The Georgia Reinstatement Nursing Form is a crucial document for nurses seeking to reactivate their lapsed licenses in the state of Georgia, managed by the Georgia State Board of Accountancy. It outlines specific requirements, including a detailed checklist, continuing professional education (CPE) prerequisites, and a non-refundable application fee, to ensure that applicants are fully prepared for the reinstatement process. This form serves as both a guide and a gateway for professionals aiming to return to the field, emphasizing the importance of compliance with state laws and board regulations.
In the realm of professional certification, maintaining an active license is crucial, and the process to reinstate a lapsed one can be both intricate and demanding. The Georgia State Board of Accountancy offers a lifeline to those in the nursing field who find themselves in this predicament through the Application for Reinstatement of License. Situated at 237 Coliseum Drive, Macon, GA, with a robust presence online, the Board emphasizes the necessity of a thorough review of this application, underscoring the adherence to specific laws, rules, and the board rule 20-10-.04 that outlines the criteria for license reinstatement. Key components include a non-refundable application fee, a comprehensive checklist to ensure the submission of a complete application, a necessity to disclose any criminal history, and detailed continuing professional education (CPE) requirements, with precise stipulations regarding the nature and timings of these requirements. Moreover, the board requires a declaration affirming the accuracy of the information provided, alongside a verification of the applicant's legal standing in the U.S. This meticulous approach ensures that only qualified individuals regain their licensure, reflecting the board's commitment to upholding high professional standards in the accountancy field in Georgia.
APPLICATION FOR REINSTATEMENT OF LICENSE
GEORGIA STATE BOARD OF ACCOUNTANCY
237 Coliseum Drive
Macon, GA 31217
Phone (478) 207-2440
www.sos.georgia.gov/plb/accountancy/
Please read the instructions carefully and be familiar with the laws and rules governing the practice of accountancy in the State of Georgia. Visit the following website for information: www.sos.georgia.gov/plb/accountancy/. Board Rule 20-10-.04 concerning reinstatement of licensure is enclosed within this application.
The Board cannot process incomplete applications. If any item is missing, incomplete or incorrect, your application cannot be reviewed by the Board. Please review the check list below and this application before you submit it to ensure that all information and documentation is complete and correct.
Consent Form for background check. This form must be completed, signed and returned with your application or your complete application will be returned.
Activities Since Last Renewal. Field must be completed. Answers could be: did not need, out of country, sick, etc.
Non-refundable application fee of $150.00 (check or money order) made payable to Georgia State Board of Accountancy
Reason For Failing To Renew. Field must be completed.
Required completed hours of continuing professional education for reinstatement.
See the table below on left for the required number of hours required for reinstatement of license. If you do not have the required hours, your complete application will be returned and you have 90 days from the date of the notification letter to re-submit the application without an additional fee.
CPE Requirements:
You are required to have obtained 40 hours of CPE per year, not to exceed 160 hours. You may be required to show proof of this only if randomly audited.
See Board Rule 20-11-.02 (1) for more information regarding CPE.
A minimum of 20% of total hours must be in accounting and auditing subjects and at least 80 hours must have been earned during the 24 months immediately preceding the date of the Reinstatement Application. (Reinstatement Application must be signed the date it is mailed.) For instance: If you sign the Reinstatement Application on 1/1/08, your 80 hours (with 16 hrs. in A&A) would be from 1/1/06 to 1/1/08. Hours earned in 2008 and 2009 may also be used for the 12/31/09 renewal year. CPE requirements must be completed before submitting the Reinstatement Application.
As information:
If your license lapsed 12/31/07, you may use hours from 1/1/06 and forward for all hours except for the recent 80 hours in the previous 24 months (with 20% in A&A).
If you license lapsed 12/31/05, you may use hours from 1/1/04 and forward for all hours except for the recent 80 hours (with 20% in A&A) in the previous 24 months.
