You are required to bring this form to Court. Fill it out before you come in on the next court date.Notice: You are required to attach to this form the following documents: A current and representative paycheck stub;. Use Form RP524, Complaint on Real Property Assessment to grieve your assessment. A. Account Information. Payoff Request Form. First name, Last name, Account Number (optional), Phone, Street address, Apartment, suite, etc. In completing this form employees will be acknowledging in writing that their second job is subordinate to their employment with Nassau County. Various kinds of childcare are available throughout Nassau County. To obtain more information call the Day Care New Applications unit at 516-227-7976.