This form is for applicants seeking licensure by endorsement or the practical examination and for applicants seeking a limited permit. It is not required for applicants seeking licensure by NCARB Certificate. Also, you must complete this form if you hold, or have ever held, a license or certificate to practice any profession* in any jurisdiction.
This form must be submitted directly by the licensing authority. This form will not be accepted if submitted by the applicant.
- Section I: Complete this section of the form before sending it to the jurisdiction.
- Section II: The jurisdiction must complete this section and return the form directly to the Office of the Professions at the address at the end of the form.
NOTE: A Form 3 is not required for licenses/certificates issued by the New York State Education Department. Also, if the certification/verification documentation provided by a U.S. jurisdiction contains the same information requested in the Form 3, completion of a Form 3 for that jurisdiction is not necessary. For certification/verification documentation that does not contain the same information, a Form 3 will need to be completed for that jurisdiction.
*Profession is defined as professional titles licensed under New York State Education Law.
Electronic Verification of Licensure, Certification and/or Examination
The Office of the Professions (OP) will accept electronic verifications of licensure, certification and examination completion from other licensing authorities located in the United States or Canada provided that:
- OP can independently authenticate that the verification is received directly from the licensing authority.
- The applicant had no opportunity to directly access or alter the verification before it is sent or transmitted.
- Any licensing authority verification submissions should be made electronically to DPLSVerif@nysed.gov.*
*DO NOT use this email to submit a question, as we will be unable to provide a response. Submit a Contact Us Form for questions regarding specific applications or to check the status of a licensure application.