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Rental Application
When do you need to move in?
How long do you anticipate staying?
________________
Are you looking for a ____ furnished or
_____unfurnished rental unit?
Unit / First Choice:
_______________________ Unit / Second Choice ____________________
What is your e-mail address?
_______________________ Do you frequently use e-mail? _____
Prior to move-in attach a copy of abbrev
electric service application -
Credit
Info or p. 2 of electric co application
CVEA
Residential Application - For your convenience (or
reference letter from a prior utility company) You must sign up for
electricity in your name prior to move-in.
Unless there are other arrangements.
Full Name/s
_________________
_______________
Current Address
______________________________________________
Phone Number (& in whose name?)
Social Security number _____ _____
_____
Names of all other occupants
Current residence…
(if more than 3 years in one home /
also list two neighbors)
&
Prior Residence (past 3 years) Name,
address & phone no. of landlord
with following format
Address: from ______to_______ Rent
paid/month $_______
Owner or agent___________________________ phone
( ) _______ ___________
Reason for leaving:
Address: from ______to_______
Rent paid/month $_______
Owner or agent___________________________ phone
( ) _______ ____________
Reason for leaving:
Address: from ______to_______
Rent paid/month $_____
Owner or agent___________________________ phone
(_____) ______ ____________
Reason for leaving:
Other occupant references for short term renting?
Credit References
1. Electric co. Name and Phone number Address of
dwelling you were responsible for: ____________________
(Please get the letter of credit for 12 months from
your prior electric company)
2. Fuel co. Name & phone number
3. Other
Personal
References:
Please give name, how they know you, their phone
number
1.
2.
3.
Prior Employer, supervisor, phone
(How long employed?
From_______ to_______)
Current Employer & Supervisor, phone
(How long employed?
From_______ to_______)
Please answer the
following questions:
Car type, age & number that will be parked?
Any pets? How many? Kind of Pet, Breed, Weight
and Age?
Are you or anyone else who would be living in the
rental a smoker?
..If a smoker, heavy _____ or light smoker _____?
Who?
Does anyone have allergies? _______ If
so who? _______ and what kind? ________________________
Any medical situations that affect the type of
rental you need? ________ (Upstairs or ground floor
rental? __________ )
Have you ever been sued for non-payment of rent?
Have you ever been evicted or asked to move out?
Have you ever broken a rental agreement or lease?
Have you ever been sued for damage to rental
property?
Have you ever moved from a rental unit without
cleaning it?
Have you ever initiated a lawsuit? If so,
explain
Narrative
(optional, but could be helpful to you)
Please introduce
yourself & what you’re looking for in housing in Valdez
Approximately what do you earn/ month? _____________ In Winter?
_________ In Summer? _________
What are
your fixed monthly payment on long term bills? (car, furniture, etc)
I authorize M. Diann Hursh or Ron Hursh, owner or
co-owner of rental units to contact previous landlord (s), Credit
and personal references that I have given in this application.
I also authorize management to obtain my consumer
credit report or to be notified by utility company of any credit history
affecting their decision for credit
With only a modest deposit, I authorize my credit
card number to be used upon move-out, if any rent is owning or cleaning
needed, etc. is required at termination of tenancy. Actual deposit
amount depends on several items & results of application review:
length of stay / number of people / Pets or no pets
The above
information, to the best of my knowledge, is true and correct. This
application shall be included as part of the rental lease agreement.
Signature of Applicant ____________________
Date
_____ Date of Birth ____ ____ ____
Signature of Co-Applicant __________________
Date
_____ Date of Birth ____ ____ ____
In case of Emergency,
who to contact:
Summary page of Contact Info:
Please mail completed application.
(Followed by a signed hard copy faxed or
mailed: Hursh Realtors, PO Box 233, Valdez, AK 99686)
Rental Application Processing fee of $50 is non
refundable, to be applied towards rent upon approval, or forfeited if
rental is approved & not taken
Should you wish a lease starting in
spring/summer, a prepaid last month’s rent is required, to be forfeited
towards higher rent during term so taken, if full lease is not honored.
Note: All above information is kept in confidence
by owner/agent. Or call in application 907-835-5333 |