C:\Users\dmickler\AppData\Local\Temp\22 Application for Reinstatement of License_6D05F61.doc
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For Board Use Only
Date of Review
Approved
Disapproved
Fee Paid
Check #
Date
Applicant #
Receipt
#
237 Coliseum Drive - Macon, Georgia 31217 - (478) 207-2440
www.sos.state.ga.us/plb/accountancy/
(Application will be returned if all questions are not answered)
Reinstatement Fee: $150.00 (Non-Refundable)
License Type
PLEASE PRINT OR TYPE
Certified Public Accountant
License No.
Date License Lapsed
1.Name on License
First
Middle
Last
2. SSN*
3. Date of Birth
*THIS INFORMATION IS AUTHORIZED TO BE OBTAINED & DISCLOSED TO STATE & FEDERAL AGENCIES PURSUANT TO O.C.G.A. SECTION 19-11-1 & O.C.G.A.SECTION 20-3-295, 42 U.S.C.A. SECTION 551 & 20 U.S.C.A.SECTION 1001.
4.Physical Address
Number and Street (P.O. Box not acceptable)Apt. No.City/StateZip
5.
Mailing Address
(if different than Street address)
Street, P.O. Box
Apt. No.
City/State
Zip
6.
Telephone Number Day
(
)
Telephone Number Evening
7.Present Employer
8.Business Address
Number and Street
City
State
9.Internet e-mail address
Since the date of your last renewal, have you been convicted of a felony or misdemeanor (other than a minor traffic violation), or entered a plea of guilty, nolo contendere, or sentenced under the “First Offender Act’, or been sanctioned by this or another state board or agency? If Yes, check below and attach copy of conviction, plea or sanction. DUI and DWI are not minor traffic offenses.
NO
YES
(If YES, attach a certified copy of conviction, plea or sanction)
ACTIVITIES SINCE LAST RENEWAL:
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REASON FOR FAILING TO RENEW:
APPLICANT AFFIDAVIT:
I hereby swear and affirm that all information provided in this application is true and correct to the best of my knowledge and belief. I further swear and affirm that I have read and understand the current state laws and rules and regulations of the Board for which I am applying for licensure and I agree to abide by these laws and rules.
By executing this affidavit under oath, as an applicant for a professional license, as referenced in O.C.G.A. § 50-36- 1, administered by the Professional Licensing Boards Division, the undersigned applicant also verifies one of the following with respect to his/her application for a public benefit (check one):
1)
I am a United States citizen. Please submit a copy of your current Secure and Verifiable
Document(s) such as driver’s license, passport, or document as indicated on the Board’s
website.
2)
I am not a United States citizen, but I am either a legal permanent resident of the United States or I
am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an
alien number issued by the Department of Homeland Security or other federal immigration agency.
Please submit a copy of your current immigration document(s) which includes either your Alien number or your I-94 number and, if needed, SEVIS number.
The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. § 50-36-1(e)(1), with this affidavit.
In making the above representations under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal statute. I also understand that any failure to make full and accurate disclosures may result in disciplinary action by the Board for which I am applying for licensure.
Executed in
(city),
(state).
Signature of Applicant
Printed Name of Applicant
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE
DAY OF
_, 20
NOTARY PUBLIC My Commission Expires:
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IMPORTANT: Please see the following for continuing professional education report & page 8 for copy of rule #20-10- 04.
CONTINUING PROFESSIONAL EDUCATION REPORT
NAME :
THIS PAGE MUST HAVE TOTALS FOR A & A HOURS AND ALL OTHER SUBJECTS HOURS. APPLICATION WILL BE RETURNED IF THESE COLUMNS ARE NOT COMPLETE. THE BOARD WILL NOT TOTAL YOUR CPE HOURS.
(See page 8 for copy of rule #20-10-.04 (REINSTATEMENT) effective January 25, 2001 for current requirement.) YOU ARE NOT REQUIRED TO SUBMIT DOCUMENTATION OF CONTINUING EDUCATION HOURS UNLESS YOU ARE AUDITED.
