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Completion of this form is for notification purposes only and shall not be considered the annual report pursuant to 19 NYCRR Part 1204. Submission of this form, by a state agency, to the Department of State provides the notification that the agency has completed its annual report. The report must be completed by February 1 of each year, and must include the information pertaining to the preceding calendar year. Each State Agency must notify the Department of State of the Agency’s completion of its annual report within 30 days after completion. This form is provided to assist State Agencies in fulfilling their obligations under 19 NYCRR Part 1204. Use of this form is optional; State Agencies may use other forms to fulfill their annual reporting and notification obligations
This form is provided as a courtesy of the Secretary of State of the State of New York, to assist State Agencies in fulfilling their Annual Report requirements pursuant to 19 NYCRR Part 1204. Use of this form is optional, but may be used to satisfy their Annual Report obligation. State Agencies may instead use other forms, where acceptable to the Secretary of State, to fulfill their Annual Report obligations.
Important: The following bulletins are provided as a courtesy from the NYS Department of Health, which is responsible for its content. Please contact the NYS Department of Health regarding information contained within each bulletin.