Line 1, IPA Name: Provide the name of the independent public
accountant or the public accounting firm (collectively referred to as IPA)
applying for listing on the HUD’s IPA Roster.
Line 2, Tax EIN No: Provide the IPA’s employer identification number issued to the IPA by the Internal Revenue Service.
Line 3-4, Address: Provide the street address where the IPA’s
office applying for registration is located.
Line 5, City: Provide the city where the IPA’s office
applying for registration is located.
Line 6, State: Provide the state or jurisdiction where the
IPA’s office applying for registration is located.
Line 7-8, Zip
Code: Provide the U.S. Postal service zip code
where the IPA’s office applying for registration is located.
Line 9,
Telephone Number: Provide the primary phone
number where the IPA’s office applying for registration can be contacted.
Line 10, First Name: Provide the first name of the individual to contact
with questions regarding this application for listing on the IPA Roster.
Line 11, Middle Name: Provide the middle name of the individual to
contact with questions regarding this application for listing on the IPA
Roster.
Line 12, Last
Name: Provide the last name of the individual to
contact with questions regarding this application for listing on the IPA
Roster.
Line 13,
Title: Provide the title of the individual to
contact with questions regarding this application for listing on the IPA
Roster.
Line 14-15,
Telephone Number: Provide the phone number (and
extension, if applicable) of the individual to contact with questions regarding
this application for listing on the IPA Roster.
Line 16, Fax Number: Provide
the fax number of the individual to contact with questions regarding this
application for listing on the IPA Roster.
Line 17-18, E-Mail: Provide the e-mail address of the individual
to contact with questions regarding this application for listing on the IPA
Roster.
Line 19,
Password: Provide the four
alphanumeric characters displayed on the image.