Form Rp-3006 - Application For Qualifications Review
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2RP-3006
New York State Department of Taxation and Finance
Office of Real Property Tax Services
(2/13)
Educational Services
W A Harriman Campus
Albany NY 12227
Phone: (518) 474-1764; Fax: (518) 435-8628
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 and county director. See
Applicant’s information
_______________________________________________________________________________________
First name
Middle initial
Last name
e-mail address
_______________________________________________________________________________________
Street address
_________________________________________________
______
___________________
City, town, or post office
State
ZIP code (include + 4)
(_____) _______-__________
(_____) _______-___________
(_____) ______-___________
Work phone no. (with area code)
Home phone no. (with area code)
Fax number (with area code)
Applicant’s education information
(Applicant must complete. If not applicable, write N/A)
Name and location of school
Year graduated/
High School or GED equivalency:
GED issued
Yes
No
Name and location of
Dates of
Number
Type of course or
Number
Type of
Date degree
post- secondary education
attendance
of years
major subject
of credits
degree
rec’d or
credited
received
awarded
expected
Professional designation (e.g., IAO,
Name of designation held (attach proof of awarding of designation):
MAI, CAE, ASA, SRPA,...)
Professional license number (attach copy): #
Expiration date:
Other appraisal training: Certain appraiser licensing, IAO, IAAO, and Appraisal Institute courses have been
approved as components of the basic course of training. If you have successfully completed approved
valuation courses, please attach a copy of your proof of successful completion.
Check box:
Yes, I am requesting a review of attached course certificates.
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