Fill Out Your Alaska F 3 Form Customize Alaska F 3

Fill Out Your Alaska F 3 Form

The Alaska F 3 form is a Personal History Statement required by the Alaska Police Standards Council (APSC) for individuals seeking certification as law enforcement officers. This form plays a crucial role in the background investigation process, helping to determine an applicant's suitability for the position. Completing this form accurately and thoroughly is essential, as it directly impacts the outcome of your application.

Ready to fill out the Alaska F 3 form? Click the button below to get started!

Alaska F 3 Sample

Alaska Police Standards Council

PO Box 111200

Juneau, Alaska 99811

Instructions to the Applicant

The information you provide in this Personal History Statement will be used in the background investigation to assist in determining your suitability for the position of an APSC Certified Officer, in accordance with Alaska Police Standards Council (APSC) regulations.

Please confirm this version is the most current version by checking APSC website: https://dps.alaska.gov/APSC/Agency-Forms

It is your responsibility to complete this form and provide all required information.

If filling out hardcopy, please fill out form in blue or black ink or type as indicated by the agency. Do not use pencil.

You must respond to all items and questions. If a question does not apply to you, write “N/A” (not applicable) in the space provided for your response.

If you need more space for any response, use the last page of this form (page 27) and identify the additional information by the question number.

Send the completed form to your background investigator or the agency to which you are applying. Do NOT send the form to APSC.

Disqualification

There are very few automatic bases for rejection. Even issues of prior misconduct, such as prior illegal drug use, driving under the influence, theft, or even arrest or conviction are usually not, in and of themselves, automatically disqualifying. However, deliberate misstatements or omissions can and often will result in your application being rejected, regardless of the nature or reason for the misstatements/omissions. In fact, the number one reason individuals “fail” background investigations is because they deliberately withhold or misrepresent job-relevant information from their prospective employer.

BOTTOM LINE: You are responsible for providing complete, accurate, and truthful responses.

Disclosure of Medically-Related Information

In accordance with the U.S. Americans with Disabilities Act, and the Genetic Information Nondiscrimination Act (GINA), applicants are not expected or required to reveal any medical or other disability-related information about themselves or their family members in response to questions on this form.

I have read and I understand the above instructions.

Signature: _________________________________________________ Date: ________________________

APSC Form F-3

Page 2

SECTION 1: PERSONAL

1.YOUR FULL NAME

LAST

FIRST

MIDDLE

2.OTHER NAMES YOU HAVE USED OR BEEN KNOWN BY (INCLUDE MAIDEN NAME AND NICKNAMES)

3.ADDRESS WHERE YOU LIVE

NUMBER / STREET

APT / UNIT

N/A

CITY

STATE

ZIP

4.MAILING ADDRESS, IF DIFFERENT FROM ABOVE (FOR EXAMPLE, PO BOX)

5.CONTACT NUMBERS

 

CELL

WORK

HOME

OTHER

TYPE:

 

 

 

 

 

 

6. CONTACT EMAIL

 

7. LIST ALL OTHER EMAIL ADDRESSES (SEPARATED BY COMMAS)

 

Attach a copy of birth certificate or passport or if applicable certification of naturalization (mandatory)

8. CITIZENSHIP

Are you a U.S. citizen?

Yes

No

IF NATURALIZED, provide your certificate number and date, place, and court naturalized

 

 

9.BIRTH PLACE (CITY / COUNTY / STATE / COUNTRY) 10. BIRTHDATE (MM/DD/YYYY) 11. SOCIAL SECURITY NUMBER 12. DRIVER’S LICENSE

NUMBER:

STATE:

EXPIRES:

13. PHYSICAL DESCRIPTION

 

EYE COLOR:

HEIGHT:

WEIGHT:

HAIR COLOR:

13.1SCARS, MARKS, AND TATOOS (include removed or altered tatoos)

SECTION 2: RELATIVES AND REFERENCES

14.IMMEDIATE FAMILY

Provide all applicable information in the spaces below. • Mark “Deceased,” if appropriate. Mark "N/A" if a category is not applicable

If more spaced is needed, use Section 15 or continue on page 27 – reference corresponding numbers.

14.A

Spouse / Domestic Partner / Boyfriend / Girlfriend / Significant

Other

 

Deceased

 

 

N/A

NAME

HOME ADDRESS (NUMBER / STREET / APT)

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF MARRIAGE/REGISTRATION

BIRTHDATE (MM/DD/YYYY)

Is there, or has there ever been, a civil or criminal restraining or stay-away

 

 

 

(MM/YYYY)

 

 

 

 

 

order in effect involving you and this individual?

