and Licensing Department BOARDS AND COMMISSIONS DIVISION New Mexico Public Accountancy Board

5200 Oakland Avenue, NE ▪ Suite D ▪ Albuquerque, New Mexico 87113 (505) 222-9850 ▪ Fax (505) 222 -9855 ▪ www.r ld.state.nm.us/boards

APPLICATION FOR A

CERTIFIED PUBLIC ACCOUNTANT (CPA) CERTIFICATE

BY RECIPROCITY

All applicants for licensure are required to provide the Board with fingerprints and other

information necessary for a state and national criminal background check. Prior to submitting an

application for a New Mexico CPA certificate, an applicant must contact the Board office at the

telephone number or email address at the top of this application to request fingerprint cards and

the accompanying forms that must be completed.

An individual who holds a license in good standing in another state will be eligible for a New

Mexico certificate when the following items have been submitted. Be advised that licenses

must be approved by the Board at a scheduled Board meeting. If your file is incomplete,

you will be notified; otherwise, it will be presented for approval at the next scheduled

Board meeting. A list of meetings may be found on the website:

www.rld.state.nm.us/boards.

Application for an Initial New Mexico CPA Certificate – this must be notarized.

Application fee of $175.00 – personal check or money order only, made payable to the New

Mexico Public Accountancy Board.

Passport Photograph – a 2’’ x 2” photograph must be stapled to the application.

Fingerprint Background Check Documents – NEW MEXICO APPLICANT PROCESSING

SERVICE- 3M COGENT LIVESCAN. As of November 5, 2013, the New Mexico Department of Public Safety (DPS) will no longer accept hardcopy

fingerprint cards. Please go to www.cogentid.com.

Photocopy of Out-of-State License – this license must be current.

Reciprocity Information Sheet – list all states in which you have been or are currently

licensed, and indicate CPE hours completed

Interstate Exchange of Information Form – used to verify your CPA Examination scores

and licensure status from another state. Mail this form to the accountancy board in the state

in which you proctored and/or to all the states in which you are or have been licensed (you

may duplicate this form as necessary). This form must be completed by that board and

mailed to the New Mexico Public Accountancy Board at the above address.

Official Transcripts – [REQUIRED ONLY IF YOU HAVE BEEN LICENSED FOR LESS

THAN TWO YEARS] must include transcripts from all institutions attended, unless course

work was transferred to another institution and itemized on that institution’s transcript.

Transcripts must bear the embossed seal or colorized stamp of the institution and arrive in

http://www.rld.state.nm.us/boards

http://www.cogentid.com/

PUBLIC ACCOUNTANCY BOARD

APPLICATION FOR A NEW MEXICO CERTIFIED PUBLIC ACCOUNTANT CERTIFICATE BY RECIPROCITY

New M ex ico R egu la t io n and L icens in g D epa r tment BOARDS AND COMMISSIO N S DIVISION


sealed envelopes. If your institution will not release an official transcript to the student, the

institution may send the transcript directly to the Board office. Candidates with transcripts

from outside the United States must submit an official foreign transcript evaluation in lieu of

original transcripts. A list of foreign transcript evaluation agencies may be found on the

National Association of Credential Evaluation Services’ website at www.naces.org.

Transcript Summary Form – [REQUIRED ONLY IF YOU HAVE BEEN LICENSED

FOR LESS THAN TWO YEARS] this must be completed by the applicant.

Experience Verification Form – [REQUIRED ONLY IF YOU HAVE BEEN LICENSED

FOR LESS THAN TWO YEARS] at least one year of experience providing service or advice

involving the use of accounting, attest, management advisory, financial advisory, tax, or

consulting skills is required. This experience must be verified by a certified public

accountant licensed in a U.S. jurisdiction during the period of supervision. This form must

be returned to you by the CPA in a sealed envelope. Do not open this envelope.

