Certification of Exemption Form 1CE - NYS Office of the Professions 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out your Social Security Number in Item 1. If you do not have one, leave this field blank.
3. In Item 2, enter your birth date using the provided format: Month, Day, Year.
4. For Item 3, print your name exactly as it appears on your licensure application or registration.
5. Complete Item 4 with your N.Y.S. License Number if applicable.
6. In Item 5, provide your mailing address clearly across the designated lines.
7. Select your profession in Item 6 by checking the appropriate box from the list provided.
8. Finally, sign and date the form in Item 7 to attest to the accuracy of your information before submitting it to the specified address.

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