School, Firm or Organization Conducting Program
Title of Program or Description of Content
Principal Instructor
Dates Attended
Accounting & Auditing
All Other Subjects
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Sub Total Hours
TOTAL HOURS CLAIMED ABOVE 2 COLUMNS MUST BE COMPLETED
I certify under penalty of perjury to the truth and accuracy of all statements, answers and representations made in this report.
Signature
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OFFICE OF SECRETARY OF STATE
PROFESSIONAL LICENSING BOARDS DIVISION
Macon, Georgia 31217
(478) 207-2440
CONSENT FORM
I hereby authorize the State Board of Accountancy (“Board”) to receive any Georgia criminal history record information pertaining to me which may be in the files of any state or local criminal justice agency in Georgia.
Full Name (Print)
Physical Address
(P.O. Boxes NOT Accepted)
Sex
Race
Date of Birth
Social Security Number
One of the following must be checked:
This authorization is valid for 90/180/
(circle one) days from date of signature.
I,
give consent to the Board to perform periodic
criminal history background checks for the duration of my licensure with this state.
Special licensure provisions (check if applicable):
Working with mentally disabled
Working with elder care
Working with children
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APPLICANT: PLEASE CHECK THE FORM OF IDENTIFICATION BELOW THAT YOU POSSESS. RETURN THIS FORM ALONG WITH A COPY OF YOUR APPROPRIATE DOCUMENTATION.
Name
Secure and Verifiable Documents Under O.C.G.A. § 50-36-2
Issued August 1, 2011 by the Office of the Attorney General, Georgia
The Illegal Immigration Reform and Enforcement Act of 2011 (“IIREA”) provides that “[n]ot later than August 1, 2011, the Attorney General shall provide and make public on the Department of Law’s website a list of acceptable secure and verifiable documents. The list shall be reviewed and updated annually by the Attorney General.” O.C.G.A. § 50-36-2(f). The Attorney General may modify this list on a more frequent basis, if necessary.
The following list of secure and verifiable documents, published under the authority of O.C.G.A. § 50-36-2, contains documents that are verifiable for identification purposes, and documents on this list may not necessarily be indicative of residency or immigration status.
A United States passport or passport card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A United States military identification card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A driver’s license issued by one of the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the
Commonwealth of the Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
An identification card issued by one of the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Commonwealth of the Northern Marianas Islands, the United States Virgin Island, American Samoa, or the Swain Islands, provided that it contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A tribal identification card of a federally recognized Native American tribe, provided that it contains a photograph of the bearer or lists sufficient identifying information regarding the bearer, such as name, date of birth, gender, height, eye color, and address to enable the identification of the bearer. A listing of federally recognized Native American tribes may be found at: http://www.bia.gov/WhoWeAre/BIA/OIS/TribalGovernmentServices/TribalDirectory/index.htm [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A United States Permanent Resident Card or Alien Registration Receipt Card [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
An Employment Authorization Document that contains a photograph of the bearer [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A passport issued by a foreign government [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A Merchant Mariner Document or Merchant Mariner Credential issued by the United States Coast Guard [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A Free and Secure Trade (FAST) card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]
A NEXUS card [O.C.G.A. § 50-36-2(b)(3); 22 CFR § 41.2]
A Secure Electronic Network for Travelers Rapid Inspection (SENTRI) card [O.C.G.A. §50-36-2(b)(3); 22 CFR § 41.2]
A driver’s license issued by a Canadian government authority [O.C.G.A. § 50-36-2(b)(3); 8 CFR § 274a.2]
A Certificate of Citizenship issued by the United States Department of Citizenship and Immigration Services (USCIS) (Form N-560 or Form N-561) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]
A Certificate of Naturalization issued by the United States Department of Citizenship and Immigration Services (USCIS) (Form N-550 or Form N-570) [O.C.G.A. § 50-36-2(b)(3); 6 CFR § 37.11]
In addition to the documents listed herein, if, in administering a public benefit or program, an agency is required by federal law to accept a document or other form of identification for proof of or documentation of identity, that document or other form of identification will be deemed a secure and verifiable document solely for that particular program or administration of that particular public benefit. [O.C.G.A. § 50- 36-2(c)]
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RULES OF THE GEORGIA STATE BOARD OF ACCOUNTANCY
20-10-.04 REINSTATEMENT
20-10-.04 Reinstatement. Amended.
