CPA AUSTRALIA
APPLICATION TO CANCEL A PRACTISING CERTIFICATE
APPLICATION FORM
WHAT IS THIS APPLICATION FOR?
This application is to cancel your practising certificate. I wish to:
cancel my Public Practice Certificate
cancel my Limited Practice Certificate.
Please complete sections A, B and C below.
A. ABOUT YOU
As you are a member of CPA Australia we already have some of your details. Please reconfirm the following personal details to ensure our records are up-to-date.
Membership No.
Title
Last name
First name
Preferred name (optional)
Name of practice entity
Registered trading name
(if different to above)
Practice email
B. REASON FOR CANCELLATION
Please indicate your reason for cancelling your practising certificate:
Note: if your reason for cancelling your Public Practice Certificate relates to a decrease in your income, you may prefer to change to a Limited Practice Certificate instead
of cancelling your Public Practice Certificate. If you wish to do this, please complete the Application to change practising certificate status, which is located on the
CPA Australia website.
C. DECLARATIONS
I declare that:
I am no longer providing a public accounting service via an entity referred to in By-Law 9.
OR
My gross annual income from public accounting services does not exceed $10,000; I do not advertise my services; and I do not audit SMSFs.
AND
I will remove all CPA Australia intellectual property, including CPA Australia signage.
I understand that I cannot advertise on Find a CPA and that any current listing/s on Find a CPA will be removed.
I relinquish my practising certificate and annual practising licence and have enclosed my current certificate and licence (or have destroyed them).
Please print and sign. We do not accept digital signatures.
Signature
Date
/
/
2 | Application to cancel a practising certificate
D. LODGEMENT OF APPLICATION
When completed, please return this form to CPA Australia, Public Practice, GPO Box 2820, Melbourne, Victoria, 3001.
E. IF YOU NEED HELP OR MORE INFORMATION
A public practice officer will be able to assist you if you require help completing this form.
Australian members can contact a public practice officer by calling 1300 73 73 73 or by emailing [email protected]
New Zealand members can contact a public practice officer by calling (+64) 09 913 7450 or by emailing [email protected].
F. WHAT HAPPENS NEXT
1. We will let you know if your application cannot be processed or we require additional information.
2.
We will let you know the outcome of your application
In general, you should receive our response by email within 10 working days of receiving your application.
3.
Appeal or review policy
Details of the appeals review process are outlined in CPA Australia’s By-Laws Part 9 on Public Practice.
G. PRIVACY STATEMENT
To view CPA Australia’s Privacy Policy visit our website at cpaaustralia.com.au.
CPAH1145_10/14
You have the right to access any Personal Information which CPA Australia holds about you, subject to the exceptions in the Privacy Act 1988 (Cth) or the New Zealand Privacy
Act 1993. You may also request the correction of information which is inaccurate. Access and/or correction requests can be made at your local CPA Australia office or via the
‘Update your profile’ service at cpaaustralia.com.au.