Candidate Declination Request · Customer Portal

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Candidate Declination Request CAS-47

Date : {pt_date}

I, {pt_candidatesname}, Exam No. {pt_examnoid} List No. {pt_listno}, a candidate for the position of {pt_examtitlecode} wish to discontinue my investigation at this time.

I understand that this will result in my name being removed from the list of eligible candidates.

SHOULD I decide to restore my name on the list of eligibles, I will submit a written request, send an e-mail to CAD@NYPD.org, or APPEAR in person to the:

Candidate Assessment Division
235 East 20th Street
New York, NY 10003

The reason for my declination at this time is as follows:

Civil service position

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Other (please explain)

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By checking this box and signing your name you agree and acknowledge all the terms in this document.

Candidate signature

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(Provide your First and Last Name)

Date

Form name

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Exam title

Exam no.

List no.

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Date

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Candidate's name

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Form status