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 _______________________  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

 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 and give Electric co permission to give us copies of electric bills - Also copy of any fuel fill ups

Full Names

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_______ Reason for leaving:

Owner or agent___________________________ phone (        ) _______   ___________ Rent paid/month

Address:                                        from ______to_______ Reason for leaving:

Owner or agent___________________________ phone (        ) _______ ____________Rent paid/month

Address:                                        from ______to_______ Reason for leaving:

Owner or agent___________________________ phone (_____) ______ ____________ Rent paid/month

Other occupant references for short term renting?

Credit References 

1. Electric co.   Name and Phone number  Address of dwelling you were responsible for:

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?

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_______, 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. 

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 signed  _________________  Date of Birth _______ ________ _______

Signature of Co-Applicant                         Date signed  _________________  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  907-835-3135