Interstate Notification of Verifying CPA’s License – [REQUIRED ONLY IF YOU HAVE

BEEN LICENSED FOR LESS THAN TWO YEARS] if the CPA attesting to your

experience is not licensed in New Mexico, mail this form to the accountancy board in the

state in which he/she is licensed (you may duplicate this form as necessary). This form must

be completed by that board and returned to the New Mexico Public Accountancy Board at

the above address.

Passing Scores for Ethics Examination – [REQUIRED ONLY IF YOU ARE LICENSED

IN A STATE THAT IS NOT SUBSTANTIALLY EQUIVALENT TO NEW MEXICO IN

TERMS OF EDUCATION, EXAMINATION, AND EXPERIENCE REQUIREMENTS]

please see enclosed instruction sheet for ordering and completing the ethics examination

administered by the American Institute of Certified Public Accountants. Score must be 90%

or higher.

Certification Checklist - this must be completed and signed

All of these documents are included in this application packet. Please print or type all requested

information.

http://www.naces.org/





SECTION I – PERSONAL INFORMATION

_____________________________________________________________________________________________

Last Name First Name MI Other Name(s) Used

____________________________________ _____________________________

Date of Birth (MM/DD/YYYY) Social Security Number

______________________________________________________________________

Name as you wish it to appear on the wall certificate (PLEASE PRINT CLEARLY)

Please Note: if you wish to have your maiden name included on the certificate,

please provide a copy of your marriage certificate.

Residence Address [ ] Check if you wish to receive mail at this address

_____________________________________________________________________________________________

Street or P.O. Box City State Zip Code

_________________________________ ___________________________________________

Home Telephone Number Email Address

Business Address [ ] Check if you wish to receive mail at this address

_____________________________________________________________________________________________

Employer Name/Firm Name

_____________________________________________________________________________________________


_________________________ _________________________ ____________________________________

Telephone Number Fax Number Email Address

In which state did you take the Uniform CPA Examination? _____________________________________________

In which state(s) do you hold a current CPA certificate? ________________________________________________

SECTION II – EDUCATION

College/University Location Major Degree/Date Conferred

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________





SECTION III – ACCOUNTING EXPERIENCE

_____________________________________________________________________________________________

Employer #1

_____________________________________________________________________________________________


__________________________ ______/______/______ ______/______/______

Position Held Dates of Employment: From To

_____________________________________________________________________________________________

Employer #2

_____________________________________________________________________________________________


__________________________ ______/______/______ ______/______/______


_____________________________________________________________________________________________

Employer #3

_____________________________________________________________________________________________


__________________________ ______/______/______ ______/______/______


_____________________________________________________________________________________________

Employer #4

_____________________________________________________________________________________________


__________________________ ______/______/______ ______/______/______






SECTION IV – PROFESSIONAL FITNESS

Answer each question. If you answer “yes” to any question, provide a complete narrative description on a separate sheet.

Please include the following: a) the nature of the offense, charge, warrant, or condition; b) the name and location of the

arresting agency, if any; and c) the date of any arrest. Also provide relevant court disposition papers including: a) a

complete copy of the judgment and sentence; and b) current status of the case, restitution, payment of fines and/or court

costs, and satisfactory completion of sentence. If court documents are not available, submit a letter from an official of the

court certifying that documents are not available. Web page printouts are not considered official court documents.

1. Have you ever been convicted of a felony under the laws of any state or of the United States? [ ]YES [ ]NO

2. Have you ever entered a plea of guilty or a plea of nolo contendere accepted by the court? [ ]YES [ ]NO

(This does not include traffic citations, unless a citation resulted in a warrant for your arrest.)

3. Do you currently have any outstanding criminal charges, warrants of arrest, or conditions of [ ]YES [ ]NO

probation pending against you in New Mexico or in any other state?

