Kelley Diffendorf
Town Clerk
(607) 775-1966


Instructions for Completion of Application

Read instructions and then print form.

Legibility and Completeness:

The Parking Permit Application form has three parts:

Part I   To be completed by the applicant.
Part II  To be completed and signed by the certifying physician.
Part III “For Official use only”.

It is the applicant’s responsibility to ensure that Parts I and II are complete and legible. Incomplete or illegible applications will be returned without approval.

You must provide your Driver’s License in order to receive a Parking Permit. If you do not have a Driver’s or Non-Driver’s license, contact the Town Clerk’s Office at 607-775-1966 for further information.

Filing of Application:

Completed applications may be brought to the Town Clerk’s Office at 70 Crescent Dr., Kirkwood, New York.

If you need additional information, please call 607-775-1966.

Parking Permit for the Disabled