THE PUBLIC ACCOUNTANTS LICENSING BOARD PROFESSIONAL CORPORATION APPLICATION FOR LICENSURE 2013

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TELEPHONE(office)____________________________(home)______________________________________ _ FAX_____________________________________________________________________________________ E-MAIL ADDRESS__________________________________________________________________________

I,

___________________________________, HEREBY

A APPLY FOR ON

DIRECTOR BEHALF OF PROFESSIONAL

OF_______________________________________,

_________________________________________________________

CORPORATE LICENSURE PURSUANT TO THE PUBLIC ACCOUNTANTS ACT (NL) AND I ENCLOSE THE REQUIRED DOCUMENTS NOTED ON THE REVERSE SIDE WHICH I ACKNOWLEDGE ARE REQUIRED TO BE SUBMITTED TO BE CONSIDERED FOR PALB PROFESSIONAL CORPORATION LICENSURE.

Dated at_______________________________________ in the Province of ____________________________ this________________ day of __________________________, 201______.

Signature DOCUMENTS MUST BE SUBMITTED TO: Dr. Dennis Hanlon, Registrar Public Accountants Licensing Board Faculty of Business Administration Memorial University of Newfoundland St. Johns, NL A1B 3X5 SEE REVERSE SIDE

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DOCUMENTS REQUIRED TO BE SUBMITTED TO BE CONSIDERED FOR PALB PROFESSIONAL CORPORATION LICENSURE:

1. THIS COMPLETED ORIGINAL FORM 2. CERTIFICATE OF INSURANCE FROM INSURANCE COMPANY CONFIRMING ANNUAL PROFESSIONAL LIABILITY INSURANCE COVERAGE FOR 2013 OF A MINIMUM OF $1M PER INDIVIDUAL CLAIM AND $2M AGGREGATE CLAIMS PER ANNUM 3. CHEQUE OR MONEY ORDER ($120 annual licensing fee for 2013. An additional $200 new application fee will be charged for all new professional corporation licensures for 2013.) 4. CERTIFICATION FROM AN AUTHORIZED REPRESENTATIVE OF YOUR ACCOUNTING BODY THAT ALL DIRECTORS OF THE CORPORATION ARE BOTH MEMBERS IN GOOD STANDING AND MEET THE REQUIREMENTS OF THAT ACCOUNTING BODY TO PRACTICE PUBLIC ACCOUNTING. 5. CERTIFICATE OF GOOD STANDING FROM THE REGISTRY OF COMPANIES 6. CERTIFICATE OF REGISTRATION OF THE PROFESSIONAL CORPORATION BY THE ACCOUNTING BODY 7. COPY OF COMPLETE APPLICATION SUBMITTED TO THE ACCOUNTING BODY BY THE PROFESSIONAL CORPORATION TO BE REGISTERED BY THAT ACCOUNTING BODY. 8. CONFIRMATION BY A DIRECTOR OF EACH PROFESSIONAL CORPORATION APPLICANT OF THE FOLLOWING AS STIPULATED IN SECTION 15.(2)(a-f) OF THE PUBLIC ACCOUNTANTS ACT (NL) AS FOLLOWS: 15-(2) The board shall direct the registrar to register a professional corporation that establishes that (a) all the voting shares of the corporation are beneficially owned by and registered in the name of one or more public accountants and there is no restriction on the right of each public accountant to exercise his or her vote as he or she wishes to; (b) the non-voting shares are owned by a natural person; (c) all the directors of the corporation are public accountants, and there is no agreement restricting the powers of the directors to manage the business and affairs of the corporation in relation to the provision of services of public accountants; (d) all of the persons who will be providing the services of public accountants as employees of or on behalf of the corporation are public accountants; (e) the articles of the corporation restrict it to providing the services of a public accountant and related matters; (f) the corporation is in good standing under the Corporations Act.

Notes: 1. The licensing fee for 2013 ($120) together with the new application processing fee for professional corporate licensure ($200) should be forwarded to the Board by December 31, 2012, but in no case later than January 31, 2013. Post-dated cheques are not acceptable. 2. Your cheque or money order should be made payable to the Public Accountants Licensing Board. 3. Please ensure all documentation referred to above is included. 4. Please notify the Board of any changes in your address. 5. Please do not copy this form for potential new licensees; they should contact the Board directly.