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Application for the Ohio permit

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ACCOUNTANCY BOARD OF OHIO 2008 OHIO PERMIT APPLICATION FORM-2007 LATE FILERS PLEASE READ CAREFULLY: Complete only ONE of the following sections. Public accounting employment Check this box if you own or operate a public accounting firm or do any public accounting and/or tax work as an employee of a public accounting firm (even if part-time). If you complete this section, you must remit the late filing fee applicable to persons practicing public accounting. NAME __________________________________________________________ FIRM (if applicable)________________________________________________ ADDRESS _______________________________________________________ CITY ______________________________ STATE ________ ZIP ________ TELEPHONE _________________________FAX_______________________ EMAIL ADDRESS ________________________________________________ Fee for Ohio permit: $150 (You must attach supporting documentation of 120 continuing education credits earned during the reporting period 11/1/04—12/31/07) Add: Late filing fee: The late filing fee is $100 for each month or part of a month you are late in filing, up to a maximum of $1,200. The postmark deadline each month is the 2nd. Calculate Late filing fee: (Months late) ________ X $100 = ________ Total fee: ________ MAKE CHECK PAYABLE TO: Treasurer, State of Ohio Employment outside public accounting By checking this box, you certify that you are performing NO public accounting work. NAME __________________________________________________________ FIRM (if applicable)________________________________________________ ADDRESS _______________________________________________________ CITY ______________________________ STATE ________ ZIP ________ TELEPHONE _________________________FAX_______________________ EMAIL ADDRESS ________________________________________________ Fee for Ohio permit: $150 (You must attach supporting documentation of 120 continuing education credits earned during the reporting period 11/1/04—12/31/07) Add: Late filing fee: The late filing fee is $50 for each month or part of a month you are late in filing, up to a maximum of $300. The postmark deadline each month is the 2nd. Calculate Late filing fee: (Months late) ________ X $50 = ________ Total fee: ________ MAKE CHECK PAYABLE TO: Treasurer, State of Ohio ___________________________________ SIGNATURE DATE Mail to: Accountancy Board of Ohio, 77 S. High St., 18th Floor, Columbus, OH 43215-6128 Telephone: (614) 466-4135; Fax: (614) 466-2628; Website: acc.ohio.gov Revised 01/2008

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