What is the Short Environmental Assessment Form?

It gathers project and site information for an approval or funding application. The applicant completes Part 1, and the lead agency completes the assessment sections.

Who completes this environmental assessment form?

The applicant or project sponsor completes Part 1. The lead agency is responsible for completing Part 2 and, when needed, Part 3.

Do I need a notary for the Short Environmental Assessment Form?

No. The applicant affirms, signs, and dates the form without a notary; the lead agency also signs its determination.

Hillsdale, NY · Columbia County

No notary required

Short Environmental Assessment Form

Applicants or project sponsors complete Part 1 to provide project and site information for an approval or funding review by a lead agency.

At a glance

Issued by: City of Hillsdale · Hillsdale, Columbia County, New York
Notarization: Not required: file this form without a notary.
Official source: storage.googleapis.com
Blank form: Download the PDF
Catalogued: Sep 28, 2026
Machine-readable: JSON record · about the forms index

What this form is

The applicant or project sponsor completes Part 1 with project details and information about the site, land use, utilities, and potential environmental conditions. The form says Part 1 becomes part of an application for approval or funding; the lead agency completes the impact assessment in Part 2 and, when needed, the significance determination in Part 3. Attach additional pages or a location map as needed.

Who needs it

An applicant or project sponsor seeking approval or funding completes Part 1, while the lead agency completes Parts 2 and 3.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This document is signed and dated without a notary; the applicant affirms the information is accurate, and the lead agency signs its determination.

How to submit this form

1
Download The Form
Download the Short Environmental Assessment Form PDF.
2
Complete Part 1
The applicant or project sponsor fills in all Part 1 items using currently available information and signs and dates the affirmation.
3
Gather Attachments
Attach a location map and any additional pages needed to supplement responses; include the narrative described in the form when applicable.
4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What is the Short Environmental Assessment Form?: It gathers project and site information for an approval or funding application. The applicant completes Part 1, and the lead agency completes the assessment sections.
Who completes this environmental assessment form?: The applicant or project sponsor completes Part 1. The lead agency is responsible for completing Part 2 and, when needed, Part 3.
Do I need a notary for the Short Environmental Assessment Form?: No. The applicant affirms, signs, and dates the form without a notary; the lead agency also signs its determination.
How do I submit the Short Environmental Assessment Form?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Short Environmental Assessment Form doesn’t need a notary, but if you have another Hillsdale form that does, a commissioned online notary can help.