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CONTINUING EDUCATION PROOF OF ATTENDANCE FORM

58th Annual Southern Federal Tax Institute

This form may only be submitted ONE time by each attendee. Please complete after your final session.

Forms must be submitted by November 17, 2023.

Upon completion of this form, please review the CE instruction sheet to determine appropriate filing for your jurisdiction and profession. Mandatory CE requirements, either in general or for certification of specialists, have been adopted in most jurisdictions. In order to meet these requirements, program sponsors are asked to retain attendance records for possible verification by regulating agencies. Therefore, all registrants must complete this form as proof of attendance. All credit will be issued based upon sessions actually attended. Please list all jurisdictions and professions (including license or identification numbers) in which you wish to receive credit. YOU MUST ENTER YOUR MINUTES FOR EACH DAY OF ATTENDANCE IN ORDER TO RECEIVE CE CREDIT.

Many accrediting agencies have mandatory cut-off dates for reporting credits. Attendees who return their forms after November 17, 2023 may be subject to additional fees or may be denied credit by the accrediting agency.

PLEASE NOTE: it is your responsibility to determine the continuing education guidelines for your jurisdiction and profession. Please review the instruction sheet found at https://www.sfti.org/ under the Continuing Education tab.

* represents required field

Contact Information

MIddle Initial

Address Line 2

Phone

Credit Applying For:

Attorney

Bar Number (1)

Bar State (1) -- Select -- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Bar Number (2)

Bar State (2) -- Select -- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Bar Number (3)

Bar State (3) -- Select -- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

CPA

CPA's - Check Box Below

CFP

Last 4 of Social Security Number

CFP License Number

Please Indicate Minutes Attended for Each Session - you must enter your minutes of attendance in order to receive CE credit.

Monday Morning Session

Enter minutes attended

Monday Mid-Day Program

Enter minutes attended

Monday Afternoon Session

Enter minutes attended

Tuesday Morning Session

Enter minutes attended

Tuesday Mid-Day Program

Enter minutes attended

Tuesday Afternoon Session

Enter minutes attended

Wed. Morning Session

Enter minutes attended

Wed. Mid-Day Program

Enter minutes attended

Wed. Afternoon Session

Enter minutes attended