4. Have you ever been arrested or detained for any crime or violation of the law? [ ]YES [ ]NO

5. Have you ever had a professional or vocational license suspended or revoked by this state

or any state or foreign country? [ ]YES [ ]NO

6. Have you ever had the right to practice before any state or federal agency suspended or

revoked for improper conduct or willful violation of the rules or regulations of such state

or federal agency? [ ]YES [ ]NO

7. Are you currently delinquent in payment of court-ordered child support? [ ]YES [ ]NO

OATH FALSE STATEMENTS OR OMISSIONS ARE CAUSE FOR DENIAL, SUSPENSION, OR REVOCATION OF LICENSURE

I, ___________________________________, swear or affirm under the penalty of perjury that all information PRINT NAME

I submitted in this application is true, correct, and complete to the best of my knowledge, information, and belief. I

understand that any material misrepresentation or material omission of fact in this application is grounds for denial,

suspension, or revocation of the CPA license that I am seeking. I also agree to comply with the 1999 New Mexico

Accountancy Act and the current governing Board rules.

Signature _______________________________________ Date ____________________________

NOTARY

Before me, a Notary Public, in and for the State of _________________and the County of ____________________,

to me known to be the person named, who, first being duly sworn, deposes and says that the signature hereto is

his/her own signature, and that the statements made in his/her application to the New Mexico Public Accountancy

Board are true to the best of his/her knowledge.

IN WITNESS WHEREOF, I have hereunder set my hand and affixed my seal, this ____day of __________, 20____

__________________________________________________

Notary Public

SEAL

__________________________________________________

My Commission Expires

Revision date: 11/07/2013



RECIPROCITY INFORMATION SHEET

_____________________________________________________________________________________________

Last Name First Name MI Other Names Used

_______________________________ ____________________________________


CERTIFICATE INFORMATION

List all states in which you have been or are currently certified:

State Certificate # Date Issued Expiration Date Licensed by Exam or by Reciprocity?

_____ __________ __________ _____________ ________________________________

_____ __________ __________ _____________ ________________________________

_____ __________ __________ _____________ ________________________________

_____ __________ __________ _____________ ________________________________

Have you been subject to disciplinary action by a regulatory board? [ ] YES [ ] NO.

If yes, please explain:___________________________________________________________________________

_____________________________________________________________________________________________

FALSE STATEMENTS OR OMISSIONS ARE CAUSE FOR DENIAL, SUSPENSION,

OR REVOCATION OF LICENSURE

I, ___________________________________, swear or affirm under the penalty of perjury that all information I

Print Name

submitted in this application is true, correct, and complete to the best of my knowledge, information, and belief. I

understand that any material misrepresentation or material omission of fact in this application is grounds for denial,

suspension, or revocation of the CPA license that I am seeking. I also agree to comply with the 1999 New Mexico

Accountancy Act and the current governing Board rules.

Signature _____________________________________________ Date ________________________

PAB 11 Page 1 of 3 Revision date: 11/07/2013



INTERSTATE EXCHANGE OF INFORMATION FORM

This form authorizes state boards of accountancy to exchange information in two areas: 1) CPA Examination score

information; and 2) licensure status of the applicant. You are encouraged to contact the accountancy board that

will complete this form to determine if processing fees will be assessed. You must complete the personal

information in Section I then forward the form to the appropriate state board for completion. A separate form must

be completed by the board of accountancy in each state in which you hold or have held a license or certificate. The

respective board will, in turn, complete the remainder of the form and mail it directly to the New Mexico Public

Accountancy Board at the address above.

This form is being used to verify (please check one or both):

[ ] Examination score information (Section II)

[ ] Licensure status of the applicant (Section III)


To Be Completed by the Applicant

_____________________________________________________________________________________________


_____________________________________________________________________________________________


_______________________________ ____________________________________


_______________________________ ____________________________________

Daytime Telephone Number Certificate Number/State of Issue

I hereby request and authorize the ___________________________Board of Accountancy to provide any and all

pertinent information requested in this form to the New Mexico Public Accountancy Board to complete an

application filed with that agency. I agree that the State Board may confirm the grades issued to me by the Advisory

Grading Service of the American Institute of Certified Public Accountants.

_________________________________________ ____________________________

Applicant Signature Date

THE REMAINDER OF THIS FORM IS TO BE COMPLETED BY STATE BOARDS OF

ACCOUNTANCY ONLY.

