INSTITUTE OF TAX CONSULTANTS
APPLICATION FOR CERTIFICATION EXAMINATION
Page 2
AGREEMENT
The Agreement below must be signed by you before a notary (someone other than family or office
personnel).  Please read the Agreement carefully.  If you agree, sign and return to ITC at the following
address:  ITC, c/o Carol Kraemer, 7500 - 212th SW, Suite #205, Edmonds WA 98026 
Submitting the Application online first will expidite the processing of your request.  Upon completion of
the Application please press "submit" for each page, then print out the form, sign it before an Notary
and then mail it to ITC. 
This is an Agreement between
and the Institute of Tax Consultants, herein known as ITC.
ITC will certify you as a Certified Tax Practitioner (Preparer), (CTP), Certified Tax Practitioner (Preparer) Specialist
(CTPS) or Certified Tax Practitioner (Preparer) Master (CTPM).
For the granting of this Certification I agree to the following:
1. If at all possible, I will maintain membership in a national tax preparers organization so that I may take advantage
of their continuing education program.
2. I will take the necessary continuing education courses to qualify for renewal of my certificate, will maintain the
required continuing education records in my file and advise ITC on renewal of my certification what continuing
education I received during the renewal period.  I have read the Program Information Guide and understand the
continuing education requirements.
3. I fully understand that there will be a renewal fee to be paid to renew my certificate every two years, the current
renewal fee being $35.00, and I will pay the fee in a timely manner.
4. I understand that I  will need to renew my certification by June 30 two years after receiving my Certificate and
every two years after that.
5. I agree to abide by the Code of Ethics of ITC.
6. I agree to answer any charges made by anyone against me and if found guilty of these charges will agree to the
findings of the Board of Regents.  I will not protest the findings of the Board of Regents except to ask for a second
hearing.  The second hearing will be before one member of the Board of Regents of ITC, one person of my choice
and one other CTP, CTPS or CTPM to be chosen by the other two members of the appeal board.  I agree the
findings of this appeal board will be binding on both parties (ITC and myself) and I will surrender my certificate and
membership card if I am advised of an adverse finding by the appeal board.
7. I agree to display my certificate in a prominent place in my office as long as I keep my education current, renew
my certificate on time and pay the appropriate fees.
8. If I fail to meet the requirements of Paragraphs 1,  2 and 3 above, or lose my certificate by not abiding by
Paragraph 4 above, of it is revoked according to the findings of Paragraphs 5 and 6 above, then I agree to return
the certificate to ITC at my own expense.
9. I agree that the phrase "AT MY OWN EXPENSE" means I will pay all postage and return receipt fee.  Further,
if ITC has to resort to Court proceedings to obtain my certificate and membership card, I will pay my own legal fees
plus all legal fees, costs and expenses that ITC must pay to have the certifilcate returned.  Legal fees, costs and
expenses shall include but not be limited to all attorney fees, filing fees, postage and registration fees, deposition
costs, travel costs, meal and lodging cost incurred in obtaining the return of my certificate and membership card.
10. I agree to return the Open Book Exam in a timely manner whether completed or not.



AFFIDAVIT
STATE OF ________________________________________
COUNTY OF ______________________________________

__________________________________ BEING FIRST DULY SWARN, DEPOSES AND SAYS: I, THE APPLICANT
NAMED IN THIS APPLICATION HAVE READ THE CONTENTS HEREOF, AND TO THE BEST OF MY KNOWLEDGE AND
BELIEF, THE FORGOING STATEMENTS ARE TRUE IN SUBSTANCE AND EFFECT AND ARE MADE IN GOOD FAITH. 
I ALSO AGREE THAT iF I DO NOT FULFILL THE REQUIREMENTS FOR MAINTAINING CERTIFICATION STATUS, AS
PER THE ABOVE AGREEMENT, I WILL RETURN MY CERTIFICATE AND ID AT MY OWN EXPENSE.

  ________________________________________________
Signiture of Applicant
Subscribed and sworn before me this _____ day of ____________, _______

________________________________________________
Notary Public in and for the State of

________________________________________________

(SEAL)
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a Tax Preparer
Enrolled Agent,  or
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