Brookhaven, NY · Suffolk County
Members’ Affidavit of Good Moral Character
This affidavit records members’ statements about their good moral character, membership, and eligibility for organizations applying to the Brookhaven Town Clerk for a Bingo or Games of Chance license.
- 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
Each member uses the affidavit to declare their membership history, relationship to the premises, familiarity with applicable rules, moral character, and compensation status. The form states that the Brookhaven Town Clerk relies on these declarations when issuing a license to the organization. Three member sections are provided, each with its own sworn statement and notary fields.
Who needs it
Members of an organization applying to the Brookhaven Town Clerk for a Bingo or Games of Chance license complete and swear to the statements in this affidavit.
Why it needs a notary
Each member signs before a notary and completes the form’s “Duly sworn to me” jurat, with a separate notary signature and stamp section for each member.
How to get this notarized
- 1
Download The Affidavit
Get the Members’ Affidavit of Good Moral Character from the Town of Brookhaven.
- 2
Complete Your Member Section
Fill in your name, residence, date of birth or age, years of membership, and member signature field.
- 3
Book An Online Notary
Arrange a video appointment with a commissioned online notary for each member who must swear to the affidavit.
- 4
Sign During The Video Session
Sign and swear to your statements before the notary, who completes the jurat, signature, and stamp fields.
- 5
Submit To The Town Clerk
Submit the completed affidavit as part of your organization’s license process, following the Town Clerk’s instructions.
Preview the form
The blank PDF straight from Brookhaven. 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 this members’ affidavit?
- Each member completes their section, then signs and swears to the statements before a notary. The notary completes the corresponding jurat, signature, and stamp fields.
- Do I need to sign in front of a notary?
- Yes. Each member section includes a “Duly sworn to me” statement and fields for the notary’s signature and stamp, so sign before the notary.
- Can I use a commissioned online notary?
- New York authorizes its notaries to perform remote online notarizations under Executive Law §135-c, in effect since 2023. You can sign during a video session with a commissioned online notary.
- Where do I submit the completed affidavit?
- The form says the Brookhaven Town Clerk relies on the affidavit when issuing the organization’s license. Confirm submission instructions with the Town Clerk; confirm with the city, town or village if unsure.