Online Rental Application Please fill out as best you can the below application and submit. We will review promptly. Thank you for considering BercoAlaska for your housing needs. Applicant Information First Name Last Name Email Phone Social Security Number Personal Information Birthday Driver's License No. State Present Home Address City State Zip Length of Time Reason For Moving Landlord Name Landlord Phone Number Previous Home Address City State Zip Length of Time Reason For Moving Landlord Name Landlord Phone Number Describe each and every person who will occupy the residence Name Name Name Name Pets Will you have any pets? YesNo If yes, please describe List ALL Automobiles and Any Other Vehicles Make 1 Model 1 Year 1 License Number 1 Make 2 Model 2 Year 2 License Number 2 Present Occupation Present Occupation Employer Name Length of Time Phone Number Address Name of Supervisor Previous Occupation Previous Occupation Employer Name Length of Time Phone Number Address Name of Supervisor Income Current Gross Income Per WeekMonthYear Financial History Have you ever filed for bankruptcy? YesNo If yes, date bankruptcy was filed Have you ever been evicted or asked to move? YesNo If yes, please describe Emergency Contact Name Phone Number City Relationship Applicant represents that all the above statements are true and correct and hereby authorizes landlord/agent to verify the above items including, but not limited to, the obtaining of a credit report and agrees to furnish additional credit references upon request.
