Chenango County, NY · Chenango County
Application Fee Waiver Request and Certification Form
Chenango County candidates use this form to request a waiver of civil service examination application fees and certify that they meet an eligibility category.
At a glance
- Issued by
- City of Chenango County · Chenango County, Chenango County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- chenangocountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets candidates request a waiver of fees for listed civil service examinations and certify their eligibility. It asks for exam numbers, titles and test dates, the candidate’s name, Social Security number, signature and date, and the applicable eligibility category. Candidates may certify that they are unemployed and primarily responsible for household support or identify qualifying assistance or job-training eligibility.
Who needs it
Candidates seeking a fee waiver for a listed civil service examination use this form to identify their eligibility and certify that their information is accurate.
How to submit it
Submit it to the county department named on the form; check the county website for current contact details before submitting.
About notarization
This form is signed without a notary; it includes no sworn or notarized attachment, so the candidate signs and dates the certification.
How to submit this form
- 1
Download the Form
Download the Application Fee Waiver Request and Certification Form.
- 2
Complete the Form
List the examination details, provide the requested candidate information, and check the eligibility category that applies.
- 3
Sign and Date
Read the certification, then sign and date the form.
- 4
Submit to the County
Submit the completed form to the county department named on it; check the county website for current contact details.
Frequently asked questions
- Do I need a notary for the Application Fee Waiver Request?
- No. The candidate signs and dates the certification without a notary, and the form does not identify a sworn or notarized attachment.
- How do I submit the Application Fee Waiver Request?
- Submit the completed form to the county department named on it. Check the county website for current contact details before submitting.
- What information does the fee waiver form ask for?
- It asks for examination numbers, titles and test dates, candidate identification and signature, and the eligibility category supporting the request.