Rental Application

                  715 East Sprague Avenue, Ste 102, Spokane WA  99202 ∙ 509/232-0170 ∙ fax 509/484-4617 

 

INSTRUCTIONS: Please enter all information correctly and completely. Missing, incomplete or fraudulent information is grounds for rejection. In order to process your application quickly, please attach most recent tax return or 4506T (IRS transcript), copies of picture ID for all adults, and copies of social security cards for all family members. All non-married adult applicants must complete separate applications. Mail or bring the completed application to the address above (if you mail the application be sure to let us know how to contact you). If you appear to be qualified based on the information submitted, you will be asked to pay the Application Fee ($33 for each adult 18 or older and $13 for each 16-17 year old for most properties). Do not enclose the fee with the application. For Cottonwood Springs II and Landmark Apartments applications only (USDA properties), the total application fee that is paid will be applied to the first month’s rent if the application is approved and a lease is signed.

 

Spokane Housing Ventures has a “no cash” policy . Make checks or money orders for screening fees out to T.I.S., the background screening service.

 

If you need assistance completing this application or have any questions regarding this form, the application process or a prospective unit, please contact resident services/occupancy manager at (509)232-0170 Ext. 205.

Return to the Spokane Housing Ventures website

PROPERTY: I am interested in renting:

 Studio   1 BR                        

 

 5th & Wash.

 Casas Salvadas

 CJ Court

 Willow Ridge

 El Estero

 Kensington Court

 2BR      3BR           

 

 Hidden Pines

 Medical Lake

 Scattered Sites

 Hartson Triplex

 Village Apts.

 Bel Franklin

 4 BR     Other         

 

 Wilton Apts.

 Woodruff Hts.

 Landmark

 Green Gables

 Cottonwood  II        

 

APPLICANT INFORMATION:

Applicant Name:

Jr. Sr. Etc.:

Full Time Student:   Yes         No

Current Address:
 

Telephone:

Rent Amount:

City, State, Zip:

Date of Birth:

Are you 18 or older?   Yes           No

SSN:

Have you ever used a different SSN or last name?     Yes           No
Please explain:
 

Driver's License # and State of issue:
 

Email address:

Co-Applicant Name:

Jr. Sr. Etc.:

Full Time Student:  Yes           No  

Current Address:
 

Telephone:

Rent Amount:

City, State, Zip:

Date of Birth:

Are you 18 or older?    Yes        No      

SSN: 

Have you ever used a different SSN or last name?      Yes           No
Please explain:
 

Driver's License # and State of Issue:
 

Email address:

 

Have you ever lived in a property owned and/or managed by Spokane Housing Ventures    Y   N     Property___________________________

 

OCCUPANT INFORMATION: Please list names of other occupants who will be living at this residence. Attach additional page if necessary.

Last Name

First Name

SSN

Gender (circle)

Birth Date

Full Time Student?

 

 

 

M    F

 

Y     N

 

 

 

M    F

 

Y     N

 

 

 

M    F

 

Y     N

 

 

 

M    F

 

Y     N

 

 

 

M    F

 

Y     N

RESIDENCE/RENTAL HISTORY: List current address first. Provide at least 3 years of rental history.  Attach an additional paper if necessary.

Move In Date

Move Out Date

Property Address

Rent

Deposit

Landlord/Owner Name

Daytime Phone

Reason For Leaving

  

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT REFERENCE: Please list your current employer. If unemployed, state so.

 

Current Employer

Supervisor

Phone

Position

How Long?

Applicant

 

 

 

 

 

Co-app.

 

 

 

 

 

INCOME: Please identify source, name of recipient and amount of current income. Is your income seasonal or sporadic?   Yes    No

Applicant Current
Gross Income

Recipient's
Name

Monthly
Amount

Co-Applicant
Current Gross Income

Recipient's
Name

Monthly
Amount

Employment

 

 

Employment

 

 

Child Support/Alimony

 

 

Child Support/Alimony

 

 

SSA

 

 

SSA

 

 

SSD

 

 

SSD

 

 

SSI

 

 

SSI

 

 

VA

 

 

VA

 

 

L&I

 

 

L&I

 

 

DSHS

 

 

DSHS

 

 

Food Stamps

 

 

Food Stamps

 

 

Other

 

 

Other

 

 

PERSONAL REFERENCE/EMERGENCY CONTACT: Please list two personal references as well as an emergency contact.

Name

Address

Phone

Relationship

 

 

 

 

 

 

 

 

 

 

 

Emergency Contact

CURRENT HOUSING, REFERRAL AND/OR SPECIAL NEEDS: Please circle all that apply. 