(1)An application for reinstatement of an expired permit shall be accompanied by:
(a) A reinstatement fee of $150.00; and
(b)Evidence satisfactory to the Board, of the completion of continuing professional education as specified below:
1.Forty hours of continuing professional education for each year since the last renewal of the permit or since the initial issuance of the permit, whichever is less, up to a maximum of 160 hours.
2.At least twenty percent of the total hours required must be earned in accounting and auditing subjects.
3.At least 80 of the continuing professional education hours must have been completed during the 2-year period immediately preceding the date of application for reinstatement.
4.The hours required may be counted toward fulfilling the continuing professional education requirements for the next biennial renewal, if they were completed during the applicable period for renewal.
5.No carryover hours may be used to satisfy continuing professional education requirements for reinstatement of an expired permit.
(c)The Board may, however, accept in lieu of the continuing professional education requirements other evidence of continued competency including, but not limited to, the passing of an examination approved by the Board.
(2)In considering the application for reinstatement the Board may conduct an investigation of the applicant to determine, among other things, if the applicant engaged in the practice of public accountancy during the period that the applicant was not the holder of a live permit to practice public accountancy. Based on the results of that investigation, the Board may deny the application for reinstatement.
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Navigating the process of reinstating a nursing license in Georgia might seem like walking through a maze, but it's essential for returning to the nursing field. This process ensures that every nurse practicing in Georgia upholds the standards and qualifications necessary for providing safe and effective care. Here's a straightforward guide on how to complete the Georgia Reinstatement Nursing form, which, in essence, is a crucial step for nurses who are seeking to re-enter the profession after their license has lapsed. Remember, attention to detail and providing accurate, up-to-date information will speed up your reinstatement process. Let's embark on this crucial step towards reigniting your nursing career.
Once your application has been submitted successfully, the Georgia Board of Accountancy will review it for completeness and accuracy. If any information is missing or if further details are needed, they will reach out to you. It is paramount to respond promptly to any queries from the board to avoid delays in the reinstatement process. Once approved, you'll receive notification and can resume practicing nursing in Georgia. Congratulations on taking this significant step towards restarting your career in nursing!
What is the Application for Reinstatement of License in Georgia?
The Application for Reinstatement of License is a form used by the Georgia State Board of Accountancy to process the reinstatement of a professional license for individuals whose licenses have lapsed or been suspended. It's essential for those looking to return to practicing accountancy in the state of Georgia. The form requires detailed information, including reasons for license lapse, continuing education records, and personal identification details.
Who needs to fill out this application?
Any individual whose Certified Public Accountant (CPA) license has lapsed in the state of Georgia and wishes to reinstate their license to resume practice must fill out this application. This includes those who didn't renew their license due to various reasons, such as being out of the country, illness, or simply not needing the license for a period.
What are the Continuing Professional Education (CPE) requirements for reinstatement?
To qualify for reinstatement, an applicant must have completed a minimum of 40 hours of CPE per year, with a maximum requirement of 160 hours if the license has been lapsed for four years or more. Notably, at least 20% of these hours must be in accounting and auditing subjects. Moreover, at least 80 hours of CPE must have been earned in the 24 months immediately preceding the submission of the reinstatement application, ensuring the applicant’s knowledge is current.
