CTEA –
Capital of Texas Enrolled Agents
PO Box 6767 Round Rock, TX 78683
IRS Approved CE Provider No. NX6M8
State Board of Accountancy No. 07579
Annual Membership Fee: $25.00 (Note: Members who are CPAs may be subject to an additional charge each February to help defray the annual TSBPA sponsor renewal fee.)
Date_______________
Name_____________________________________
PTIN__________________________
Designation (e.g., Enrolled Agent, CPA, Attorney, Return Preparer) ____________________
Business Name_____________________________________________________________
Email _____________________________________________________________________ Street Address______________________________________________________________
City, State, Zip_________________________________________________________
Business Phone__________________ FAX_________________ Cell_________________
Are you willing to assist the group with presentations on your area(s) of expertise? Yes/No Areas of expertise (e.g., Depreciation, Offers in Compromise, International Tax, etc.) ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
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