Yonkers Parking Authority

8 Buena Vista Avenue- Yonkers, NY 10701

Tel: (914) 965-2467  Fax: (914) 965-0735

Applicant Information

 

Name:                           ___________________________________________

Address:                        ___________________________________________

City/State/Zip:                ___________________________________________                         

                                                            

Home Phone:                 ____________________  Cell Phone: _____________________

Work Telephone:            _____________________ Email Address: ___________________

 

Vehicle Information

 

1st Vehicle Plate: ___________________      State Registration____________

Color: __________  Year:_____________Make:___________Model:___________

 

2nd Vehicle Plate: ___________________      State Registration____________

Color: __________  Year:_____________Make:___________Model:___________

 

Parking Facility: ______________________________

Method of Payment: Cash ______ Check _____ Credit Card _____ MO _____

A copy of your license, registration and a current utility bill

                                must be submitted with your application.                  



I hereby confirm that I have read, understood and will comply with all of the above information. I also certify that all the information completed in this application is in all respects true and completed to the best of my knowledge.

 

 

Date: ____________________ Applicant Signature: ________________________