N.Y. Comp. Codes R. & Regs. tit. 8, § 19.2 – Certificates of religious and denominational institutions.

(a) name of institution;
(b) address;
(c) name of religious or denominational organization by which operated, controlled or supervised;
(d) statement of the provision, by law or otherwise, under which the operation, control or supervision is vested and exercised;
(e) statement that institution elects to be considered a religious or denominational institution;
(f) statement as to whether institution admits nonmembers of the particular denomination; and
(g) signature of chief executive officer and verification.

Certificates to be filed by religious or denominational institutions shall be verified and contain the following: