MASTERING Form 4A for the PE Exam Using a 5-Step Process

In this article (and video above), I walk you through everything you need to know about completing Form 4A using a clear, five-step process. Whether you’re filling it out for the first time or helping someone else navigate the process—this is the guide you didn’t know you needed.

I am going to use New York as an example, since I am licensed there—but keep in mind that the process may vary slightly from state to state.

What is a Form 4A?

Form 4A is the Verification of Experience form. It confirms that you’ve completed the engineering work required to qualify for licensure. It must be filled out by a supervisor, preferably a licensed PE, and submitted directly to the New York State Education Department (NYSED)—not by you. You can download the latest version of Form 4A directly from the NYSED website displayed on the screen and in the description of this video.

Now let’s talk about Completing the Form…

Step One – Applicant Information

You, the applicant, complete Section I. Enter your full name, date of birth, social security number or assigned ID, and the name of the university where you earned your degree.

For Example:

• Name: John L. Doe
• Date of Birth: 01/15/1990
• SSN: 123-45-6789
• School: Rincon Polytechnic Institute

Step Two  – Verification of Experience

This is completed by your supervisor or employer who is verifying your engineering experience. They’ll list your employment start and end dates, your job title, and whether the experience was full- or part-time.

For Example:

• Employment Dates: 08/2015 to 12/2018
• Job Title: Structural Engineer
• Full-Time: Yes
• Name of Firm: ABC Consulting Engineers
• Business Address: 123 Main St., Albany, NY 12201

Step Three – Description of Duties

Now let’s talk about the part of Form 4A that trips up the most people—Describing your duties. You will complete this part and this is where you show the licensing board that your engineering experience meets the requirements for licensure, especially in terms of design, analysis, and decision-making under the supervision of a PE.

Here’s the key: this isn’t a job description. It’s your opportunity to paint a clear, confident picture of your real engineering work—what you designed, calculated, planned, and managed.

Use specific project examples and focus on how you applied engineering principles. Instead of saying “assisted with bridge design,” say something like, “I designed a 50-foot span steel bridge, performed load calculations using AASHTO standards, and coordinated drawings using AutoCAD.” The more detail you give, the easier it is for the board to see that you’re doing professional-level engineering.

Also, be assertive—use “I” statements like “I led,” “I designed,” or “I coordinated.” This shows ownership and active involvement, not passive assistance.

And don’t forget—New York requires at least two years of design-oriented experience under a licensed PE. So if you’ve done design, make sure it’s front and center.

Bottom line? Treat this section seriously. Be clear, be specific, and tell your engineering story like a professional. You worked hard—make sure that comes through loud and clear.

Here’s an example:

During the Elm Street Bridge Replacement project, I led the structural design for a new 50-foot span. I performed detailed load analyses (dead, live, wind load calculations per AASHTO guidelines) and designed the steel beam and column sections to safely carry those loads. I created the construction drawings in AutoCAD and coordinated with our civil and geotech teams to integrate the bridge design with the roadway approach and foundations. I also reviewed and interpreted relevant code requirements (NYSDOT bridge specs) to ensure full compliance, and I made key design decisions such as selecting an optimal girder spacing to balance structural efficiency and cost.

To avoid delays, don’t make these common mistakes:

• Vague or incomplete duty descriptions
• Missing signatures
• Applicant submitting the form
• Illegible handwriting
  

A Good Example would be:

“I performed site inspections, soil sampling, and geotechnical report writing.”

Whereas a Bad Example would say something like:

“Helped with engineering analysis and reports.”

Step Four – Verifier’s Affidavit

The verifier must complete and sign the affidavit. If they are a licensed engineer, they must include their license number and state of licensure. If they are not licensed, additional documentation is usually required.

Here’s a Sample:

• Verifier’s Name: Jane D. Smith, P.E.
• License No: 76543
• State: NY
• Signature:
• Date: 01/10/2025

Step Five: Submitting Form 4A

Once completed, the verifier must send the form directly to the NYS Education Department. Do not submit it yourself. The form can be mailed or emailed, depending on the board’s current policies. Always check with NYSED for the latest instructions.

Their Mailing Address is:
New York State Education Department
Office of the Professions
Division of Professional Licensing Services
89 Washington Avenue, Albany, NY 12234-100

And that’s how to complete Form 4A for your PE license. Be thorough, stay professional, and follow the submission rules.

I hope you found this article helpful. In upcoming articles, I will solve some more PE exam practice problems and answer other questions from our subscribers. Pass the PE Exam videos will publish monthly, so be sure to click the subscribe button so you don’t miss something that could make a substantial difference in your exam result.

Lastly, I encourage you to ask questions in the comments of this video or on this page, and I’ll read and respond to them in future videos. So, if there’s a specific topic you want me to cover or answer, we have you covered.

I’ll see you next week… on Pass the PE Exam

Anthony Fasano, P.E., AEC PM, F. ASCE
Engineering Management Institute
Author of Engineer Your Own Success