PUBLIC ACCOUNTANCY BOARD INTERSTATE EXCHANGE OF INFORMATION FORM



SECTION II – EXAMINATION SCORE INFORMATION

The following are grades awarded on the Uniform CPA Exam(s) for the applicant named above, as reported by the

AICPA Advisory Grading Service:

Date of Candidate I.D. AUD/ BEC/ FAR/ REG/

Exam Number Audit LPR FARE ARE

___________ ____________ __________ ________ _________ _________

___________ ____________ __________ __________ _________ _________

___________ ____________ __________ __________ _________ _________

___________ ____________ __________ __________ _________ _________

___________ ____________ __________ __________ _________ _________

1. Was the applicant ever denied admission to the Exam? [ ] YES [ ] NO If yes, please explain the

circumstances below. Also explain if any grades were changed, if an exam other than the Uniform CPA Exam was

used, or any reason why the grades should not be accepted.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

2. If the candidate has not completed the Uniform CPA Exam, are there any restrictions preventing him/her from

sitting in your state?

[ ] YES [ ] NO.

3. If the candidate has not passed all parts of the CPA Exam, indicate the expiration date of those parts that have

been passed and for which parts credit has been awarded:

_____________________________________________________________________________________________

SECTION III – CERTIFICATION/LICENSURE STATUS OF THE APPLICANT

Certificate Information

1. The applicant was granted an [ ] original [ ] reciprocal CPA certificate number_____________________,

issued on ______________________ (MM/DD/YYYY) which is in good standing unless otherwise noted below.

____________________________________________________________________________________________

____________________________________________________________________________________________

PUBLIC ACCOUNTANCY BOARD INTERSTATE EXCHANGE OF INFORMATION FORM



2. The applicant has completed an AICPA Ethics Examination [ ] YES [ ] NO

Score (%)______ Date_________ Developed and graded by: [ ] AICPA [ ] State Board of Accountancy

License/Permit to Practice Public Accounting Information

1. [ ] YES [ ] NO This state is a two-tier state.

2. [ ] YES [ ] NO The license/permit from this Board is in good standing. Expiration date: _____________

3. [ ] YES [ ] NO The applicant is currently licensed to engage in the practice of public accountancy.

4. [ ] YES [ ] NO Has there ever been any disciplinary action instituted against the applicant? If yes, please

explain below.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

5. If the applicant does NOT hold a license/permit issued by your Board, please indicate the requirements to be met

for issuance or reinstatement:

[ ] License/permit not required

[ ] Pay appropriate fee and/or post bond

[ ] Complete acceptable accounting/auditing experience

[ ] Complete continuing professional education requirements

[ ] Other (please specify)______________________________________________________________________

OFFICIAL SIGNATURE OF VERIFYING BOARD

__________________________________________________

Board/Agency

__________________________________________________

BOARD SEAL REQUIRED Name of Board Representative Printed Name

__________________________________________________

Board Representative Signature




TRANSCRIPT SUMMARY FORM

[REQUIRED ONLY IF YOU HAVE BEEN LICENSED FOR LESS THAN TWO YEARS]

The academic requirement for New Mexico certification is 30 semester hours (45 quarter hours) of credit in

accounting, 3 hours of which may be in business law. For conversion purposes, one quarter hour equals two-thirds

(2/3) of one semester hour.

_____________________________________________________________________________________________


_____________________________________________

Social Security Number

List institutions of higher education at which accounting courses were completed:

1.________________________________________ 3._________________________________________

2.________________________________________ 4._________________________________________

Semester/ Semester Quarter

Institution Course Number & Title Year Hours Hours

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________

___________________ ____________________ ________ ________ ________




WORK EXPERIENCE VERIFICATION FORM

EXPERIENCE REQUIREMENT

An applicant for initial issuance of a certified public accountant certificate shall show that he has had at least one

year of experience. This experience shall include providing service or advice involving the use of accounting, attest,

management advisory, financial advisory, tax or consulting skills as verified by a certified public accountant who

meets requirements prescribed by the board. The experience is acceptable if it was gained through employment in

government, industry, academia, or public practice. [1999 Public Accountancy Act, Section 8(H)]

