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Forms

The following are some of our most requested forms and the requirements for each of them. Our veteran counselors are happy to assist you with any questions you may have about completing any of these forms.

Please note, most Dutchess County forms are available as PDF documents. This format requires that you have Adobe Acrobat Reader installed on your device. Click on the Adobe Acrobat Reader icon Adobe Acrobat icon to download a free copy of this software.

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Authorization for Disability Record (.pdf)

The Authorization for Disability Record (.pdf) form is used to request the Veterans' Administration to furnish the Dutchess County Department of Human Resources with the applicant's medical and disability records in order to receive additional credits on a civil service exam as a disabled veteran. Please see Veterans' Credits for further information.



Tommy Zurhellen Fund Application

The Tom Zurhellen Fund is available for your applications for financial assistance. Any veteran who is danger of becoming homeless, or any measure of reduction in your health and welfare due to loss of employment or unfortunate circumstance is recommended to apply.

 

In addition, maintaining the existence and strength of our of Service Organizations in Dutchess County is of the utmost importance. Recognizing that our American Legion and VFW posts are struggling, we are also asking our American Legion and VFW Post commanders to consider applying for the Tom Zurhellen fund to assist in maintaining your post’s health.

 

Remember, please call us at 845-486-2060 for assistance in applying

 

Tom Zurhellen Fund Application.pdf



Veterans Discount Program (Return the FAVOR) Application

  1. Bring your Military Separation Papers i.e. DD-214, WDO-AGO 53-55, etc., indicating your Full-Time Active Duty service to the Division of Veterans Services Office, located at 85 Civic Center Plaza, Suite 105 in Poughkeepsie between 9am and 4pm.
  2. Complete the Veteran's Discount Program (Return the FAVOR) Application Form (.pdf).
  3. Proceed to the County Clerk's Office located on the 1st Floor of 22 Market Street, Poughkeepsie, NY.  Press the "J" category at the customer service booth.
  4. Receive your Dutchess County Veteran's Identification Card from the County Clerk's Office.


Veteran's Personal Data sheet (.pdf)

Complete the Veteran's Personal Data Information Sheet to register with our office for the first time or update any information we already have on file for you

Mail or drop off the form to:

Division of Veterans Services
85 Civic Center Plaza
Poughkeepsie, NY 12601

Please call us at 845-486-2060 if you have any questions or need help completing this form.



Veterans Service Credit

Candidates may be eligible to receive a veterans’ credit of 5 points in an open competitive examination and 2.5 points on a promotion examination, if they meet certain criteria listed below. Veterans may be eligible for an additional credit of 5 points on an open competitive examination (for a total of 10 points) and 2.5 points on a promotion examination (for a total of 5 points) if they meet additional criteria to be classified as a disabled veteran.  Those individuals who meet the criteria below, must submit a Veterans’ Credit Application (.pdf) form along with a copy of their DD-214 Separation from Service form or Discharge Papers to our office. (Note: DD-214 or Discharge Papers must indicate honorable discharge or release under honorable conditions).  For Disabled Veterans’ Credit, the candidate must also submit a Disability Record Authorization (.pdf) form. The Veterans’ Credit Application form and Disability Record Authorization form are available from this office. Under these criteria, all documentation must be submitted to this office prior to the establishment of the eligible list.

Criteria for Veterans’ Credit

  1. Be a U.S. citizen or an alien lawfully admitted for permanent residence at the time of application and examination
  2. Reside in New York State at time of application for examination
  3. Have received an honorable discharge or been released under honorable conditions. It also includes veterans who have an Other-Than-Honorable (OTH) or a General Under Honorable Conditions Discharge due to any of the following:
    • Post-Traumatic Stress Disorder (PTSD)
    • Traumatic Brain Injury (TBI)
    • Military Sexual Trauma (MST)
    • Sexual Orientation
    • Gender Identity

Criteria for Disabled Veterans

  1. Veteran was disabled in the actual performance of duty;
  2. Veteran is currently receiving payments from the Veterans’ Administration for such disability, which is rated at 10% or more.

NOTE:  Veterans who have used non-disabled veteran credits for a Civil Service appointment or promotion and who were/are subsequently certified as being a disabled veteran by the United States Department of Veterans Affairs, are entitled to additional credits for a subsequent appointment or promotion.  For more information, contact the Dutchess County Department of Human Resources.

For candidates in the armed forces as of the date of the examination:
Those individuals who are in the armed services but will meet the above criteria at the time of discharge must provide proof of active status (military ID card, military orders, or other official military document) as of the date of the exam. This proof of active status should be submitted at time of application but cannot be accepted after the eligible list is established. Credits will be conditionally assigned to the candidate but will not be added to the candidate’s grade until the individual is actually discharged and submits the documentation described under candidates already discharged at date of examination.

NOTE:  Veterans’ Credits may only be used once for actual appointment. Upon appointment, credits assigned to other eligible lists will be removed and future credit denied.  Veterans’ Credits may only be added to a passing score (70.0 or higher).

Revised 3/98
Revised 8/01
Revised 09/22

Return to:
Dutchess County Department of Human Resources
22 Market Street
Poughkeepsie, NY 12601
EmailHRExams@dutchessny.gov