Yes

No

 

 

 

 

 

 

 

 

 

14.B

Former Spouse/Domestic Partner/Significant Other or Boyfriend/Girlfriend dated longer than three months

Deceased

 

 

N/A

NAME

HOME ADDRESS (NUMBER / STREET / APT)

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF MARRIAGE/REGISTRATION

BIRTHDATE (MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

DATE OF DISSOLUTION

Is there, or has there ever been, a civil or criminal restraining or stay-away

 

 

 

 

 

 

 

(MM/YYYY)

 

No

 

 

(MM/YYYY)

 

order in effect involving you and this individual?

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

Page 3

SECTION 2: RELATIVES AND REFERENCES continued

14.C Parents / Guardians

List ALL parents/guardians, living or deceased, including biological, adoptive, foster, step-parents, in-laws, etc.

14.C.1 Parent / Guardian:

Mother

Father

Step-mother

Step-father

In-law

Other:

 

Deceased

NAME

 

HOME ADDRESS (NUMBER / STREET / APT)

 

CITY

 

STATE

ZIP

HOME PHONE

MAILING ADDRESS (IF DIFFERENT)

CITY

STATE ZIP

WORK PHONE

CELL PHONE

EMAIL

14.C.2 Parent / Guardian:

Mother

Father

Step-mother

Step-father

In-law

Other:

 

Deceased

NAME

 

HOME ADDRESS (NUMBER / STREET / APT)

 

CITY

 

STATE

ZIP

HOME PHONE

MAILING ADDRESS (IF DIFFERENT)

CITY

STATE ZIP

WORK PHONE

CELL PHONE

EMAIL

14.C.3 Parent / Guardian:

Mother

 

Father

Step-mother

Step-father

In-law

Other:

 

 

 

 

 

 

 

 

 

NAME

 

HOME ADDRESS (NUMBER / STREET / APT)

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

 

MAILING ADDRESS (IF DIFFERENT)

 

 

 

CITY

 

Deceased

STATE ZIP

STATE ZIP

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

14.C.4 Parent / Guardian:

Mother

Father

Step-mother

Step-father

In-law

Other:

 

Deceased

NAME

 

HOME ADDRESS (NUMBER / STREET / APT)

 

CITY

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

MAILING ADDRESS (IF DIFFERENT)

 

 

CITY

 

STATE

ZIP

WORK PHONE

CELL PHONE

EMAIL

14.D Brothers / Sisters

List ALL LIVING siblings, including half-siblings, step-siblings, foster-siblings, etc.

N/A

14.D.1 Sibling:

Brother

Sister

Half-brother

Half-sister

Other:

 

 

 

NAME

 

 

AGE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

 

MAILING ADDRESS (IF DIFFERENT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

 

 

CELL PHONE

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.D.2 Sibling:

Brother

Sister

Half-brother

Half-sister

Other:

 

 

 

NAME

 

 

AGE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

 

MAILING ADDRESS (IF DIFFERENT)

 

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

 

 

CELL PHONE

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

 

APSC Form F-3

 

 

 

 

 

 

 

Page 4

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 2: RELATIVES AND REFERENCES continued

 

 

 

 

 

 

 

 

14.D.3

Sibling:

Brother

Sister

Half-brother

Half-sister

Other:

 

 

 

 

 

NAME

 

 

 

 

AGE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

 

MAILING ADDRESS (IF DIFFERENT)

 

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

 

 

CELL PHONE

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.D.4

Sibling:

Brother

Sister

Half-brother

Half-sister

Other:

 

 

 

 

 

NAME

 

 

 

 

AGE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

 

 

MAILING ADDRESS (IF DIFFERENT)

 

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WORK PHONE

 

 

CELL PHONE

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.E Children

N/A

List ALL LIVING children, including natural, adopted, step, and/or foster care. Include any other children who reside with you. Provide the name and contact information of the custodial parent/guardian, if other than you.