Current Housing Type:

Referred by:

Special Housing Needs:

House

Self

Ground Floor

Doubled up with another family

Sign for rent

Wheel chair accessible

Transitional Housing Apartment

Flyer or Newspaper

Ramp

Shelter

Church

Barrier free

Homeless

Housing Authority

Hearing- or sight-accessible smoke detectors

Car/streets

Social service staff

English as a second language

Treatment Center

Outreach team

Live-in caretaker

Apartment

Alcohol/drug program

Large Family (4 or more)

Other (Please List)

Mental health program

Other (Please List)

 

Emergency housing program

 

 

Other (Please List)

 

MISCELLANEOUS: Please answer all questions.

Are you currently receiving a Section 8 voucher or certificate?

 Yes   No

Have you or any member of your household ever been evicted from your home?

 Yes   No

Do you own a vacuum cleaner or do you have access to one on a regular basis?

 Yes   No

Within the last seven years, have you or any member of your household filed bankruptcy?

 Yes   No

 If yes, is the bankruptcy discharged?

 Yes   No

Are you or any member of your household currently having your wages garnisheed?

 Yes   No

Have you or a household member ever been charged with illegal manufacture or distribution of a controlled substance?

 Yes   No

Have you or a member of your household ever been convicted of a crime?

 Yes   No

 Describe Offense:

Year convicted:

 

Are you or any member of your household a registered sex offender in any state?

 Yes   No

Are you or any member of your household required to register your address with a corrections office or with police personnel?  

 Yes   No

Do you own a pet? (Please inquire about our pet policy.)

 Yes   No

Do you own a waterbed? (Please inquire about our insurance policy.)

 Yes   No

VEHICLE INFORMATION:

 

Year

Make/Model

License State

License Number

Auto #1

 

 

 

 

Auto #2

 

 

 

 

OPTIONAL INFORMATION: TO BE USED ONLY FOR EQUAL OPPORTUNITY COMPLIANCE MONITORING PURPOSES.    Spokane Housing Ventures is committed to offering equal housing opportunities to qualified individuals and families and does not discriminate with regard to race, color, religion, national origin, sex, marital or familial status, disability, veterans/military status or sexual orientation.  Your answers to these questions are optional and will be used only to help us determine our compliance with equal opportunity guidelines.

APPLICANT:

Gender:

 Male

 Female

 

Marital Status:

 Married

 Separated

 Single (Divorced, Widowed, Never Married)

 

CO-APPLICANT:

Gender:

 Male

 Female

 

Marital Status:

 Married

 Separated

 Single (Divorced, Widowed, Never Married)

 

Release of Information, Disclosure and Authorization to Verify

 

In compliance with state and federal consumer reporting law, you are hereby advised that a screening will be conducted regarding the information contained in this application. The report may contain information regarding your credit-worthiness, character, general reputation, personal characteristics and mode of living. By signing this application, you authorize MOCO, Inc., whose address is PO Box 2826, Seattle, WA 98111, and whose telephone number is (800) 814-8213, to conduct the screening and to release information obtained to Spokane Housing Ventures. If the application is denied or approved conditionally based on information contained in the report, you may request and obtain a copy of the report. You have the right to dispute the accuracy of information contained in the report. You may have additional rights under both state and federal law.

I (we) hereby authorize Spokane Housing Ventures to verify the information herein in order to evaluate my (our) eligibility for tenancy. I (we) understand that verification will require inquiries to past and present employers and other  income sources, past and present landlords, and social service agencies. It may also require obtaining credit reports and examination of public records and databases. Credit reports and public records will be obtained from third party sources. I (we) understand that all information submitted herein and which Spokane Housing Ventures and/or MOCO may obtain from other sources for verification purposes will be held in strict confidence by Spokane Housing Ventures and MOCO, and not used for any purpose, or disclosed to any parties, not related to evaluating my (our) eligibility for tenancy.  

I (we), ______________________________________________ understand that all information provided herein to Spokane Housing Ventures  as part of my (our) application for tenancy will be thoroughly reviewed by staff and or their agents. I (we) hereby certify that this application has been made freely and voluntarily, and that the information entered above is accurate to the best of my (our) knowledge and the statements are true and complete. False, fraudulent or misleading information may be grounds for denial of tenancy or subsequent eviction.

Signature _____________________________________________________     Date ___________

Signature _____________________________________________________     Date ___________

 

To appeal or dispute the decision of Spokane Housing Ventures, please submit it in writing to:

Spokane Housing Ventures, 715 E Sprague Avenue, Suite 102, Spokane, WA 99202.

Back to top of Application