Online Membership Application (* Indicates a required field)

* Choose One:

Full Membership: Payment in the amount of $75.00 must be submitted with this application (the membership fee of $50.00 will be applied to the third and fourth quarter of this year annual dues if accepted; the additional $25.00 goes to the non-refundable application fee).

 
Associate Membership: For persons whose place of business is located outside the geographical boundaries of New York State. A payment is in the amount of $75.00 must be submitted with this application (the membership fee of $50.00 will be applied to the third and fourth quarter of this year annual dues if accepted; the additional $25.00 goes to the non-refundable application fee).
Remit to: NYSPPSA, P.O. Box 632, Moriches, NY 11955
 
* First Name * Last Name
 
* Name of Firm
 
* Address1 Address2
 
* City * State * Zip
 
Mailing Address 1 Mailing Address2
 
City State Zip
 
Telephone (note: ONLY FILL IN THE NUMBERS THAT YOU WANT PUBLISHED IN THE DIRECTORY)
- - - -
Daytime (office) Toll Free
- - - -
Fax Cell
- -  
Residence  
 
Have you ever been convicted of a felony?
No Yes (If yes, attach separate sheet with details)
 
* I have been affiliated with the profession of process serving for a period of Years and Months
 

Directory Listing(s)
Email Website
 
List me in the directory under the City of
 
Services Provided:
PS Process Service CF Court Filings CRS Court Record Searches SP Subpoena Preparation
ST Skip Trace PC Photocopying
PI Private Investigations Lic.No.: EO - E&O Insurance
Other
 
Counties Served (list only those areas in which you serve without charging an additional fee for forwarding papers) MAX 7 Counties

I authorize the New York State Professional Process Service Association to investigate the statements made on this application and my qualifications for membership. I understand that membership, if granted, will be in MY NAME and not in the name of any company owned by me or with which I am affiliated and I authorize publication, of the information listed in the Directory Box, in the NYSPPSA Directory. I further understand that my membership cannot be transferred to another person. I agree to abide by the NYSPPSA Bylaws and Cannons of Ethics and to all amendments thereto. I agree to submit to binding arbitration in all disputes with NYSPPSA members involving fees, work performance and professional conduct in accordance with the procedures set forth in the NYSPPSA Bylaws.


I DECLARE UNDER PENALTY OF PERJURY THAT THE STATEMENTS MADE IN THIS APPLICATION ARE TRUE AND CORRECT.

DATE Signature of Applicant_____________________________________________