14.E.1 Child:

Son

Daughter

Other:

Biological Parents:

 

 

 

 

NAME

 

 

AGE

 

 

CUSTODIAL PARENT/GUARDIAN (IF OTHER THAN YOU)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

ADDRESS (NUMBER / STREET / APT)

 

CITY

 

STATE

 

ZIP

 

CONTACT NUMBER

EMAIL

14.E.2 Child:

Son

Daughter

Other:

Biological Parents:

 

 

 

 

NAME

 

 

AGE

 

 

CUSTODIAL PARENT/GUARDIAN (IF OTHER THAN YOU)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

 

ADDRESS (NUMBER / STREET / APT)

 

CITY

 

STATE

 

ZIP

 

CONTACT NUMBER

EMAIL

14.E.3 Child:

Son

Daughter

 

Other:

 

Biological Parents:

 

 

NAME

 

 

AGE

 

CUSTODIAL PARENT/GUARDIAN (IF OTHER THAN YOU)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

 

ADDRESS (NUMBER / STREET / APT)

 

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.E.4 Child:

Son

Daughter

Other:

 

Biological Parents:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME

 

 

AGE

CUSTODIAL PARENT/GUARDIAN (IF OTHER THAN YOU)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH

 

 

 

ADDRESS (NUMBER / STREET / APT)

 

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

Page 5

SECTION 2: RELATIVES AND REFERENCES continued

15.LIST OF REFERENCES

List at least 5 people who know you well, such as close personal relationships, social and family friends, former spouses and significant others, teachers, military colleagues, and/or co-workers. Do NOT include relatives, employers, housemates, or any individuals listed elsewhere.

 

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

 

15.1

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

 

 

 

 

EMAIL

 

 

 

WORK PHONE

CELL PHONE

 

 

 

 

 

 

 

STATE ZIP

STATE ZIP

How do you know this person?

How long have you known this person?

15.2

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

How long have you known this person?

15.3

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

How long have you known this person?

15.4

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

 

 

How long have you known this person?

 

 

 

 

 

 

 

 

 

 

15.5

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

 

 

How long have you known this person?

 

 

 

 

 

 

 

 

 

 

15.6

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE ZIP

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

WORK PHONE

CELL PHONE

EMAIL

How do you know this person?

How long have you known this person?

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

Page 6

SECTION 2: RELATIVES AND REFERENCES continued

 

 

 

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

15.7

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

 

 

How long have you known this person?

 

 

 

 

 

 

 

 

 

 

 

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

15.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

 

 

How long have you known this person?

 

 

 

 

 

 

 

 

 

 

 

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE

ZIP

15.9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

WORK PHONE

CELL PHONE

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

How do you know this person?

 

 

How long have you known this person?

 

 

 

 

 

 

 

 

 

 

15.10

NAME OF REFERENCE

HOME ADDRESS (NUMBER / STREET / APT)

CITY

STATE ZIP

HOME PHONE

MAILING ADDRESS (NUMBER / STREET / SUITE)

CITY

STATE ZIP

WORK PHONE

CELL PHONE

EMAIL

How do you know this person?

How long have you known this person?

SECTION 3: EDUCATION

You will be required to furnish unopened official transcripts or other proof to support all of your educational claims before hire or certification.

If more space is needed, continue your response on page 27.

16. CHECK APPLICABLE

MM/YYYY

High School Diploma:

MM/YYYY

GED:

WHAT LANGUAGE(S) DO YOU SPEAK?

17.LIST HIGH SCHOOL(S) ATTENDED

NAME OF HIGH SCHOOL

17.1

PUBLIC/PRIVATE OR HOMESCHOOL?

CITY

FROM (MM/YYYY)

TO (MM/YYYY)

STATE

NAME OF HIGH SCHOOL

17.2

PUBLIC, PRIVATE, OR HOMESCHOOL?

CITY

FROM (MM/YYYY)

TO (MM/YYYY)

STATE

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

Page 7

SECTION 3: EDUCATION continued

18.LIST ALL COLLEGES AND UNIVERSITIES ATTENDED

 

NAME OF COLLEGE/UNIVERSITY

FROM (MM/YYYY)

TO (MM/YYYY)

TOTAL UNITS COMPLETED

 

18.1

 

 

 

 

 

 

 

QTR SYSTEM

SEM SYSTEM

 

 

 

 

 

 

 

 

 

 

ADDRESS (NUMBER / STREET)

 

 

 

 

TYPE OF DEGREE EARNED

 

CITY

STATE

ZIP

MAJOR / AREA OF STUDY

18.2

NAME OF COLLEGE/UNIVERSITY

ADDRESS (NUMBER / STREET)

FROM (MM/YYYY)

TO (MM/YYYY)

TOTAL UNITS COMPLETED

QTR SYSTEM SEM SYSTEM TYPE OF DEGREE EARNED

CITY

STATE

ZIP

MAJOR / AREA OF STUDY

18.3

NAME OF COLLEGE/UNIVERSITY

ADDRESS (NUMBER / STREET)

