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Get NY DOS-0999 2009

You may also pay by MasterCard or Visa using the appropriate credit card authorization form. REQUESTS RECEIVED WITHOUT PAYMENT WILL BE RETURNED DOS-0999 04/09. Request for Certification/Certified Copies of Records NYS DEPARTMENT OF STATE DIVISION OF LICENSING SERVICES P. O. BOX 22001 ALBANY NY 12201-2001 Customer Service 518 474-4429 www. dos. state. ny. us PLEASE FILL IN ALL OF THE INFORMATION REQUESTED Your Phone Number Your Name Your Current Address Mail Certification To G Check box if same as above. Type of License to be Searched Name You Want Searched Previous Name if applicable Unique Identification Number NOTE The Division of Licensing Services maintains a six year file of licensees. Records prior to that time period are unavailable. 25 fee per record CERTIFICATION If the certification is for another state please provide the name of that state CERTIFIED LICENSE HISTORY CERTIFIED COPIES OF APPLICATIONS Please submit this request to our office at the above address with a check or money order made payable to NYS Department of State. Request for Certification/Certified Copies of Records NYS DEPARTMENT OF STATE DIVISION OF LICENSING SERVICES P. O. BOX 22001 ALBANY NY 12201-2001 Customer Service 518 474-4429 www. dos. state. ny. us PLEASE FILL IN ALL OF THE INFORMATION REQUESTED Your Phone Number Your Name Your Current Address Mail Certification To G Check box if same as above. O. BOX 22001 ALBANY NY 12201-2001 Customer Service 518 474-4429 www. dos. state. ny. us PLEASE FILL IN ALL OF THE INFORMATION REQUESTED Your Phone Number Your Name Your Current Address Mail Certification To G Check box if same as above. Type of License to be Searched Name You Want Searched Previous Name if applicable Unique Identification Number NOTE The Division of Licensing Services maintains a six year file of licensees. Type of License to be Searched Name You Want Searched Previous Name if applicable Unique Identification Number NOTE The Division of Licensing Services maintains a six year file of licensees. Records prior to that time period are unavailable. 25 fee per record CERTIFICATION If the certification is for another state please provide the name of that state CERTIFIED LICENSE HISTORY CERTIFIED COPIES OF APPLICATIONS Please submit this request to our office at the above address with a check or money order made payable to NYS Department of State. Request for Certification/Certified Copies of Records NYS DEPARTMENT OF STATE DIVISION OF LICENSING SERVICES P. O. BOX 22001 ALBANY NY 12201-2001 Customer Service 518 474-4429 www. dos. state. ny. us PLEASE FILL IN ALL OF THE INFORMATION REQUESTED Your Phone Number Your Name Your Current Address Mail Certification To G Check box if same as above. Type of License to be Searched Name You Want Searched Previous Name if applicable Unique Identification Number NOTE The Division of Licensing Services maintains a six year file of licensees. O. BOX 22001 ALBANY NY 12201-2001 Customer Service 518 474-4429 www. dos. state. ny. us PLEASE FILL IN ALL OF THE INFORMATION REQUESTED Your Phone Number Your Name Your Current Address Mail Certification To G Check box if same as above. Type of License to be Searched Name You Want Searched Previous Name if applicable Unique Identification Number NOTE The Division of Licensing Services maintains a six year file of licensees. Records prior to that time period are unavailable. 25 fee per record CERTIFICATION If the certification is for another state please provide the name of that state CERTIFIED LICENSE HISTORY CERTIFIED COPIES OF APPLICATIONS Please submit this request to our office at the above address with a check or money order made payable to NYS Department of State. .

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