Since your last renewal, have you been convicted of a crime or offense (not minor traffic violation), in the state or elsewhere or has any license, permit, commission, registration or application for a license, permit, commission, registration held by or submitted by you or a company in which you are or were a principal been revoked, suspended, or denied by any state, territory or governmental jurisdiction or foreign country for any reason?

IF "YES," submit a written explanation giving the place, court jurisdiction, nature of the offense, sentence and/or other disposition. You must provide a copy of the accusatory instrument (e.g., indictment, criminal information or complaint) and a Certificate of Disposition. If you possess or have received a Certificate of Relief from Disabilities, Certificate of Good Conduct or Executive Pardon, you must provide a copy of same.

* I have either completed 22.5 hours of continuing education for this period or I am exempt from this requirement because I am currently licensed as a real estate broker and have been licensed under Article 12A of the Real Property Law for 15 consecutive years or more as a real estate broker or real estate salesperson, or I am an admitted NYS Attorney

I am not under obligation to pay child support.

I am under obligation to pay child support (You must select any of the four statements below that are true and apply to you)

I do not owe four or more months of child support payments.

I am making child support payments by income execution or court approved payment plan or by a plan agreed to by the parties.

My child support obligation is the subject of a pending court proceeding.