FROM (MM/YYYY)

TO (MM/YYYY)

TOTAL UNITS COMPLETED

QTR SYSTEM SEM SYSTEM TYPE OF DEGREE EARNED

CITY

STATE

ZIP

MAJOR / AREA OF STUDY

18.4

NAME OF COLLEGE/UNIVERSITY

ADDRESS (NUMBER / STREET)

FROM (MM/YYYY)

TO (MM/YYYY)

TOTAL UNITS COMPLETED

QTR SYSTEM SEM SYSTEM TYPE OF DEGREE EARNED

CITY

STATE

ZIP

MAJOR / AREA OF STUDY

19.LIST ALL TRADE, VOCATIONAL, AND BUSINESS SCHOOLS / INSTITUTES ATTENDED

19.1

NAME OF TRADE, VOCATIONAL, OR BUSINESS SCHOOL/INSTITUTE

CITY

FROM (MM/YYYY)

TO (MM/YYYY)

DID YOU COMPLETE THE COURSE?

 

 

Yes

No

STATE TYPE OF SCHOOL OR TRAINING

 

19.2

NAME OF TRADE, VOCATIONAL, OR BUSINESS SCHOOL/INSTITUTE

CITY

FROM (MM/YYYY)

TO (MM/YYYY)

DID YOU COMPLETE THE COURSE?

 

 

Yes

No

STATE TYPE OF SCHOOL OR TRAINING

 

20. Have you ever taken an Arrest and/or Firearms Course?

 

 

Yes

No

IF YES, provide the following information:

 

 

 

 

 

 

 

 

 

 

 

A. COURSE PRESENTER NAME

LOCATION (CITY / STATE)

 

 

 

 

 

 

 

B. COURSE COMPLETION

 

 

COMPLETION DATE (MM/YYYY)

 

Did you successfully complete the course?

Yes

No

 

 

 

 

 

 

 

21. Have you ever attended a Basic Law Enforcement Academy: Police, Corrections, Probation/Parole, Village Police

......................

Yes

No

IF YES, provide the following information:

 

 

 

 

21.1

NAME OF ACADEMY

LOCATION (CITY, STATE)

FROM (MM/YYYY)

TO (MM/YYYY)

NAME OF TRAINING OFFICER / ACADEMY COORDINATOR

DID YOU PASS/GRADUATE?

Yes No

CONTACT NUMBER

21.2

NAME OF ACADEMY

LOCATION (CITY, STATE)

FROM (MM/YYYY)

TO (MM/YYYY)

NAME OF TRAINING OFFICER / ACADEMY COORDINATOR

DID YOU PASS/GRADUATE?

Yes No

CONTACT NUMBER

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

Page 8

SECTION 3: EDUCATION continued

22.Have you ever been subject to any disciplinary action, including academic probation, civil fine, suspension, expulsion, or resignation

from any high school(s), college/university, business, trade school, or basic course/academy?

Yes

No

IF YES, describe in detail below. Starting with high school, list any and all disciplinary actions received in any school, educational institution, or basic course. Include when the disciplinary action(s) occurred, name of school(s), and explanation of circumstances.

SECTION 4: RESIDENCE HISTORY

23.LIST OF RESIDENCES

List all residences during the last 10 years or since age 15.

Provide complete addresses (include markers such as Street, Drive, Road, East, West, etc., and unit/apt number). Do NOT use PO Boxes.

If the residence is a military base, identify name of base in address, nearest city, state, and zip code. Do NOT list military barracks mates unless you shared individual quarters.

If more space is needed, continue your response on page 27.

ADDRESS WHERE YOU NOW LIVE (NUMBER / STREET / APT)

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

23.1

 

 

 

 

Present

 

 

 

 

 

CITY

STATE

ZIP

IF RENTING: PROPERTY MANAGER, RENT COLLECTOR, OR OWNER

MAILING ADDRESS OF PROPERTY MANAGER, RENT COLLECTOR, OR OWNER (NUMBER / STREET / APT / PO BOX)

CONTACT NUMBER

CITY

STATE

ZIP

EMAIL

 

 

Name(s) of those with whom you live:

 

 

 

 

 

FORMER ADDRESS (NUMBER / STREET / APT)

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

23.2

 

 

 

 

 

CITY

STATE

ZIP

IF RENTING: PROPERTY MANAGER, RENT COLLECTOR, OR OWNER

MAILING ADDRESS OF PROPERTY MANAGER, RENT COLLECTOR, OR OWNER (NUMBER / STREET / APT / PO BOX)

