Fillable Oath Card (State University of New York at Farmingdale)

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Oath Card (State University of New York at Farmingdale)

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DOS-1690 (Rev. 11/06)
State Employee Statement in Lieu of Oath
Pursuant to Civil Service Law §62
and Public Officers Law §78 Certificate
Name of Appointee:
(Last Name)(First Name)(Middle Initial)
I do hereby pledge and declare that I will support the constitution of the United States, and the
constitution of the State of New York, and that I will faithfully discharge the duties of the position
of
Title of Position:
Agency Name:
Agency Code:
according to the best of my ability.
(Signature of Appointee)(Date)
I, the Appointee named above, hereby acknowledge receipt of a copy of sections 73, 73-a, 74, 75,
76, 77 and 78 of the Public Officers Law, together with such other material related thereto as may
have been prepared by the Secretary of State, and I acknowledge that I have read the same and that
I undertake to conform to the provisions, purposes and intent thereof and to the norms of conduct
for members, officers and employees of the legislature and state agencies.
(Signature of Appointee)(Date)
(Do not include any social security number anywhere on this form)
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Oath Card (State University of New York at Farmingdale)

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Completed 25 July 2020

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