What happens if I don't meet the CPE requirements?
If you do not meet the necessary CPE requirements at the time of your application, your application will be returned to you. You will then have 90 days from the date of the notification letter to complete the lacking CPE hours and resubmit your application without incurring an additional fee.
What is the fee for the Reinstatement Application?
The fee for the Reinstatement Application is $150.00. It is important to note that this fee is non-refundable. Payment must be made via check or money order, payable to the Georgia State Board of Accountancy, and submitted along with the completed application form.
What documentation is required for the Reinstatement Application?
Applicants are not required to submit documentation of their CPE hours unless they are selected for an audit. However, they must accurately report these hours in the application.
When applying for the reinstatement of a nursing license in Georgia, applicants often encounter various pitfalls that can delay or jeopardize their application process. Awareness and careful adherence to the Georgia State Board of Accountancy's guidelines can help applicants navigate this process more efficiently. Here are ten common mistakes made during the completion of the Georgia Reinstatement Nursing Form:
To avoid these common mistakes, applicants should review each section of the application carefully, ensure all documentation is complete and accurate, and strictly follow the guidelines provided by the Georgia State Board of Accountancy. Diligence in the application process not only facilitates a smoother review by the Board but also expedites the reinstatement of your nursing license.
When professionals in Georgia apply to reinstate their nursing licenses, they enter a process that requires meticulous documentation. This is not just about filling out the reinstatement application; it's about providing a comprehensive insight into their professional preparedness, continuous education, and legal compliance. The documents accompanying the Georgia Reinstatement Nursing Form ensure that the applications are thoroughly vetted, maintaining the high standards expected in the healthcare sector. Here’s a glance at some of these vital documents and their purposes.
In summary, these documents play a crucial role in the reinstatement process for nurses in Georgia, ensuring that all candidates meet the rigorous standards necessary for safe and effective patient care. They serve not only as a testament to an applicant's qualifications and integrity but also as a means to protect the public by ensuring that only competent and ethical professionals reenter the nursing workforce.
The Georgia Reinstatement Nursing form is similar to other documents within different professional fields that require documentation of ongoing education, legal compliance, and employment history for the reinstatement or renewal of a professional license. These documents share common attributes, such as the need for personal identification, professional education tracking, and legal attestation to eligibility for licensure. Two notable documents with resemblances are the Medical License Reinstatement form and the Professional Engineer License Renewal form.
Medical License Reinstatement Form: Similar to the Georgia Reinstatement Nursing form, the Medical License Reinstatement Form necessitates detailed documentation of continuing medical education (CME) credits. Medical professionals must provide evidence of completed CME hours, usually within a specific period before applying for reinstatement, to ensure they are up to date with current medical practices and standards. This requirement mirrors the Continuing Professional Education (CPE) requirements found in the nursing reinstatement form, emphasizing both professions' dedication to ongoing learning and competency in their respective fields. Additionally, both forms typically require a background check consent form, underscoring the importance of maintaining high ethical standards within the profession.
Professional Engineer License Renewal Form: The Professional Engineer License Renewal Form shares similarities with the nursing reinstatement form, particularly in the areas of professional development documentation and the affidavit of legal compliance. Engineers seeking to renew their licenses must document their Professional Development Hours (PDH), which, like the nursing form's CPE hours, serves to confirm their engagement with recent advancements in their field. This documentation ensures that professionals remain competent and capable of providing high-quality services. Furthermore, both forms require applicants to attest to their compliance with state laws and regulations, reinforcing the professional's accountability and commitment to ethical practice.
When filling out the Georgia Reinstatement Nursing Form, it's important to keep a few things in mind to ensure the process goes smoothly and your application is accepted. Here are 10 dos and don'ts to guide you:
Following these guidelines will help streamline your application process and avoid unnecessary delays. Ensuring that all parts of the application are correct and complete is crucial for a smooth reinstatement into the nursing profession in Georgia..
