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Holdover Eviction Submission Form

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Holdover Eviction Submission Form

NOTICE:

Due to time constraints, any Notice of Termination submissions/requests after May 25, 2023 will not be processed until the following month.

Deeded Property Owner(s) *

Property Address *

First

Last

Unit and Zipcode

First

Last

Do you have a current Rental Registry or Certificate of Compliance from the City of Syracuse for this property? (Check here: https://ips.egov.basgov.com/syracuse/parcelsearch.aspx) *

Yes
No
N/A (Property is not in City of Syracuse)

Access Code or Key Required for Common Area *

Yes - Access Code
Yes - Physical Key
No

Provide Access Code Here: *

All Occupants Name(s) (18 years of age and older) *

First

Last

Tenant Names

First

Last

Tenant Names

First

Last

Section 8 Assistance? *

Yes
No

Type of Lease *

Oral Lease
Written Lease

Duration of Written Lease *

Month-to-Month
One-Year or More
Not Applicable

Tenancy Start Date *

General Reason for Lease Termination *

Monthly Rent Amount *

Have you received OCERA, ERAP or LRAP for this Tenant? *

Yes
No
Unsure

Date that OCERA, ERAP or LRAP was received: *

Special Notes:

Contact Info for Party Submitting Form: *

First

Last

Company

E-Mail Address *

Telephone Number *