CONTACT NUMBER

CITY

STATE

ZIP

EMAIL

 

 

Name(s) of those with whom you lived:

 

 

 

 

 

Reason for moving:

 

 

 

 

 

FORMER ADDRESS (NUMBER / STREET / APT)

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

23.3

 

 

 

 

 

CITY

STATE

ZIP

IF RENTING: PROPERTY MANAGER, RENT COLLECTOR, OR OWNER

MAILING ADDRESS OF PROPERTY MANAGER, RENT COLLECTOR, OR OWNER (NUMBER / STREET / APT / PO BOX)

CONTACT NUMBER

CITY

STATE

ZIP

EMAIL

 

 

Name(s) of those with whom you lived:

 

 

 

 

 

Reason for moving:

 

 

 

 

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

APSC Form F-3

 

 

 

 

Page 9

SECTION 4: RESIDENCE HISTORY continued

 

 

 

 

 

FORMER ADDRESS (NUMBER / STREET / APT)

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

23.4

 

 

 

 

 

CITY

STATE

ZIP

IF RENTING: PROPERTY MANAGER, RENT COLLECTOR, OR OWNER

MAILING ADDRESS OF PROPERTY MANAGER, RENT COLLECTOR, OR OWNER (NUMBER / STREET / APT / PO BOX)

CONTACT NUMBER

CITY

STATE

ZIP

EMAIL

 

 

Name(s) of those with whom you lived:

 

 

 

 

 

Reason for moving:

 

 

 

 

 

FORMER ADDRESS (NUMBER / STREET / APT)

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

23.5

 

 

 

 

 

CITY

STATE

ZIP

IF RENTING: PROPERTY MANAGER, RENT COLLECTOR, OR OWNER

MAILING ADDRESS OF PROPERTY MANAGER, RENT COLLECTOR, OR OWNER (NUMBER / STREET / APT / PO BOX)

CONTACT NUMBER

CITY

STATE

ZIP

EMAIL

 

 

Name(s) of those with whom you lived:

 

 

 

 

 

Reason for moving:

 

 

 

 

 

24.LIST OF HOUSEMATES

Provide contact information for all housemates listed in Question 23 with whom you have resided during the past 10 years or since age 15.

Do NOT list anyone for whom you have already provided contact information.

If more space is needed, continue your response on page 27.

NAME OF HOUSEMATE

 

CONTACT NUMBER

 

24.1

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

STATE

ZIP

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

NAME OF HOUSEMATE

 

CONTACT NUMBER

 

24.2

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

STATE

ZIP

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

NAME OF HOUSEMATE

 

CONTACT NUMBER

 

24.3

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

STATE

ZIP

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

NAME OF HOUSEMATE

 

CONTACT NUMBER

 

24.4

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

STATE

ZIP

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

 

 

APSC Form F-3

 

 

Page 10

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 4: RESIDENCE HISTORY continued

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24.5

NAME OF HOUSEMATE

 

 

CONTACT NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

 

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF HOUSEMATE

 

 

CONTACT NUMBER

 

 

 

24.6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

 

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF HOUSEMATE

 

 

CONTACT NUMBER

 

 

 

24.7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT ADDRESS IF DIFFERENT (NUMBER / STREET / APT)

CITY

 

 

STATE

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

NATURE OF RELATIONSHIP (E.G., RELATIVE, LANDLORD, FRIEND, HOUSEMATE ONLY, ETC.)

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25. Have you ever been evicted or asked to leave a residence?

 

 

 

 

Yes

No

 

 

 

 

 

26. Have you ever left a residence with unpaid damage, owing rent, utilities, or other household expenses?

Yes

No

 

 

 

 

 

 

 

 

 

If you answered “YES” to Questions 25 and/or 26, explain (include when, where, and circumstances):

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 5: EXPERIENCE AND EMPLOYMENT

27.JOB EXPERIENCE

List ALL jobs you have had in last 10 years, including part-time, temporary, self-employment, and volunteer. (Begin with your most current.)

If you have military experience, including guard or reserve duty, enter your military base, assignments, or unit of assignment. A separate block is used for each change of duty station and/or deployment.

List ALL periods of unemployment in excess of 30 days. If more space is needed, continue your response on page 27.

If you cannot locate the information, explain all efforts your have made to find it on page 27.

