!

FACS

Foreign%Academic%Credentials%Service,%Inc.%
105!West!Vandalia,!Suite!120!
Edwardsville,!IL!62025!!
(T)!!618.656.5291!(F)!!618.656.5292!(E)!facs@aol.com!
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REQUEST%FOR%ADVISORY%EVALUATION%OF%FOREIGN%CREDENTIALS%

Note:!Please!read,!complete!and!return!this!form!with!your!educational!credentials!and!fee!payment.!!!Please%type%or%print%neatly.!

PERSONAL%INFORMATION%
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Middle/Maiden!

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Name:!______________________________________________________________________!!Mr.!!!!Ms.!!!Mrs.!!
Last/Family!

First/Given!

Mailing!Address:!_______________________________________________________________________________!
_____________________________________________________________________________________________!
_____________________________________________________________________________________________!
City!

State/Province/Region!

Country!

Zip!Code/Postal!Code!

EUmail!Address:!________________________________________________________________________________!
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Note:%%Please%add%our%eLmail%address%facs@aol.com%to%your%address%book%to%avoid%our%messages%being%marked%as%Spam.!!
Telephone:!______________________________________!Fax:!__________________________________________!
Date!of!Birth:!____________________________________!Country!of!Birth:!_______________________________!
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!
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month/date/year!
Country!(s)!of!Credential:!________________________________________________________________________!
Have!you!ever!applied!to!FACS?!!!!!Yes!!!!!!No!If!yes,!indicate!year:!_____________________________________!
Please!indicate!if!you!are!applying!for:!!!!!Uniform!CPA!Examination!!!!CPA!Certificate/License!!
If!applying!for!CPA!Certificate/License,!please!indicate!the!state!and!year!of!passing!in!full!the!Uniform!CPA!Examination:!__________________!
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!!!!!!!!!!!!!!!!!!State!!
!!!Year!

Indicate!board(s)!of!accountancy!to!which!the!advisory!evaluation!is!to!be!mailed*:!
____________________________________________!!!!!!______________________________________________!
____________________________________________!!!!!!______________________________________________!
*The%state%board(s)%of%accountancy%to%which%the%advisory%evaluation%is%to%be%mailed%is%REQUIRED%to%complete%advisory%evaluation.%

Indicate!amount!of!fees!attached!(see!page!4):!_______________________________________________________!

PROCEDURES%AND%CONDITIONS%

Each!applicants!academic!credentials!will!be!evaluated!to!assess!whether!his!or!her!educational!preparation,!
in!the!opinion!of!FACS,!fulfills!the!education!requirement!to!sit!for!the!Uniform!CPA!Examination!in!the!state!
or! jurisdiction! to! which! the! application! is! being! made.! ! The! board! of! each! state! or! other! jurisdiction! will!
consider!the!FACS!evaluation!as!advisory!and!reserves!the!right!to!make!final!determination!as!to!the!eligibility!
of!the!applicant.!!FACS!reviews!only!the!academic!experience!of!an!applicant!and!does!not!provide!advisory!
recommendations! concerning! the! reciprocity! of! foreign! earned! professional! qualifications! and! work!
experience.!
A!correct!eUmail!address!must!be!provided!for!eUmail!confirmation!of!receipt!of!application!and!for!contact!if!
additional!information!is!required!to!complete!the!evaluation!process.%
Any! educational! credential!submitted! after!an! evaluation! has!been! completed!will!require!a!new!evaluation!
and!a!new!fee!payment.!!Requests!to!change!an!evaluation!from!one!board!to!another!board!(for!example,!
Washington!to!Florida)!will!require!a!new!fee!payment!for!a!new!evaluation.!%
All! information! requested! must! be! provided! within! a! oneUyear! period,! at! which! time! the! evaluation! process!
will!have!to!be!initiated!again.!
FACS!retains!completed!evaluation!records!for!five!(5)!years!from!the!year!of!evaluation.!!

EDUCATIONAL%PREPARATION%
Report! every! school,! college,! and! university! you! have! attended! or! are! now! attending.! ! Give! exact! dates! of!
attendance.!
Elementary/Primary!Schools!
Name!and!Location!(city,!country)!

