NH Board of Accountancy 78 Regional Drive Building Two Concord NH 03301 (P) 603-271-3286 (F) 603-271-8702 TDD Access: Relay NH 1-800-735-2964 E-mail: boa@nh.gov
NEW HAMPSHIRE BOARD OF ACCOUNTANCY RECOMMENDATION FORM FOR APPLICATION FOR CERTIFICATION
To Be Completed by Applicant:
Name	Date
Street
Apt., Floor, Flat etc:
Town, City:   State: None Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Province:   Country:   Zip or City Code:
Is this your mailing address:     Your work address     Your Home Address:
Application is being filed for: Original Certification:     Reciprocity:
To Be Completed by Person Writing the Reference Letter Name Address:
Relation: Friend:     Co-Worker:     Other:     (Employers not eligible)
The following written explanation must contain, number of years known and description of the above individuals’ character.
Signature	Date