Housing Application

"*" indicates required fields

1Housing Information

2Personal Information

3Income Information

4Current Housing

5References

6Documents & Certification

Application Type*

Affordable Home

Affordable Rental

Home Location*

Rental Location*

Applicant Name*

Address*

Applicant Email*

Applicant Phone

Applicant Cell Phone

Applicant Work Phone

Is there a co-applicant?*

Yes

Co-Applicant Name

Co-Applicant Email*

Co-Applicant Phone

Co-Applicant Cell Phone

Co-Applicant Work Phone

Tribal Affiliation*

Regional Coporation*

Other Tribal Affiliation*

Other Regional Corporation*

Family Composition

Name	Relationship	Actions

There are no Members.

Is anyone in your immediate family related to any board of commissioners, staff of CRBRHA, or your village council members?*

Yes

Please explain relationship.*

Authorized Contacts

Name	Actions

There are no Contacts.

Person’s other than signers authorized to receive information or updated information regarding your tenancy account.

Statement of Current Housing

Current Housing Status*

I own a home

I rent a home

I am without a home

Landlord Information

Landlord Phone

Landlord Email

Current Housing Location*

If without a home, describe current housing arrangements.*

Current Housing Condition*

Housing is adequate

Housing is substandard

Housing is unsafe

Current Housing Explanation*

Please describe substandard or unsafe conditions. If current housing is adequate, please let us know why you are applying for housing.

Credit History

I have had credit with the following creditors and authorize them to provide credit information to the Copper River Basin Regional Housing Authority for consideration regarding my application for Mutual Help or Low Rent Housing.

Name of Creditor

Account Number

Creditor Address

Name of Creditor

Account Number

Creditor Address

Name of Creditor

Account Number

Creditor Address

Landlord Reference

Listed below are names of former landlords. I authorize them to provide information to the Copper River Basin Regional Housing Authority regarding my former tenancy.

Landlord Name

Landlord Phone

Landlord Address

Landlord Name

Landlord Phone

Landlord Address

Release Document

Please download this PDF and sign all pages. You can then either upload the signed document here or mail or drop it off to Copper River Basin Regional Housing Authority.

Signed Release Document

Max. file size: 50 MB.

Applicant Signature*

Co-Applicant Signature*

Application Fee*

Price:

Total

Credit Card*

Cardholder Name

Card Details

Billing Address

Street Address City State / Province / Region ZIP / Postal Code Country

This field is for validation purposes and should be left unchanged.

If you have an account with CRBRHA, including vacant or current, your account must be paid in full to move into any Affordable Rental or Affordable Home. You must be income eligible. If you do not meet the income guidelines, you will be placed on the waiting list and it is your responsibility to update your application anytime your situation changes.

Deposits Required:

Security Deposit
Key Deposit
First Month Rent
Proof of Electric Deposit (in your name)

Affordable Rental Deposits:

4-Bedroom: $700
3-Bedroom: $650
2-Bedroom: $600
1-Bedroom: $550
Key Deposit: $15
2nd Key Deposit: $20

Copper River Basin Regional Housing Authority provides auto pay. You may complete the credit card billing authorization form and CRBRHA will bill your card once per month for the amount of rent on the date you select or you may call (907) 822-3633 to pay by phone.

Housing Application

Income

Alaska PFD

Employment Information

Payee & Case Management

Family Assets

Banking

Criminal Conviction

Statement of Current Housing

Credit History

Landlord Reference

Release Document

Contact

Address

Hours

Housing Application

Income

Alaska PFD

Employment Information

Payee & Case Management

Family Assets

Banking

Criminal Conviction

Statement of Current Housing

Credit History

Landlord Reference

Release Document

Footer

Contact

Address

Hours