HUSKY REALTY Inc.
The undersigned hereby makes an application to rent the following property:
_Property Address: _________ _______________________.
Anticipated move date of _____________at a monthly rent of $_____ ________ and
security deposit of $__________. Pet rent of $ 25.00 first pet $20.00 per additional pet(s).
PLEASE TELL US ABOUT YOURSELF
Full Name______________________________ Home Phone ( ) _____________________.
Cell Phone ( ) __________________ Email Address: ______________________________
Date of Birth______________________ Social Security#_______________________________
Co-Applicant Date of Birth______________________ Social Security# ____________________
Co-Applicant Cell Phone ( )_________________ Email Address:______________________
Name(s) of Dependents also occupying the premises __________________________________
Dependents Date of Birth_________________________________________________________
List All Pets____________________________________________________________________
PLEASE GIVE RESIDENTIAL HISTORY (LAST 3 YEARS)
Current Address_______________________________Apt#________ City__________________ State______ Zip________
Month/Year Moved In______________________ Reasons for Leaving_____________________ Rent $__________
Landlord/Owner/Agent___________________________ Phone ( ) ____________________
Previous Address (last 3 years)_________________ ________________________________ Rent $____________
Landlord/Owner/Agent____________________________ Phone ( ) ___________________
PLEASE DESCRIBE YOUR CREDIT HISTORY
Have you declared bankruptcy in the past seven (7) years?
Have you ever been evicted from a rental residence?
Have you had two or more late rental payments in the past year?
Have you ever willfully or intentionally refused to pay rent when due?
PLEASE PROVIDE YOUR EMPLOYMENT INFORMATION
Your Status: _____Full Time _____Part Time _____Student _____Unemployed _____
Dates employed_____________________________ Employed as______________________
Supervisor Name___________________________________ Phone ( )_________________
For Military – Rank / Which unit & organization - __ ___________ .
Salary $_________________per________________. (If employed by above less than 12 months, give name & phone of previous employer or school: _______________________________________________________________________
other sources of income you would like us to consider, please list income, source, and person (banker, employer, etc.) who we may contact for confirmation. You do not have to reveal alimony, child support, or spouse's annual income unless you want us to consider for this application.
Amount $___________________ Source/Contact Name__________________________________________________________
PLEASE LIST YOUR REFERENCES
Name_________________ Type of Account_________________
Name_________________ Type of Account_________________
Personal Reference or Emergency Contact:
Phone _______________________ Relationship_______________________
Your Driver's License Number_________________ State_________________
Co-Applicant Driver’s License Number ____________ State ______________
Make / Model _________________Year _________________License Plate State_________________
Please give any additional information that might help owner/management evaluate this application?
Where may we reach you to discuss this application?
Day Phone # ( ) ______________________ Night Phone # ( )__________ ___________
I hereby apply to lease the above described premises for the term and upon the set conditions above set forth and agree that the rental is to be payable the first day of each month in advance. As an inducement to the owner of the property and to the agent to accept this application. I warrant that all statements above set forth are true; however, should any statement made above be a misrepresentation or not a true statement of facts, all of the deposit will be retained to offset the agent's cost, time, and effort in processing my application.
I hereby deposit $___________ as earnest money to be refunded to me if this application is not accepted in 3 business banking days. Upon acceptance, this deposit shall be retained as part of the security deposit. When so approved and accepted, I agree to execute a lease for ___________ months before possession is given and to pay the balance of the security deposit prior to the move in date. If the application is not approved or accepted by the owner or agent, the deposit will be refunded, the application hereby waiving any claim for damages by reason of non-acceptance which the owner or agent may reject. I recognize that as a part of your procedure for processing my application, an investigative consumer report may be prepared whereby information is obtained through personal interviews with others with whom I may be acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living.
The above information, to the best of my knowledge, is true and correct.
Please sign: X__________________________________
Print . _________________
Name of Applicant Date:
Release of Information
I authorize an investigation of my credit, tenant history, banking and employment for the purposes of renting a house, apartment, or condominium from this owner/manager.
Name (please print)
Return this application to Husky Realty: Fax (907) 357-4741 or email to Steve@FtRich.com
Mail: Husky Realty, Inc. PO Box 874961 Wasilla AK 99687
APPLICANT: PLEASE DO NOT WRITE BELOW (FOR OFFICE USE ONLY)
Deposit of $__________________ Received by ____________________________ Date_______________
OFFICE NOTES: Equal Housing Opportunity