Form Rp-3006 - Application For Qualifications Review
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2RP-3006 (Revised 11/09)
New York State Department of Taxation and Finance
Office of Real Property Tax Services
Educational Services
WA Harriman State Campus, Albany, NY 12227
phone (518) 474-1764; fax (518) 486-3799
APPLICATION FOR QUALIFICATIONS REVIEW
Applicants are advised that all statements made by them in conjunction with their application for
qualifications review are subject to investigation and verification. Answer all requested information on this
form. Please note: Applicants must meet qualification standards BEFORE appointment to the office of sole
appointed assessor or county director. Applicant’s Information:
_______________________________________________________________________________________
First Name
Middle Initial
Last Name
E-Mail Address
_______________________________________________________________________________________
Street Address
_________________________________________________
_________________ _______________
City, Town, or Post Office
State
Zip Code + 4
(_____)-_______-__________
(_____)-_______-___________
(_____)-______-_______________
Area Code-Work Phone Number
Area Code-Home Phone Number
Area Code-FAX Number
Applicant’s Education Information
: (Applicant must complete. If not applicable, write: N/A)
High School or GED equivalency:
Name & location of school
Year graduated/GED issued
Yes
No
Number of
Type of
Number of
Type of
Date Degree
Name and Location
Dates of
Years
Course or
Credits
Degree
Rec’d or
Attendance
of post- secondary
Credited
Major Subject
Received
Awarded
Expected
education
Professional Designation (e.g. IAO,
Name of designation held (Attach proof of awarding of
MAI, CAE, ASA, SRPA...)
designation)
Professional License: (Attach copy) Lic. #
Expiration date:
Other Appraisal Training: Approved professional courses such as R-1, R-2, R-3, G-1, G-2, G-3, certain
IAAO & Appraisal Institute courses have been approved as components of the basic course of training. If
you have successfully completed these or other approved valuation courses, please attach a copy of your
proof (certificate) of successful completion. Check box:
: Yes, I am requesting a review of attached
course certificates.
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