Home | Join | Site Map
 
Search

Home Page
 
NYSSCPA Temporarily Out of the Workforce Application Form 2009/2010

For details on the dues reduction policy criteria and qualifications click here.

For information on the NYSSCPA Benevolent Fund please click here.
Name
Address
City
State
Zip Code
Telephone Number
E-mail address
Membership Number
Member Since

Under the terms of its 017 reduced dues class, the Society may grant a dues reduction for the following reasons:
I.  Full Unemployment
(unemployed for greater than six months and is looking for new employment)

II. Full-Time Student   
(certified and a full time student)

III. Financial Hardship  
(temporary illness, disability, or full-time care for a loved one)
IV. Retired  
(not yet 62 years of age and working less than 1,000 hours per year)

V. Waiver  
(active military duty or an extenuating circumstance)

I. Full Unemployment
a. Name of previous employer:
b. Last date with employer:

c. Are you currently collecting unemployment insurance? Yes      No

d. Position held with last employer:
e. Length of services with
last employer:
f. Please specify any additional reason(s) for your reduction request. (Optional)

II. Full-Time Student (Please attach a copy of your current class registration).
a. Are you working full or part-time while in school?: Yes      No
b. When did you leave your past position?:
c. When did you return to school?:
d. How many credits are you taking?:
e. Expected date of completion?:

f. Please specify any additional reason(s) for your reduction request. (Optional)

III. Financial Hardship

a. Are you currently on SSI? Yes      No

If yes, please provide copy of the benefits verification letter from SSI via fax to Member Services at 1 (866) 495-1354 or email xfox@nysscpa.org.

b. Are you on family leave? Yes      No

c. Are you caring for a loved one(s) with no compensation? Yes      No

If you checked yes for b or c , when do you plan to return to the workforce?

d. Please specify any additional reason(s) for your reduction request. Also, please provide date and time when income was affected.

IV. Retired

a. Are you under 62 years of age? Yes      No

b. When did you retire?

c. Are you currently employed?

If yes, where are you currently employed?

d. How many hours are you working per year?

V. Waiver

a. Are you currently on Active Duty? Yes       No

If yes, please provide copy of your military deployment letter from the US Government via fax to Member Services at 1 (866) 495-1354 or email xfox@nysscpa.org.

b. Do you have extenuating circumstances? Yes       No

If yes, please explain in detail below and submit any supporting documentation via fax to Member Services at 1 (866) 495-1354 or email xfox@nysscpa.org.

All applicants must complete the section below:

a. Why do you want to maintain your membership?

b. How can we assist you in being more involved in the NYSSCPA?

c. Signature required if submitting by mail.     ______________________________________
                                                                                      Applicant’s Signature

By checking this box, I, hereby affirm that my current status as indicated above is authentic and I pledge to alert the NYSSCPA once I re-enter the workforce or otherwise become ineligible for this status.

Type in the characters you see in the picture below:

[This resource requires a Javascript enabled browser.]

 


Home
| About Us | Continuing Education | Future CPAs | Government Affairs | Professional Resources | Publications | Sound Advice | Tax Resources

Chapters | Committees | Member Center | Events Calendar | Classifieds | Careers | E-zine Subscriptions | The Trusted Professional | The CPA Journal



Search | Site Map | Become a Member | Jobs | Press Room | Contact Us | Feedback

©1997 - 2009 New York State Society of Certified Public Accountants. Legal Notices