Warren County Department of Civil Service Administration
1340 State Route 9 Lake George, New York 12845
Phone: (518) 761-6440 Fax: (518) 761-6905
www.warrencountyny.gov/civilservice
APPLICATION FOR VETERAN’S CREDITS
__________________________________________________________________________________________
Exam Title: _________________________________ Exam Number: ________________________
Full Name: __________________________________ Social Security Number:________________
Mailing Address: ___________________________________________________________________________
__________________________________________________________________________________________
Veteran’s Credits Claimed: (Check one)
___ Non-Disabled Wartime Veteran
Applicants for Non-Disabled Wartime Veteran’s Credits must submit this form and provide a copy of their
DD-214 separation papers or other official documentation. A copy of a DD-214 or other official documentation
must be submitted for filing with Warren County Civil Service Administration only once; but a new Application for
Veteran’s Credits form must be filed for each examination application.
____Disabled Wartime Veteran
In addition to the requirements listed above, applicants for Disabled Wartime Veteran’s Credits must also
submit a 1) “ Disability Record Authorization” form OR 2) letter from the US Department of Veterans’ Affairs
dated within one year of application date indicating the applicant has a disability rated at 10% or more that was
incurred during time of War.
Veteran’s Administration Claim Number: _____________
Date Disability Record Authorization sent to Department of Veterans Affairs: ____________
______________________________________________
___________________________________________
Date of Enlistment or Induction: ____________
Dates of Active Service: From:______________ To: _____________
Were you discharged honorably or under honorable conditions? Yes ___ No ___
Have you ever been appointed through the use of Veteran's Credits to any position in the State Civil Service or any
City or Civil Division of New York State? Yes ___ No ___
If Yes, when and where_________________________________________________________________________
Note: If you used your veteran’s credits for permanent appointment or promotion in New York State or its civil
divisions, you may not claim them again.
I HEREBY CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE TO THE BEST OF MY
KNOWLEDGE AND BELIEF
Veteran’s Signature: ____________________________________ Date:______________________
click to sign
signature
click to edit
![]()
