Nassau County, NY · Nassau County
Application for Annual Waiver of Item Pricing Requirements
Retail stores use this application to request or renew a Nassau County waiver from item pricing requirements and provide store and corporate details.
At a glance
- Issued by
- City of Nassau County · Nassau County, Nassau County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- nassaucountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application lets a retail store request, renew, or reapply for an annual waiver of item pricing requirements. It asks for store and corporate contact information, the store’s retail square footage, and the waiver fee enclosed. Applicants agree to pricing accuracy, scanner access, and shelf-price requirements; the form says the waiver may be revoked for noncompliance.
Who needs it
A retail store seeking to apply, renew, or reapply for an annual Nassau County waiver of item pricing requirements needs this application.
How to submit it
The form lists the Nassau County Department of Consumer Affairs at 240 Old Country Road, Mineola, NY 11501, and says each application must include the applicable non-refundable waiver fee.
About notarization
This application is signed without a notary; it identifies no notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download the Application
Download the annual item pricing waiver application for Nassau County.
- 2
Complete the Application
Select the request type and fill in the store and corporate information, retail square footage, and fee amount.
- 3
Gather the Waiver Fee
Include the non-refundable waiver fee based on the store’s retail square footage; the form lists prorated fees for applications between annual cycles.
- 4
Submit to the County
Send the application and fee to the Nassau County Department of Consumer Affairs at the address listed on the form.
Frequently asked questions
- Do I need a notary for the Annual Item Pricing Waiver Application?
- No. The application has a signature line but no notary block, and it identifies no notarized or sworn attachment; the signer just signs and dates it.
- How do I submit the Annual Item Pricing Waiver Application?
- The form lists the Nassau County Department of Consumer Affairs at 240 Old Country Road, Mineola, NY 11501. It says to include the applicable non-refundable waiver fee.
- What information does the application ask for?
- It asks for store and corporate names, addresses, contact details, the store’s exact retail square footage, and whether the request is new, a renewal, or a reapplication.
- What requirements apply to stores granted a waiver?
- The form lists pricing accuracy inspections, consumer-accessible price-check scanners, correct pricing and overcharge corrections, visible shelf prices, and compliance with Department of Consumer Affairs rules.