Affordable Housing Northwest PDX - Leading Housing Solutions for Affordable Communities

30% Set Aside Grows on City Council & PDC Commission

The 30% set aside policy is gaining momentum both on City Council and the PDC Commission. Despite that the City Council hearing on the set aside being delayed until October 18, there is growing suppo ...(complete story)

$100 million for Affordable Housing

The Housing Alliance needs your help! We are asking the Legislature to take bold action to address the affordable housing crisis that is gripping ou ...(complete story)

Affordable Housing Northwest - Portland is an Equal Housing Opportunity property management organization. The Affordable Housing Rental Application Must Be Completed By Each Adult Applicant.

Applying For:

Property:

Unit:

Date Unit Wanted:

Applicant:

First Name:

Middle Name:

Last Name:

Date of Birth :

Social Security Number:

Phone:

Drivers License/ID License Number:

State:

Present Address:

City, State & Zip:

From:

To:

Former Landlord :

Phone:

Landlord Address:

City, State & Zip:

Other states & countries you have lived in during the past 5 years

Are you or any member of your household a student or anticipates being a student?

Yes

No

Present Employer:

Date Hired:

Position:

Employer Address:

City, State & Zip:

Phone:

Gross Pay :

Other Income :

Source:

References:

Bank (Checking) :

Phone :

Account Number :

Bank (Savings) :

Phone :

Account Number :

Have you established rental credit?

Yes

No

List all other outstanding debts:

Total Debt Balance:

Total Monthly Payments:

Relative:

Relative Phone:

Relative Address:

City, State & Zip:

Personal Reference:

Reference Phone:

Reference Address:

City, State & Zip:

Have you ever been evicted?

Yes

No

If so, what date?

Have you ever been convicted of any felony or misdemeanor?

Yes

No

If yes, please explain.

Other Occupants:

Name	DOB	Social Security Number	Automobile	License Plate

Other Information:

Are you planning to have pets ?

Yes

No

If so, what kind?

Are you intend to use any of the following?

Waterbed

Aquarium

Musical Instrument

Why are you vacating your present place of residence?

Have you given notice where you live now?

Yes

No

How did you hear about our property?

Approval:

I certify that the above information is correct and hereby authorize you to do a credit check and make any inquires you feel to evaluate my tenancy and credit standing. I understand that giving incomplete or false information is grounds for rejection of this application. If any information supplied on this application is later found to be false, this is grounds for termination of tenancy.

Owner/Agent has charged a screening charge as set for above. Landlord may obtain a consumer credit report and/or an Investigative Consumer Report which may include the checking of the applicant’s credit, income, employment, rental history, criminal court records and may include information as to his/her character, general reputation, personal characteristics, and mode of living. You have the right to request additional disclosures provided under Section 606 (b) of the Fair Credit Reporting Act, and a written summary of your rights pursuant to Section 609 (c). You have the right to dispute the accuracy of the information provided to the Owner/Agent by the screening company or the credit reporting agency as
well as complete and accurate disclosure of the nature and scope of the investigation.

If the applicant is approved, applicants will have hours from the time of notification to either execute a rental agreement and make all the deposits required thereunder or make a deposit to hold the unit and execute a deposit receipt which will provide for the forfeiture of the deposit if the applicants fail to occupy the unit. If the applicants fail to timely take the steps required above, they will be deemed to have refused the unit and the next application for the unit will be processed.


First and Last Name		Email Address		Date

Affordable Housing Northwest - Portland
1708 S.W. Columbia
Portland, Oregon 97201
Phone: 503.497.1188
Toll: 800.783.3454
Fax: 503.497.1181