Malverne, NY · Nassau County
Contractor Withdrawal Affidavit
The Contractor Withdrawal Affidavit lets the contractor of record swear that they no longer are, or will not be, performing work under a Malverne permit.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The affidavit identifies the permit and the property address, and records the contractor’s statement that they no longer are, or will not be, performing work under that permit. A contractor of record uses it to notify the Incorporated Village of Malverne about their withdrawal from permitted work. The form includes spaces for the date, permit number, contractor details, signature, and notarial jurat.
Who needs it
The present contractor of record for work under a Malverne permit uses this affidavit when they no longer will perform work under that permit.
Why it needs a notary
The form carries a sworn-to-before-me jurat, and the contractor of record must sign the affidavit before a notary public.
How to get this notarized
- 1
Download the Affidavit
Get the Contractor Withdrawal Affidavit from the Incorporated Village of Malverne.
- 2
Fill In the Form
Enter the date, permit number, work location, and contractor details. Leave the signature for the notary session.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary.
- 4
Sign on Video
Join the video session, take the oath, and sign when the notary instructs you.
- 5
Submit to the Village
Send the notarized affidavit to the Incorporated Village of Malverne according to its instructions.
Preview the form
The blank PDF straight from Malverne. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I notarize the Contractor Withdrawal Affidavit online?
- Complete the affidavit, then book a session with a commissioned online notary. Sign during the video session when instructed, and submit the notarized form to the Village of Malverne.
- Do I need to sign the affidavit in front of a notary?
- Yes. The form says the contractor is sworn and includes a sworn-to-before-me jurat. Sign before the notary, not in advance.
- Can I use an online notary for this affidavit?
- New York authorizes remote online notarization by its own notaries under Executive Law §135-c, effective since 2023. A commissioned online notary can notarize your affidavit in a remote session.
- What information does the form ask for?
- It asks for the date, permit number, work location, contractor name and address, printed name, and signature. The contractor swears they will no longer perform work under the permit.
- Where do I submit the completed affidavit?
- The form identifies the Incorporated Village of Malverne at 99 Church Street. Confirm with the city, town or village if unsure about submission instructions.