Alaska Rental Application

Property Address: [[Property Full Address]], [[City]], Alaska [[ZIP Code]]
Monthly Rent: $[[Monthly Rent Amount]]
Security Deposit Amount: $[[Security Deposit Amount]] (maximum two months' rent per AS 34.03.070)
Desired Move-In Date: [[Desired Move-In Date]]
Lease Term Requested: [[Lease Term, e.g., 12 months / month-to-month]]
Application Date: [[Application Date]]
Application / Screening Fee: $[[Application Fee Amount]] (non-refundable; no statutory cap under Alaska law)

Landlord / Property Manager: [[Landlord or Management Company Full Name]]
Phone: [[Landlord Phone Number]] | Email: [[Landlord Email Address]]

This Rental Application is submitted for the purpose of evaluating the Applicant(s) for tenancy. All information will be used in accordance with the Fair Credit Reporting Act (FCRA), Alaska Residential Landlord and Tenant Act (AS 34.03), Alaska Human Rights Law (AS 18.80), and other applicable federal and state laws.

Important Disclosures
- Alaska law does not impose a statutory cap on application or screening fees. The fee stated above is non-refundable whether or not the application is approved.
- A consumer report (credit, background, criminal, eviction, and rental history) may be obtained.
- Applicant has the right under the FCRA to obtain a copy of any consumer report and to dispute the accuracy of information contained in it.
- Approval is not guaranteed. All decisions are based on consistently applied, objective screening criteria.
- Providing false information on this application is grounds for denial or, if tenancy has commenced, termination of tenancy.

All variable information is shown using `[[Token Name]]` placeholders.

1. Applicant and Household Information

Primary Applicant Full Legal Name: [[Primary Applicant Full Legal Name]]
Date of Birth: [[Primary Applicant Date of Birth]]
Social Security Number: [[Primary Applicant SSN]] (last 4 digits: [[Primary Applicant SSN Last 4]] for initial processing)
Driver's License or State ID: [[Primary Applicant DL State and Number]]
Current Phone: [[Primary Applicant Phone]]
Email: [[Primary Applicant Email]]
Current Address: [[Primary Applicant Current Address, City, State, ZIP]]
How long at current address? [[Duration at Current Address]]
Reason for leaving current address: [[Reason for Leaving]]

Co-Applicant / Additional Adult Full Legal Name: [[Co-Applicant Full Legal Name or "N/A"]]
Co-Applicant Date of Birth / SSN / ID: [[Co-Applicant DOB, SSN Last 4, DL Info or "N/A"]]
Co-Applicant Phone / Email: [[Co-Applicant Contact Info or "N/A"]]

All Other Occupants (names, ages, relationship):
[[List all other proposed occupants with ages and relationship to applicant(s), e.g., "Jane Doe, age 12, daughter; John Doe, age 8, son"]]

Total Number of Occupants: [[Total Number of Occupants Including Applicant(s)]]

2. Rental History (Past 3, 5 Years, List Most Recent First)

Current or Most Recent Landlord / Property Manager: [[Current Landlord Name]]
Property Address: [[Current Rental Property Address]]
Monthly Rent: $[[Current Monthly Rent]]
Dates of Tenancy: [[Start Date]] to [[End Date or "Present"]]
Phone / Email for Verification: [[Landlord Phone and Email]]
Reason for Leaving: [[Reason for Leaving Current / Most Recent]]

Previous Landlord / Property Manager: [[Previous Landlord 1 Name]]
Property Address: [[Previous Rental Address 1]]
Monthly Rent: $[[Previous Monthly Rent 1]]
Dates of Tenancy: [[Previous Tenancy 1 Start]] to [[Previous Tenancy 1 End]]
Phone / Email: [[Previous Landlord 1 Phone and Email]]
Reason for Leaving: [[Reason for Leaving Previous]]

Additional Prior Rental (if within 5 years): [[Additional Prior Landlord Name, Address, Dates, Rent, Phone, Reason for Leaving]]

Have you ever been evicted or had an eviction action filed against you? [[Yes / No, If yes, explain dates, location, outcome]]

Have you ever broken a lease or been asked to vacate for reasons other than nonpayment? [[Yes / No, If yes, explain]]

Have you ever filed for bankruptcy? [[Yes / No, If yes, provide chapter, date, and status]]

3. Employment and Income Information

Current Employer: [[Current Employer Name]]
Employer Address: [[Employer Address]]
Position / Title: [[Job Title]]
Supervisor / HR Contact: [[Supervisor or HR Name and Phone]]
Dates of Employment: [[Employment Start Date]] to [[Present or End Date]]
Monthly Gross Income: $[[Monthly Gross Income from This Job]]
Other Income Sources (amount and source): [[Other Income, e.g., "Child support $[[amount]] / month; alimony $[[amount]]"]]

Previous Employer (if current employment < 2 years): [[Previous Employer Name, Position, Dates, Income, Contact]]

Co-Applicant Employment: [[Co-Applicant Employer, Position, Income, Dates or "N/A"]]

Total Combined Monthly Gross Household Income: $[[Total Combined Monthly Gross Income]]

Bank / Financial Institution References (optional but helpful):
- Bank Name: [[Bank Name]], Account Type: [[Checking / Savings]], Approx. Balance: $[[Approximate Balance]]

4. Credit, Criminal, and Background Authorization

By signing below, each Applicant authorizes the Landlord, its agents, or a consumer reporting agency to obtain consumer reports, credit reports, background checks (including criminal records), eviction history, and rental references for the purpose of evaluating this application.