Applicants shall have their experience verified by an active, licensed CPA as defined in the Act or by an active,

licensed CPA from another state. One year of experience shall consist of full or part-time employment that extends

over a period of no less than one year and no more than three years and includes no fewer than 2000 hours of

performance of services described above. [Board Rule: 16.60.3.9 NMAC]

INSTRUCTIONS FOR COMPLETING THIS FORM

Applicants: Complete Section I of the enclosed form and forward it to an active, licensed CPA for verification. If

you had multiple CPAs that can verify your experience, the most recent should complete the form. The CPA should

return it to you in a sealed envelope. Include the sealed envelope in your completed application packet. If

experience was obtained from more than one entity, make a copy of this form and complete a Work Experience

Verification Form for each entity.

Verifying CPAs: Please complete Section II of the enclosed form and return it to the applicant in a sealed

envelope with your signature on the back. Any exceptions to the candidate’s quality of experience, character, or

fitness for service in the professional capacity of a CPA should be directed to the Board under separate cover.

SECTION I

To be Completed by the Applicant

CANDIDATE INFORMATION

______________________________________________________________________________ Last Name First Name MI Other Name(s) Used

________________________________ ___________________________________________


EMPLOYER INFORMATION

_____________________________________________________________________________________________

Employer Name

_____________________________________________________________________________________________


PUBLIC ACCOUNTANCY BOARD WORK EXPERIENCE VERIFICATION FORM



__________________________ ______/______/______ ______/______/______


Position was (check one) [ ] Part time [ ] Full time

EMPLOYER CATEGORY (select one)

[ ] Client practice of public accountancy [ ] Government

[ ] Commercial enterprise/industry [ ] Law firm

[ ] Education [ ] Other (specify)____________________

I ________________________________________, swear or affirm under the penalty of perjury that all information PRINT NAME

contained herein is true, correct, and complete to the best of my knowledge, information, and belief. I understand

that any material misrepresentation or material omission of fact in this document is grounds for denial, suspension,

or revocation of the CPA license that I am seeking.

Signature___________________________________________ Date_______________________

SECTION II

To be Completed by the Verifying CPA

__________________________ ______/______/______ ______/______/______

Position Held by Candidate Dates of Employment: From To

Length of Experience (years/months/days) _____________________

Experience was (check one) [ ] Part time [ ] Full time

I verify that this candidate demonstrated high standards of professional competence in the following areas (check all

that apply):

[ ] Accounting [ ] Management advisory

[ ] Attest [ ] Financial advisory

[ ] Consultation on tax matters [ ] Consulting

[ ] Preparation of financial statements and reports [ ] Preparation of tax returns

[ ] Consultation, design and/or implementation of computer [ ] Other (describe)___________________

software involving accounting and auditing

PUBLIC ACCOUNTANCY BOARD WORK EXPERIENCE VERIFICATION FORM



Please check the appropriate answer for each of the following questions:

[ ] YES [ ] NO During this time, I observed the candidate and I believe the candidate’s independence

on non-routine accounting matters, integrity on professional issues, and ability to learn

and stay abreast of important accounting pronouncements was demonstrated.

[ ] YES [ ] NO With respect to the character of the candidate, I recommend this person for licensure as a

Certified Public Accountant.

[ ] YES [ ] NO During the time that I observed the applicant I was actively licensed for a minimum of

one year.

________________________________________________ __________________________________________

Name of CPA (please print or type) Position or Title

_________________________________________________

Certificate Number and State of Issuance

_____________________________________________________ ____________________________

Employer Name Telephone Number

_____________________________________________________________________________________________

Address

______________________________________________________ __________________________________

Signature of CPA Date




INTERSTATE NOTIFICATION OF

VERIFYING CPA’S LICENSE

This form authorizes state boards of accountancy to exchange information regarding the licensure status of the

applicant’s verifying CPA. You are encouraged to contact the accountancy board that will complete this form to

determine if processing fees will be assessed. You must complete the personal information in Section I, and your

verifying CPA must complete the information in Section II and sign the form. Forward the form to the appropriate

state board for completion. The respective board will, in turn, complete the remainder of the form and mail it

directly to the New Mexico Public Accountancy Board at the above address. This sealed envelope will then be

submitted to the New Mexico Public Accountancy Board as part of your application packet.


