Permit to Perform Breath Alcohol AnalysisNew York State 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the agency information at the top of the form, including your Agency ID and contact details.
  3. In the 'Date of Homicide' section, input the date using the format mm/dd/yy.
  4. Fill in the 'Victim Demographics' and 'Offender Demographics' sections with accurate details such as age, sex, race, and ethnic origin.
  5. Select appropriate options from the standardized lists for 'Weapon Used', 'Relationship of Victim to Offender', and 'Circumstance Preceding the Homicide'. If none apply, choose 'Other' and provide a brief description.
  6. Review all entries for accuracy before submitting. Use our platform's features to save or share your completed form easily.

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Pursuant to NYS Department of Health (DOH) regulations, breath analysis operator certification must be renewed every two-years and within the 120 calendar days preceding the permit expiration date.
The Breath Test Operator qualification course is a 16-hour training whereby students are approved to operate the Intoxilyzer equipment. Upon satisfactory completion of the course, certification will be conferred by the state of Florida.
The breath alcohol test measures the amount of alcohol in the blood by testing exhaled air. The test is performed by blowing into a breath machine 15 minutes after alcohol consumption. The test determines how much alcohol it takes to raise the blood-alcohol level to a dangerous level.