Fair Credit Reporting Act (FCRA) Disclosure:
A consumer report may be obtained in connection with this application. If the application is denied in whole or in part because of information in a consumer report, the Applicant will be provided the name and address of the consumer reporting agency that furnished the report and a statement of the Applicant's rights under the FCRA.

Authorization:
I/we authorize verification of all information provided on this application, including but not limited to credit, income, employment, rental history, criminal background, and references. I/we release all persons and entities from any liability for providing truthful information in response to this authorization.

5. Pets, Vehicles, and Additional Information

Pets (including service/assistance animals):
[[Describe all pets, type, breed, weight, age, number, or "None". Note: assistance animals are permitted as required by law regardless of pet policy.]]

Vehicles to be parked at the property:
[[Year/Make/Model/License of each vehicle or "None"]]

Do you or any household member smoke? [[Yes / No]]

Have you or any household member been convicted of a felony or misdemeanor (other than minor traffic offenses) in the past 7 years? [[Yes / No, If yes, provide details including jurisdiction, charge, date, and disposition]]

Emergency Contact (not residing with you):
Name: [[Emergency Contact Full Name]]
Relationship: [[Relationship]]
Phone: [[Emergency Contact Phone]]
Address: [[Emergency Contact Address]]

6. References (Non-Family Preferred)

Personal / Professional Reference 1:
Name: [[Reference 1 Name]]
Relationship: [[Reference 1 Relationship]]
Phone / Email: [[Reference 1 Phone and Email]]
Years Known: [[Reference 1 Years Known]]

Personal / Professional Reference 2:
Name: [[Reference 2 Name]]
Relationship: [[Reference 2 Relationship]]
Phone / Email: [[Reference 2 Phone and Email]]
Years Known: [[Reference 2 Years Known]]

7. Fair Housing and Nondiscrimination Notice

Landlord complies with the Alaska Human Rights Law (AS 18.80.240) and the federal Fair Housing Act. It is unlawful to discriminate in the rental of housing on the basis of race, color, religion, sex, national origin, marital status, physical or mental disability, or other protected characteristics.

This application will be evaluated using the same objective criteria for all applicants. If you believe you have been discriminated against, you may contact the Alaska State Commission for Human Rights or the U.S. Department of Housing and Urban Development (HUD).

8. Applicant Certification and Signature

I/we certify that all information provided in this Rental Application is true, complete, and accurate to the best of my/our knowledge. I/we understand that any false statement or material omission may result in denial of this application or termination of any tenancy that may result. I/we have read and understand the disclosures and authorizations above.

Primary Applicant Signature: _______________________________ Date: [[Signature Date]]

[[Primary Applicant Printed Name]]

Co-Applicant Signature (if applicable): _______________________________ Date: [[Signature Date]]

[[Co-Applicant Printed Name]]

Additional Adult Occupant Signature (if applicable): _______________________________ Date: [[Signature Date]]

[[Additional Adult Printed Name]], -

Application Processing Notes (For Landlord Use Only)

Application Received: [[Date/Time Received]]
Application Fee Received: $[[Fee Amount]], Method: [[Cash / Check # / Credit Card]]
Screening Ordered: [[Date]]
Consumer Report Received: [[Date]]
Decision: [[Approved / Denied / Conditional, Date]]
Notification to Applicant: [[Date and Method]]

Screening Criteria Summary (attach full criteria if separate):
- Minimum credit score or equivalent: [[Criteria]]
- Income requirement (e.g., 3x rent): [[Criteria]]
- Rental history: [[Criteria]]
- Criminal background: [[Criteria]]
- Other: [[Criteria]]

Notes / Conditions of Approval:
[[Landlord Notes]], -

Alaska Rental Application Statutory Reference

Additional Attachments / Consents

• [[FCRA Summary of Rights (provided separately)]]
• [[Landlord's written screening criteria (if not summarized above)]]
• [[Lead-Based Paint Disclosure and Pamphlet (if pre-1978)]]
• [[Other consents or addenda]], -

Disclaimer

*Template, not professional legal advice. This Alaska Rental Application is a sample form. Landlords should customize screening criteria, fees, and disclosures to comply with current federal and Alaska law (including AS 34.03, AS 18.80, and FCRA). Consult a licensed attorney or property management professional for advice specific to your operations and any local municipal requirements. Laws and best practices change.*

Sources (as of June 2026):
- Alaska Residential Landlord and Tenant Act, AS 34.03.001 et seq.
- Alaska Human Rights Law, AS 18.80
- Fair Credit Reporting Act, 15 U.S.C. § 1681 et seq.
- Federal Fair Housing Act and implementing regulations, -

*End of Alaska Rental Application template.*