Minnesota Society of CPAs Peer Review Enrollment Form
Name and Address of the main office of the firm (including sole practitioners)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Information about your firm:
1. Name of managing partner or equivalent: Mr. 
Ms. 
___________________________________________________________________________
First Name
M.I.
Last Name
Are you a member of the MNCPA?
Yes 
No
Telephone: _________________________________________________________________
Fax: ______________________________________________________________________
E-mail address: ______________________________________________________________
2. Name of peer review contact: Mr. 
Ms. 
Same as managing partner 
___________________________________________________________________________
First Name
M.I.
Last Name
Telephone: _________________________________________________________________
Fax: ______________________________________________________________________
E-mail address: _____________________________________________________________
Federal Employer Identification Number* (EIN) – Do not enter a social security number
___ ___ - ___ ___ ___ ___ ___ ___ ___
*If your firm does not have an EIN, please go to http://www.irs.gov to apply for an EIN online. Providing
a valid EIN is required for enrollment and is a condition of cooperation with the program.
3. (a) Total number of CPA and non-CPA partners: ________
(b) Number of CPA partners:_______
4. Number of CPAs including partners:_________
5. Number of personnel¹ including partners:___________
6. Total number of engagements performed or expected to be performed on Engagements under the
Statements on Auditing Standards (SASs) or Government Auditing Standards (GAS), Examinations under
the Statements on Standards for Attestation Engagements (SSAEs) or Engagements under PCAOB
standards.
 None  1to 5  6 to 9  10 or more
7. Has the firm performed, or does the firm expect to perform, the following:
Year-end
 Yes
 No
Month/Year
_________
Report date
(if issued)
Month/Year
_________
Compilations² of financial statements with disclosures?  Yes
 No
_________
_________
Compilations of financial statements that
omit substantially all disclosures?
 Yes
 No
_________
_________
Preparation of financial statements with
disclosures?
 Yes
 No
_________
_________
Preparation of financial statements that omit
substantially all disclosures?
 Yes
 No
_________
_________
Engagements performed under the Statements on
Standards for Attestation Engagements (SSAEs) incl.
financial forecasts and projections, agreed upon
procedures and other engagements, and excluding
the engagements referred to in questions 6?
 Yes
 No
_________
_________
Reviews of financial statements?²
Start date of initial engagement above: _____/_____/______
MM DD
YYYY
Please note: The firms due date for its initial peer review is based on its practice, the year-ends of its
engagements, and the number and type of engagements to be encompassed in the review. If the firm
expects to perform engagements but has not done so, please enter N/A in the date field(s) provided above.
The firm (or individual) MUST notify the peer review administrating entity promptly if there are any
changes in the types of services being rendered after submission of this form.
If you answered None to question 6 and No to question 7, except for Preparation Services, MNCPA
bylaws do not require your firm to be enrolled in Peer Review; however, your state board of accountancy
or other licensing or regulatory bodies may require your firm to be enrolled in a practice monitoring
program as a requirement for licensure. Does your firm elect to enroll at this time? ___Yes ___No __ N/A
You will be required to confirm the status of your audit or attest practice on an annual basis if you elect to
enroll.
8. PCAOB Registration-Is your firm currently or does it expect to be subject to permanent inspection by the
Public Company Oversight Board (PCAOB)?
 Yes
 No
If yes, indicate the following:
a) Total number of SEC issuers for which the firm prepared audit reports during the preceding calendar
year, as most recently reported to the PCAOB:________________
b) Total number of SEC issuers for which the firm played a substantial role in the audit during the
preceding calendar year, as most recently reported to the PCAOB:____________
c) Total number of non-SEC issuer broker-dealers subject to inspection by the PCAOB for which the
firm prepared audit or attestation reports during the preceding calendar year, as most recently reported
to the PCAOB:___________
9. Does the firm perform, or expect to perform, any engagements under PCAOB standards that are not
subject to permanent inspection by the PCAOB?
 Yes  No
If yes, please indicate the total number of such engagements:______________
10. If your firm is a provider of quality control materials (QCM), does your firm perform the peer review of
any of the users of those materials? ____Yes ____No
If you responded yes to question 8, 9, and/or 10, and your firm is required to have its review administered
by the National Peer Review Committee (NPRC) at the AICPA and your firm will be subject to the NPRC
Peer Review.
11. If the firm is not required to have its review administered by the NPRC, does it choose to do so?
_____Yes ____No
If you are uncertain about your answers to questions 8 through 10 or their impact, please contact NPRC at
[email protected] or 919-402-4502.
Applicant’s statement: To the best of our knowledge and belief, the information submitted herewith is true
and correct. We understand that acceptance of this application will enroll our firm in the MNCPA Peer Review
Program. We agree to be bound by the policies and procedures for the MNCPA Peer Review Program,
including those which may restrict our right to resign from the MNCPA Peer Review Program once a peer
review has commenced. In particular, we understand that resignations during the course of a peer review will
not be allowed except as set forth in Standards of the AICPA Peer Review Program Manual. We also
understand that is all the partners of the firm who are members of the MNCPA resign while a peer review is in
process, the firm will not be unenrolled from the MNCPA Peer Review Program until the review is completed.
Acknowledgement of Requirements
This statement should be signed by the firm’s managing partner.
Signature________________________________________________Date__________________
Print Name__________________________________________Title______________________
¹The term “professionals” as used herein refers to all personnel who perform professional services for which the firm is
responsible, whether or not they are CPAs (AICPA, Professional Standards, vol. 2, QC sec. 20.03, footnote 4).
²T he term “compilation” and “review” as used herein refer to compilation and review engagements performed under SSARS. “Finan cial forecasts
and projections” as used herein refers to compilation or agreed-upon procedures engagements of prospective financial statements performed
under SSAE, Financial Forecasts and Projections(AICPA, Professional Standards, vol. 1, AT sec. 200). Examinations performed under those
standards are included in question 5.
³Certain portions of the CPA firm’s system of quality control may reside or operate in conjunction with the system of quality control of a nonCPA-owned entity with which the CPA firm is closely aligned through common employment, leasing of employees, equipment, facilities, etc. or
other similar arrangements. In this situation, the CPA firm sells all or a portion of its non-attest practice to a non-CPA-owned entity. However,
the majority of t he financial interests in the CPA firm’s attest practice is owned by CPAs