To Be Completed by the Applicant

_____________________________________________________________________________________________


_____________________________________________________________________________________________


___________________________________ ___________________________________________


SECTION II – VERIFYING CPA INFORMATION

To be Completed by the Verifying CPA

____________________________________________ ___________________ ______________

Name as it Appears on Certificate Certificate Number State of Issuance

I hereby request and authorize the __________________________Board of Accountancy to provide any and all

pertinent information requested in this form to the New Mexico Public Accountancy Board to complete an

application filed with that agency for the above-named applicant.

____________________________________________ ____________________________

CPA Signature Date

THE REMAINDER OF THIS FORM IS TO BE COMPLETED BY STATE BOARDS OF

ACCOUNTANCY ONLY.




SECTION III – LICENSURE STATUS OF THE APPLICANT’S VERIFYING CPA

Is the CPA currently licensed in your state? [ ] YES [ ] NO

Indicate the dates that he/she has been actively licensed to practice accounting:

From: _____/_____/_____ To _____/_____/_____.

If not currently licensed, indicate below the requirements to be met for issuance or reinstatement.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

OFFICIAL SIGNATURE OF VERIFYING BOARD

__________________________________________________

Board/Agency

__________________________________________________

BOARD SEAL REQUIRED Name of Board Representative Printed Name

__________________________________________________

Board Representative Signature




ETHICS EXAMINATION REQUIREMENT

EXAMINATION FACTS

If you are licensed in a state that is not substantially equivalent to New Mexico in terms of

education, examination, and experience requirements and are applying for licensure in New

Mexico by reciprocity, you must pass the American Institute of Certified Public Accountants

(AICPA) Ethics Course with a grade of 90% or better. This self-study course must be completed

within one year from the date of purchase. Your invoice serves as proof of purchase. If you do

not complete the examination within one year, you must re-order it.

Upon passage of the examination, you will receive a certificate of completion from AICPA.

Please ensure that you designate the New Mexico Public Accountancy Board as a score recipient

when registering for the examination, as we must receive a score report directly from AICPA. If

you do not receive a passing score, a letter will be sent to you from AICPA. Included will be a

re-test answer sheet in order that you may resubmit answers to the same exam. Please note that

your application will not be considered complete and will not be presented to the Board

until a passing score notice has been received directly from the AIPCA.

The Board cannot interpret any questions on the examination or explain any portion of the

examination to you. If you have questions regarding the examination, you may call (201) 938-

3528 or (201) 938-3778.

ORDERING THE EXAMINATION

Please contact the New Mexico Society of Certified Public Accountants at (505) 246-1699 to

purchase the AICPA Ethics Course. You may also order online at www.nmscpa.org using

MasterCard or Visa. On their website homepage you will find an “Owl” icon that will make it

easy to see where to place your order. Please note: If this is to be shipped to a foreign address

you must contact the AICPA directly. Please call (888) 777-7077 or e-mail to

[email protected] - specifying the course title Professional Ethics: The AICPA’s

Comprehensive Course and indicating whether the preferred format is Text or CD-ROM.

http://www.nmcpa.org/

mailto:[email protected]




CERTIFICATION CHECKLIST

PLEASE PLACE A CHECK MARK BESIDE EACH ITEM INCLUDED IN YOUR PACKET. ALL

ITEMS MUST BE SUBMITTED IN A COMPLETE PACKET. INCOMPLETE PACKETS AND

ITEMS SENT SEPARATELY WILL BE RETURNED.