Date!of!Entrance!

Month!

Date!of!Leaving!

Year!

Month!

Year!

Name!of!Diploma,!Degree,!
or!Certificate!(in!original!

!
!

!
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language!and!exact!English!
translation)!

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Secondary!Schools!(High!School,!Colegio,!Liceo,!Lycee,!Gymnasium,!etc.)!
!

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Colleges,!Universities,!Higher!Institutes!and!other!universityUlevel!schools!
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Other!PostUsecondary!schools!(such!as!professional!or!vocational)!
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Earned!professional!qualifications!(e.g.,!Chartered!Accountant,!Certified!General!Accountant,!etc.)!
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DOCUMENTS%REQUIRED%

Educational!credentials!must!include!official!transcripts!of!records!from!all!universities!and!other!institutions!
of! higher! education! attended,! including! those! in! the! United! States.! ! Such! records! must! report! all! courses!
(subjects)! by! title! completed,! grades! earned,! and! degrees,! diplomas,! and! certificates! awarded.! ! In! those!
countries!(e.g.!India,!Pakistan,!United!Kingdom)!where!universities!do!not!issue!course!by!course!transcripts!as!
in!the!United!States,!applicants!must!present!all!official!examination!results!for!each!year!of!study,!including!
the!final!year,!specifying!each!course!(subject)!by!title!taken!and!marks!achieved;!and!certification!of!degree!or!
diploma!awarded.!!The!issuing!institution!must!officially!certify!those!examination!results.!
!
Applicants!who!have!attended!European!universities!and!other!higher!education!institutions!(for!example,!in!
Germany,!Switzerland,!France,!Netherlands,!Sweden,!Poland,!Russia,!etc.)!must!request!those!institutions!to!
provide! FACS! with! an! official! report! of! all! courses! (subjects)! by! title! completed! toward! the! diploma! that!
includes! the! number! of! instructional/lecture/seminar! hours! offered! weekly! in! each! course! (subject)! during!
each!academic!semester!or!year.!!Official!copies!of!diplomas!earned!and!all!examination!results!in!each!course!
(subject)!must!be!provided.!
Academic!records!from!European!schools!that!participate!in!the!European!Credit!Transfer!and!Accumulation!
System!should!report!ECTS!credits!for!each!course.!!
Applicants! who! have! attended! colleges! or! universities! in! the! Peoples! Republic! of! China! must! request! those!
institutions! to! provide! FACS! with! transcripts! of! academic! record! that! reports! the! credit! value! and/or! class!
hours!for!each!course!(subject)!must!be!provided.!!Note,!the!Certificate!of!Graduation!may!not!include!the!full!
title!of!the!degree!earned.!!Please!also!include!the!Certificate!of!Degree,!when!applicable.!!Records!submitted!
in!sealed!envelopes!from!the!issuing!college!or!university!cannot!be!returned!to!the!applicant.!!
Applicants! who! have! received! the! General! Certificate! of! Education! in! Advanced! Level! subjects! or! who! have!
passed! the! Hong! Kong! Advanced! Level! Examination! should! submit! official! copies! of! these! certificates! or!
examination!results!that!report!their!Advanced!level!subjects!by!title.!!
Applicants! who! have! earned! professional! qualifications! in! accounting! in! another! country! should! submit!
relevant! supporting! documents,! including! complete! and! official! examination! results! and! qualifications!
granted.!
FACS! recommends! that! descriptions! of! courses! in! accounting! and! businessUrelated! subjects! be! provided.! ! If!
this! documentation! is! not! in! the! English! language,! it! must! be! accompanied! by! an! official! English! language!
translation.!!
Official!English!language!translations!must!accompany!official!copies!of!records!that!are!in!another!language.!!
Official! records! including! diplomas,! in! the! original! language! must! be! submitted! with! the! English! language!
translations.!
FACS! may! request! the! applicant! to! provide! additional! or! other! records! and/or! to! complete! supplemental!
forms! describing! his! or! her! educational! preparation! in! order! to! formulate! an! accurate! advisory! evaluation.!!
FACS! will! also,! when! necessary,! contact! an! institution! in! another! country! or! in! the! United! States! for! further!
information!about!an!applicants!credentials!including!verification!of!authenticity.!
In! the! event! that! FACS! determines! that! the! academic! credentials! submitted! for! evaluation! have! in! any! way!
been! altered,! tampered! with,! or! forged,! no! evaluation! will! be! prepared.! ! All! fees! will! be! forfeited! and!
appropriate!notification!will!be!issued.!!

