Rp 1 Verification Form - Nys State Board Of Real Property Services

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NYS STATE BOARD OF REAL PROPERTY SERVICES
RP 1 VERIFICATION FORM
DATE :______ ___________________
COMPANY NAME: ____________________________
COMPANY CODE
NUMBER
NOTHING
Authorized Company Contact:
FORMS
OF PAGES
TO
INCLUDED
REPORT
Telephone Number
Fax Number
RP 1.1
RP 2.1
Mailing Address:
RP 2.2
RP 3.1
RP 4.1
E-Mail Address:
RP 4.2
RP 4.3
MECHANIZED REPORTING
RP 4.4
CHECK METHOD OF REPORTING:
RP 4.5
MAGNETIC TAPES ____
RP 4.6
FLOPPY DISKETTES ____
RP 4.9
OTHER ____
(desc.)__________________________
RP 5.1
RP 5.3
FORMAT USED: (i.e.: lotus, etc.)
RP 6.1
RP 7.1
RP 7.2
RECORD LAYOUT: (if tape)
RP 7.3
RP 7.4
FILE NAME (S):
RP 8.1
1
RP 8.2/8.3
2
RP 8.4
3
RP 8.5
4
5
TOTAL PAGES
NUMBER OF RECORDS:
VERIFICATION
The undersigned ______________________________ certifies that he/she is
NAME
__________________________ of _________________________________________
TITLE
REPORTING COMPANY NAME
that the attached report to the State Board of Real Property Services, consisting of
the report forms indicated above, with any inserts or accompanying supplemental
material, covering the period from Month___________Day_____Year_________ ,
to Month___________Day_____Year_________ , is true to the best of his/her
knowledge and belief.
Signature of Authorized Officer of the Company
RP 7400 Rev. 11/97

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