Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application Fee Waiver Request & Certification Form

  1. Check the Box(es) That Apply to You

    Note: Individuals who can be claimed as a dependent on any other person’s tax return are not eligible for application fee waiver as head of household.

  2. have read the above portion of Section 50.5(b) of the Civil Service Law relating to the waiver of application fees and certify that I am qualified to receive such waiver for the reasons indicated above. I understand that my claim for application fee waiver may be investigated and I may be disqualified from the listed civil service examination(s) if I make any false statement regarding my eligibility for application fee waiver.

  3. By typing your name into this field you authorize Yates County to consider this an electronic signature.

  4. Leave This Blank:

  5. This field is not part of the form submission.