[ ] Application for an Initial New Mexico CPA Certificate by Reciprocity

[ ] Fee of $175.00

[ ] Passport Photograph

[ ] Photocopy of Out-of-State License

[ ] Reciprocity Information Sheet

[ ] Official Transcripts [REQUIRED ONLY IF YOU HAVE BEEN LICENSED FOR LESS THAN TWO

YEARS]

[ ] Transcript Summary Form [SEE TRANSCRIPT REQUIREMENT ABOVE]

[ ] Experience Verification Form [REQUIRED ONLY IF YOU HAVE BEEN LICENSED FOR LESS

THAN TWO YEARS]

*** Please note that the Interstate Exchange of Information Form must be sent directly to the Board

office from the state board of accountancy that completes it.

*** Please note that the Interstate Notification of Verifying CPA’s License must be sent directly to the

Board office from the state board of accountancy that completes it. [REQUIRED ONLY IF YOU

HAVE BEEN LICENSED LESS THAN TWO YEARS]

*** Please note that a Certificate of Completion for the AICPA Ethics Examination must be sent directly

to the Board office from the AICPA. [REQUIRED ONLY IF YOU ARE LICENSED IN A STATE

THAT IS NOT SUBSTANTIALLY EQUIVALENT TO NEW MEXICO IN TERMS OF EDUCATION,

EXAMINATION, AND EXPERIENCE REQUIREMENTS]

*** Please note that fingerprints are still required and must be submitted using www.cogentid.com.

___________________________________ ____________________________________

Printed Name of Applicant Signature

___________________________________

Date




NEW MEXICO APPLICANT PROCESSING SERVICE – 3M COGENT LIVESCAN As of November 5, 2013, the New Mexico Department of Public Safety (DPS) will no longer accept hardcopy fingerprint cards. Applicants will visit a 3M Cogent fingerprinting location. Applicants that require a New Mexico background check should:

Registration – All applicants must be registered prior to conducting the fingerprint process.

o Applicants – Register online at www.cogentid.com. You will need the

Public Accountancy Board’s ORI # NM920240Z. Applicants may also contact the Registration Call

Center to register by phone: 1-877-99NMAPS (1-877-996-6277).

Payment – Payment of $44.00 may be made online or at time of being fingerprinted:

o Applicants may pay online at the time of registration using a credit/debit card or the applicants can

pay with a money order or cashier’s check at the time of being fingerprinted (NO CASH OR

PERSONAL CHECKS WILL BE ACCEPTED.)

Registration ID/Document Control Number – Applicants will receive a Registration Confirmation that is

needed while visiting the 3M Cogent location.

Select a 3M Cogent Location – See the list available.

Conduct Fingerprint Process – No appointment is required.

Results – Background check results will be sent directly to your employer. 3M Cogent does not have access

to background check results, or make employment determinations. Please check with your employer

regarding your background check results

OUT-OF-STATE APPLICANTS: Applicants that are out-of-state, or applicants that are unable to visit a fingerprinting location, may submit a hardcopy fingerprint card to 3M Cogent. Out of state applicants that require a New Mexico background check should:

Obtain two inked fingerprint cards captured on standard FD-258 applicant fingerprint cards.

Registration – All applicants must be registered prior to sending hardcopy fingerprint cards.

o All Applicants – Register online at www.cogentid.com. Select the Fingerprint Card User box.

Applicants may also contact the Registration Call Center to register by phone: 1-877-99NMAPS (1-

877-996-6277).

Payment – Payment of $44.00 may be made online or sent with your fingerprint card:

o Online – Applicants may pay online at the time of registration using a credit/debit card.

o With Fingerprint Card – Money order only. Cash and personal checks are not accepted.

Registration ID/Document Control Number –All other applicants will receive a Registration ID. Write this

number on the back of your fingerprint cards.

Submission – Mail the cards (and if applicable, payment) to:

3M Cogent, New Mexico CardScan 5025 Bradenton Avenue, Suite A Dublin, OH 43017

Results – Background check results will be sent directly to your employer. 3M Cogent does not have access

to background check results, or make employment determinations. Please check with your employer

regarding your background check results.

