Rental Application

When do you need to move in?

How long do you anticipate staying? ________________ 

Are you primarily looking for a ____ furnished or _____unfurnished rental unit?

First choice of one of our rentals _______________________ 

What is your mailing address?

What is your physical address in Valdez?  _______________________  What is your out-of-area address?

Do you frequently use e-mail?  _____ e-mail address:

 Please, 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.

Full Names

Current & Primary Address (location)

Phone Number (& in whose name?)

Social Security number   _____  _____   _____      

Names of all other occupants & anticipated 'off and on' visitors

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 a letter of credit for 12 months from your prior electric company)

2. Fuel co.         Name & phone number (If you have rented in Valdez previously, do you pay fuel by autofill?  If so, in whose name?

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?  How old is the pet?         How long have you had it?       How long do  you expect to have it?

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_______, 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

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, fax or hand deliver completed application.

 (Followed by a signed hard copy faxed or mailed: Hursh Realtors, PO Box 233, Valdez, AK 99686)

Application must be COMPLETE and accurate, or approval for a rental may be withdrawn.  No omissions of relevant information:  especially all residencies within the last 3 years

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.

Agent is co-owner of these rental units & represents Self with assistance to Renters *  pdf

Note:  All above information is kept in confidence by owner/agent.  Or call in application  907-835-5333