INDEX TO BLANK FORMS. FORM NO. 1a. Application paper, Schedule B..... PAGE 481 1b. Application paper, Schedule B, for reformatory guards.... 484 17. Circular letter from appointing officer to persons who have 496 25. Request for and certificate of examination for positions in .. 498 BLANK FORMS. Form No. 1a.- Application Paper. NEW YORK CIVIL SERVICE COMMISSION. DIRECTION. 1. All the statements in the application are to be under oath. 2. Every false statement knowingly made by the applicant in this paper, or connived at by him in any certificate which may accompany the same is good cause for removal during probation. All appointments are first made for the probationary term of three months. 3. The application paper must be filled by the applicant in his own handwriting. 4. Send application, properly filled out and the certificate signed, to the New York Civil Service Commission, Albany, N. Y. 5. No recommendations or certificates besides those provided at the end of this blank will be received. 6. A failure to fill the blanks properly, or to send satisfactory certificates, will cause the application to be returned for correction, but no such opportunity will be given a second time. Applications which show that the applicant lacks the qualifications as to age, health, residence, etc., or that he is manifestly unfit for the service, will be rejected. 7. The receipt of the application, in proper form, will be acknowledged by the commission. 8. The applicant will be notified of the first examination which may be deemed conveniently located for him to attend, after his application is received. He should give notice of any change in his postoffice address. APPLICATION. Desiring to enter the civil service of the State of New York as a ......in the... . . . . .at. . . . . . . ., I make this application, and declare ...... the following to be facts concerning myself, viz.: (1.) My full name is (2.) My post-office address is (3.) My legal residence is. (4.) I am a citizen of the State of New York. (N. B.- If a naturalized citizen, give dete of naturalization.) (5.) I have been a resident of the State of New York since... (6.) My present occupation or business is.... (7.) To the best of my knowledge and belief I was born at on the .... day of ......., 18... I am therefore ...... years of age. (8.) I believe and represent myself to be a person of good health, and without mental or physical incapacity or infirmity, of which I am aware, which in any way disqualifies me for a full discharge of official duty in the service which I seek to enter. (9.) My principal occupation and my residence during each of the last five calendar years were as follows: (10.) Were you ever examined for the civil service? If so, where, when, and for what position? (11.) Were you ever in the civil service? If so, state what service and the cause of your leaving it? (12.) My education was received chiefly in (here state school, academy or college, and length of course). (13) I have the following qualifications or experience which would be useful in the public service. (14.) If you were in the military or naval service of the United States in the late war, give name of organization or vessel to which attached, date of enlistment or commission, position or rank, date and cause of discharge from the service, and any physical disability incurred in the service. STATE OF NEW YORK, COUNTY OF... . . And on this...... day of having been duly sworn (or affirmed) before me, stated that to the best of his knowledge and belief the several statements in the foregoing application contained, whether in writing or print, are true. [Signature of officer.] [Official title.] Given at I, . . . . . . , PHYSICIAN'S CERTIFICATE. ...., on ......... 188... a practicing physician, resident in the above named place, do hereby certify that I have examined the applicant, and believe him to be free from any physical defect or disease which would be likely to interfere in any respect with the proper discharge of his duties, should he be selected for the service of the State of New York. [Signature of physician.] (N. B.—Whenever deemed expedient for the interests of the service, and particularly for positions other than clerks, an applicant who has proven himself as otherwise eligible for appointment will be liablė to a physical examination by a physician in the service of the State, or acting on its behalf.) CERTIFICATES OF CHARACTER. Directions.-Not less than three nor more than five persons must vouch for the character of the applicant, and they must be citizens of good character and standing in the community where they and the applicant reside, and must have been personally acquainted with him for at least one year. Should an applicant receive an appointment, the names of the citizens may be publicly announced. Sections 9 and 13 of the Civil Service Act read as follows: § 9. No recommendation of any person who shall apply for office or place under the provisions of this act, which may be given by any Senator or Member of Assembly, or officer confirmed by the Senate, or judge of any court, except as to the character or residence of the applicant, shall be received or considered by any person concerned in making any examination or appointment under this act. § 13. No recommendation or question under the authority of this act shall relate to the political opinions or affiliations of any person whatever. N. B.-The persons who sign the following vouchers are notified that they may be required by appointing officers to give, over their own signatures, further information concerning their knowledge of the applicant VOUCHER NO. 1. I (being more than twenty-five years of age, and not a kinsman of the applicant) have been a resident of .... past. I have been personally acquainted with for ........ years the applicant above, and I state, upon my honor, that I have read the application of said applicant, and believe each of the statements therein made to be |