Please enable JavaScript in your browser to complete this form.Deeded Property Owner(s) *Property Address *FirstLastUnit and ZipcodeFirstLastDo 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) *YesNoN/A (Property not in City of Syracuse)Access Code or Key Required for Common Area *Yes - Access Code (Provide door code in Special Notes section)Yes - Physical KeyNoProvide Access Code Here: *All Occupant Name(s) (18 years of age and older) *FirstLastTenant NamesFirstLastTenant NamesFirstLastSection 8 Assistance? *YesNoType of Lease *Oral LeaseWritten LeaseLease Start Date *Monthly Rent Amount *Have you received OCERA, ERAP or LRAP for this Tenant? *YesNoUnsureDate that OCERA, ERAP or LRAP was received: *Payments in Arrears *FirstLastMonth 2FirstLastMonth 3FirstLastMonth 4FirstLastMonth 5FirstLastMonth 6FirstLastMonth 7FirstLastMonth 8FirstLastMonth 9FirstLastMonth 10FirstLastMonth 11FirstLastMonth 12FirstLastChoose One: *I just want the tenant(s) out, do not make a "Pay to Stay" dealYou may make a "Pay to Stay" dealChoose One: *In an effort to speed up the eviction process, I am willing to waive monetary judgment against the Tenant in exchange for an Eviction WarrantI am not willing to waive judgment against the TenantSpecial Notes:Contact Info for Party Submitting Form: *FirstLastCompanyE-Mail Address *Telephone Number *Submit