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Get NY Landlord Registration Statement For Rental Certificate - City Of Schenectady 2019

BUREAU OF CODE ENFORCEMENT CITY OF SCHENECTADY NEW YORK City Hall 105 Jay St. Room 17 Schenectady NY 12305 Ph. 518 382-5050 Fax 518 372-9459 Eric Shilling Chief Building Inspector LANDLORD REGISTRATION STATEMENT FOR RENTAL CERTIFICATE Date Submitted Bldg Dept. 518 382-5050 Fax 518 372-9459 Eric Shilling Chief Building Inspector LANDLORD REGISTRATION STATEMENT FOR RENTAL CERTIFICATE Date Submitted Bldg Dept. Official Property Address Owner Occupied check one Yes No Tax Identification Number/S.B. L. Name of Owner s Owner s Address No P. O. Boxes Telephone Home Cell Fax Owner s e-mail address Buildings with 10 or more units -Select annual inspection rental payment preference 500 20/unit 50/rental IF YOU DO NOT OCCUPY THE REGISTERED PROPERTY AND RESIDE OUTSIDE THE COUNTY OF SCHENECTADY YOU MUST DESIGNATE A MANAGING AGENT AUTHORIZED TO ACCEPT SERVICE OF NOTICES AND LEGAL PROCESS AND WHO RESIDES OR HAS AN OFFICE IN THE COUNTY OF SCHENECTADY. BUREAU OF CODE ENFORCEMENT CITY OF SCHENECTADY NEW YORK City Hall 105 Jay St* Room 17 Schenectady NY 12305 Ph. 518 382-5050 Fax 518 372-9459 Eric Shilling Chief Building Inspector LANDLORD REGISTRATION STATEMENT FOR RENTAL CERTIFICATE Date Submitted Bldg Dept. Official Property Address Owner Occupied check one Yes No Tax Identification Number/S*B. L* Name of Owner s Owner s Address No P. O. Boxes Telephone Home Cell Fax Owner s e-mail address Buildings with 10 or more units -Select annual inspection rental payment preference 500 20/unit 50/rental IF YOU DO NOT OCCUPY THE REGISTERED PROPERTY AND RESIDE OUTSIDE THE COUNTY OF SCHENECTADY YOU MUST DESIGNATE A MANAGING AGENT AUTHORIZED TO ACCEPT SERVICE OF NOTICES AND LEGAL PROCESS AND WHO RESIDES OR HAS AN OFFICE IN THE COUNTY OF SCHENECTADY. Name of Agent Agent Physical Address Agent s e-mail address Agent verification completed Verifying Officer Verification Initial Agent acknowledges position as Property Agent for Property located at Preferred method of contact email Phone Text / Pager PROPERTY DESCRIPTION Property Type Residential Mixed Residential and Commercial Number of Residential Units in the Registered Property One Two Three Four Other please specify Is the Property Insured for Property Damage and Fire Loss Yes Name of Insurance Company Insurance Agent Name City/State Zip Please provide a copy of your current year insurance declarations/ coverage page The undersigned owner certifies under penalty of perjury that the foregoing information is true and correct. Sworn to me before this day Owner NOTARY PUBLIC/COMMISSIONER OF DEEDS Commission Expiration Date NON-COUNTY RESIDENT OWNERS I certify and agree that I am a non-resident property owner designate the agent herein named to serve as the Agent of record for purposes of managing the property identified herein and authorize and consent to service of all notices warnings communications and legal processes upon the designated agent. The undersigned agent accepts the designation as agent and agrees to serve as the owner s agent for all purposes required by Chapter 168 of the Code of the City of Schenectady.

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