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SERVICES%AND%FEES%
Fees!must!be!paid!in!advance!and!are!nonUrefundable!once!the!evaluation!process!has!been!initiated.!

1.

Evaluation!Fee!
!!
$200/each!state!(Arizona,!Colorado,!Connecticut*,!Michigan**,!Nebraska,!Nevada,!!
Oklahoma,!Pennsylvania,!South!Dakota,!Vermont,!and!Wisconsin)! !

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$150/each!state!(Florida,!Kentucky,!Mississippi,!New!Mexico,!North!Carolina,!!

!!!

and!North!Dakota,)! !

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$100/each!state!(For!full!list,!please!visit!our!website!!www.facsusa.com)!

$__________!

$__________!
$__________!

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*This!is!for!Connecticut!State!Board!of!Accountancy!license!application.!
**This!is!for!Michigan!State!Board!of!Accountancy!license!application.!!
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OPTIONAL%SERVICES%%
The%above%evaluation%fee%includes%one%copy%of%the%evaluation%report%mailed%to%the%board%of%accountancy%and/or%
board%coordinator,%and%one%unofficial%copy%eLmailed%to%the%applicants%eLmail%address%provided.%%Please%note%
that%if%original%documents%are%to%be%returned,%a%mailing%service%must%be%selected.%%
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2.

RUSH!SERVICES!
__________!5!Business!Day!Rush!($150.00)***!
__________!10!Business!Day!Rush!($75.00)***!

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$__________!
$__________!

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***Rush%services%begin%upon%receipt%and%approval%of%all%required%documents,%application%forms%and%fee%payments.%%Applications%
requesting%rush%service%are%reviewed%within%48%hours%of%receipt.%Mailing%time%is%not%included%in%rush%services.%%Please%see%mailing%
options%below.%%%
_____________%
Please%initial%here%that%you%have%read%the%full%Rush%Service%instructions%on%our%website%%www.facsusa.com%

3.

Official!Copies!(Copy/Copies!will!be!sent!by!first!class!mail!or!airmail!unless!otherwise!indicated.)!
__________!x!$10.00/each!extra!copy!(Official!copies!requested!at!time!of!evaluation)! !

!!!!!(number)!!!!!!
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4.

Mailing!Services!!

$__________!

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U.S.P.S.!Priority!Mail!(domestic!only)!
UPS!Courier!Delivery!(domestic)! !
UPS!Courier!Delivery!(international)!

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!
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($10.00/address)!!
($20.00/address)!!
($60.00/address)!!

$__________!
$__________!
$__________!

5.

Facsimile!Transmission!of!Evaluation!(must!provide!accurate!fax!number)!
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__________________________________________!! ($15.00/transmission)!
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(Fax!Number)!

$__________!

TOTAL%FEES% %

$__________!

The!above!fee!schedule!is!subject!to!change.!
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Please!make!check!or!money!order!payable!in!US!funds!to!FACS,!Inc.!!(Note,!payment!from!outside!US!must!be!in!
US!Dollars!and!must!be!issued!from!a!bank!that!has!branches!in!the!US!and!includes!routing!numbers.)!
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I!certify!that!all!of!the!information!provided!on!this!form!is!accurate!and!complete;!!
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and!I!have!read!and!accept!the!procedures!and!conditions!described!on!this!form.!!
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________________________________________!!!!!!!!!!________________________________________!
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Applicants!Signature! !

Date!
Rev.!12/14!

4!