When individuals consider reinstating their nursing license in Georgia, it's not uncommon for them to encounter common misconceptions regarding the process. It's important to clarify these misunderstandings to ensure that those looking to return to the nursing field are well-informed and can navigate the reinstatement process with ease.
It's only about paying a fee: While there is a non-refundable application fee of $150.00, reinstatement involves more than just paying money. Applicants must provide a comprehensive account of their activities since their last renewal and meet the required continuing professional education hours.
Any continuing education credits will count: The Georgia State Board of Accountancy requires specific continuing professional education (CPE) for reinstatement. A minimum of 20% of the total hours must be in accounting and auditing subjects, with at least 80 hours earned in the 24 months immediately preceding the application for reinstatement.
Submitting an application guarantees reinstatement: An application does not ensure automatic reinstatement. The Board reviews each application individually, and if the requirements are not met or if information is incomplete, the application will be returned.
You can wait indefinitely to reapply after a denial: If your application is incomplete or lacks the necessary CPE hours, it will be returned, and you have 90 days from the date of the notification letter to re-submit your application without paying an additional fee. Time is of the essence.
All past education credits are valid: The Board specifies that only CPE hours earned within a certain period before the application date are considered. If your license lapsed, you may use hours from a set start date forward, except for the most recent 80 hours, which must be from the 24 months immediately prior to reinstating.
The background check is optional: A consent form for a background check is mandatory and must be completed, signed, and returned with your application. Failure to do so will result in the application being returned.
Physical presence in Georgia is not required for reinstatement: While the application process can be completed from anywhere, the rules and regulations governing the practice of accountancy in Georgia are applicable, and understanding of these local laws is crucial for reinstatement.
License reinstatement information is hard to find: All information regarding the license reinstatement process, including required forms and detailed instructions, is readily available on the official website of the Georgia State Board of Accountancy.
Personal circumstances are not considered: The application includes a field for explaining the reason for failing to renew. Here, individuals have the opportunity to provide context about their circumstances, whether it was due to health issues, being out of the country, or other reasons that might have prevented timely renewal.
Understanding these nuances can make a significant difference in successfully navigating the process of reinstating a nursing license in Georgia. It is always recommended to review the latest regulations and requirements directly from the state's Board of Accountancy to ensure compliance and a smoother application process.
Filling out and using the Georgia Reinstatement Nursing form involves several important steps that must be carefully completed to ensure successful processing by the Georgia State Board of Accountancy. Attention to detail and thoroughness in completing the application are crucial.
The application demands a non-refundable fee of $150.00, payable by check or money order to the Georgia State Board of Accountancy. This fee is required to process the application, emphasizing the importance of ensuring that all other parts of the application are filled out correctly to avoid delays.
Continuing Professional Education (CPE) requirements must be met and documented on the application. Nurses looking to reinstate their license need to have completed 40 hours of CPE per year, up to a total of 160 hours, with at least 20% of those hours in accounting and auditing. Additionally, at least 80 of those hours must have been earned in the 24 months before submitting the reinstatement application. Failure to meet these requirements will result in the return of the application.
Candidates must disclose any criminal convictions, including misdemeanors and felonies (excluding minor traffic violations), by attaching certified copies of the conviction, plea, or sanction. Such disclosures are imperative for a transparent evaluation process by the board and are necessary for the consideration of the application.
Applicants are required to affirm that all information provided in the application is true and correct and that they have read and understand current state laws and regulations. This affidavit ensures that applicants acknowledge the importance of accuracy in their application and compliance with statewide standards for nursing practice.
Every section of the Georgia Reinstatement Nursing form serves a distinct purpose in evaluating the eligibility and readiness of nurses seeking to return to practice. Detailed attention to these instructions not only facilitates a smoother application process but also reflects the applicant's commitment to adhering to the professional standards set forth by the Georgia State Board of Accountancy.
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