Firm Information:
 

Your name:
E-mail address:
Company name:
Address 1:  Address 2:
City:
State:
Zip Code:
Telephone:
Fax:
Preferred contact method:	Select a method E-mail Telephone Fax Postal mail

Peer Review Profile Information:

When is your peer review due date?	Select due date  January 2005  February 2005  March 2005  April 2005  May 2005  June 2005  July 2005  August 2005  September 2005  October 2005  November 2005  December 2005  In 2006 In 2007 Not sure
What type of peer review do you want?	Select a peer review typeSystem reviewEngagement review Report review SECPS peer review
How many professionals in your firm?	Select number 1 2-5 6-10 11-20 21-100 More than 100
How many offices do you have?	Select number 1 2 3 4 More than 4
How many audit and accounting hours do you have?	Estimate range of hours 0-1,000 1,001-2,000 2,001-6,000 6,001-10,000More than 10,000
Do you have a written quality control document?	Yes  No
How many peer reviews has your firm had?	Select number 1 2 3 4 5 More than 5
Was a letter of comments issued for your last peer review?	Yes  No

What types of engagements do you perform? (Check all that apply.)

	Engagements
Service Type	Number	Est. Hrs.
Audits of SEC registrants
Audits subject to Governmental Auditing Standards
ERISA audits
Audits of Financial Institutions with assets in excess of $500 million
Other audits
Agreed-upon procedures under SAS No. 75
Examination of prospective financial statements
Agreed-upon procedures of prospective financial statements
Examination of written assertions
Review of written assertions
Agreed-upon procedures of written assertions
Review of historical financial statements
Full disclosure compilations
Compilations that omit substantially all disclosures
Compilation engagements performed under SSARS No. 8 where an engagement letter was issued instead of a report

In which of the following industries does your firm perform more than 10 percent of its chargeable audit and accounting hours? (Check all that apply.)

110 Agricultural, Livestock, Forestry & Fishing 115 Airlines 120 Auto Dealerships 125 Banking 130 Broadcasting and Entertainment 135 Brokers and Dealers in Securities 140 Brokers and Dealers in Commodities 145 Casinos 150 Colleges and Universities 155 Common Interest Realty Associations 160 Computer Software Development and Sales 165 Construction Contractors 170 Continuing Care Retirement Communities 175 Credit Union 180 Extractive Industries - Oil and Gas 185 Extractive Industries - Mining 190 Finance Companies 195 Franchisors 200 Property and Casualty Insurance Companies 205 Government Contractors 210 Health Maintenance Organizations 216 Hospitals 217 Nursing Homes 222 HUD

225 Insurance Agents and Brokers 230 Investment Companies and Mutual Funds 235 Leasing Companies 240 Life Insurance Companies 245 Manufacturing 250 Mortgage Banking 255 Motor Carriers 260 Not-for-Profit Organizations 265 Employee Benefit Plans [including ERISA audits] 268 Personal Financial Statements 270 Professional Services [Doctors, Lawyers, etc.] 275 Publishing 280 Real Estate Brokerage 285 Real Estate Development 295 Real Estate Investment Trusts 300 Reinsurance Companies 305 Retail Trade 310 Savings and Loan Associations 315 Small Loan Companies 320 School Districts 325 State and Local Government 330 Telephone Companies 335 Utilities 340 Wholesale Distributors Other (describe)

Other Information:

What published practice aids, if any, do you use in performing your A&A engagements?

What additional information would you like me to consider in providing your estimate?

What additional information would you about me or my firm?

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For additional information:
   duane.reyhl@ahpplc.com
   jeffrey.fineis@ahpplc.com
   roger.hitchcock@ahpplc.com

© 1997-2003, Duane Reyhl, CPA
Updated January 4, 2004