 

27.1

NAME OF CURRENT EMPLOYER OR MILITARY UNIT

 

 

 

 

 

 

 

FROM (MM/YYYY)

TO (MM/YYYY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS (NUMBER / STREET / SUITE / OR BASE)

 

 

 

 

 

 

SUPERVISOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

STATE

ZIP

 

CONTACT NUMBER

 

 

EXT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

JOB TITLE / RANK

 

 

 

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DUTIES / ASSIGNMENTS

 

 

 

TYPE OF

EMPLOYMENT (CHECK ALL THAT APPLY)

 

 

 

 

 

 

 

 

FT

 

PT

Temp

Self-employed

Volunteer

 

 

 

 

 

 

 

 

 

 

 

 

 

NAMES OF CO-WORKERS AND PHONE NUMBER

 

 

 

REASON FOR WANTING TO LEAVE

 

 

 

 

 

1)

2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is there any reason this employer may make negative statements about you if contacted?

 

 

 

 

Yes

No

 

 

IF YES, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ver. 11/22/2019

Initial here to verify you have provided complete and accurate information:

Common mistakes

  1. Not Using the Correct Ink Color: Applicants often forget to fill out the form in blue or black ink. Using pencil or other colors can lead to rejection.

  2. Leaving Questions Blank: It is crucial to answer all questions. If a question does not apply, write “N/A.” Leaving questions unanswered can raise red flags.

  3. Incorrectly Listing Personal Information: Mistakes in names, addresses, or dates can cause confusion. Double-check all personal details before submission.

  4. Failing to Provide Required Documents: Applicants must attach a copy of their birth certificate, passport, or naturalization certification. Missing documents can delay the process.

  5. Not Updating Contact Information: If your contact numbers or email addresses change, make sure to update them on the form. Incorrect information can hinder communication.

  6. Omitting Important Family Information: Be thorough when listing relatives and references. Missing a family member or reference can lead to complications in the background check.

  7. Providing Inaccurate or Misleading Information: Deliberate misstatements or omissions can lead to disqualification. Always be honest and accurate in your responses.

Detailed Steps for Filling Out Alaska F 3

Filling out the Alaska F 3 form is an important step in your application process. This form gathers personal information that will be used in your background investigation. It’s essential to provide complete and accurate details to avoid any issues with your application. Follow these steps carefully to ensure you fill out the form correctly.

  1. Start with your full name. Fill in your last name, first name, and middle name.
  2. If you have used other names, such as a maiden name or nickname, list them in the next section.
  3. Provide your current address, including the number, street, apartment/unit, city, state, and ZIP code.
  4. If you have a different mailing address, include that information as well.
  5. List your contact numbers, including cell, work, home, and any other type of number.
  6. Enter your email address and any other email addresses you may have, separated by commas.
  7. Attach a copy of your birth certificate, passport, or certification of naturalization.
  8. Indicate whether you are a U.S. citizen. If you are naturalized, provide your certificate number and the date, place, and court of naturalization.
  9. Fill in your birth place, birthdate, and social security number.
  10. Provide your driver's license number, state, and expiration date.
  11. Describe your physical features, including eye color, height, weight, and hair color.
  12. List any scars, marks, and tattoos, including any that have been removed or altered.
  13. In the relatives and references section, provide information about your immediate family, marking “Deceased” or “N/A” as appropriate.
  14. Include details about your parents or guardians, and any siblings, noting if they are living or deceased.
  15. List your children, including their names, ages, and custodial parent/guardian information if applicable.
  16. Finally, list at least five references who know you well, ensuring they are not relatives or individuals listed elsewhere.
  17. Sign and date the form to confirm that you have read and understood the instructions.

Once you have completed the form, review it for any errors or missing information. Then, submit the form to your background investigator or the agency to which you are applying. Remember, do not send it to APSC directly.

Dos and Don'ts

When filling out the Alaska F-3 form, it's crucial to follow specific guidelines to ensure your application is processed smoothly. Here are ten important dos and don’ts to keep in mind:

  • Do confirm that you are using the most current version of the form by checking the APSC website.
  • Do complete all sections of the form thoroughly and accurately.
  • Do use blue or black ink if filling out a hardcopy form; typing is also acceptable.
  • Do write “N/A” for any questions that do not apply to you.
  • Do attach a copy of your birth certificate, passport, or naturalization certification as required.
  • Don’t use pencil to fill out the form.
  • Don’t withhold or misrepresent any information; this could lead to disqualification.
  • Don’t send the completed form to APSC; instead, submit it to your background investigator or the applying agency.
  • Don’t forget to include all required contact information for relatives and references.
  • Don’t disclose any medical or disability-related information about yourself or family members unless specifically asked.

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