Rental Application from Bill Laughner

                        $35.00 Per Adult  18+  Rental Application     $35.00 Per Adult 18+        

                        $50.00  Married Couple       Cash or Certified Check Only                  $50.00  Married Couple 


Each Occupant Over 18 Years of Age MUST Fill Out a Rental Application    



Return To:     Standing Rock Holdings, LLC  PO BOX 971, Mcmurray PA 15317   Office: (724) 942-4292                                                                                  

First   Name:   MI:                         Last Name:  



Date of Birth:


  Is   this your phone?:
Cell   Phone: Pager: Alternate   Phone:

Whose   Phone?:

List your   Addresses for the Previous 5 years

Current Address:   City,   State, Zip:    
    Owner/Manager:   Phone:   Monthly   Rent:
    Moved In date:   Why   are you moving?    
Previous Address:   City,   State, Zip:    
    Owner/Manager:   Phone:   Monthly   Rent:
    Moved In date:   Moved   out date:    
Previous Address:   City,   State, Zip:    
    Owner/Manager:   Phone:   Monthly   Rent:
    Moved In date:   Moved   out date:    
Employment and   Income

Current Employer:   Address:  

     Position:   Phone: Hire   Date: Hours   worked per week:
 Gross Wages:$ (   ___month ___week ___hour ) What   other income & source?:    
2nd   Job Employer: Phone: Income$   __wk,   __Mon __Hr
Are   You on Section 8?: If   Yes, Have You had your briefing?: If   yes, I have a   BEDROOM   Voucher
How   long will you live here?: ___ 1   yr  ___2 yr  ___ 3 yr + Your   Attorney’s Name:    
Is   the total move-in amount available now?:   Have   you broken a lease?: Are   You a Convicted Felon?:
How   many Evictions have been filed on you?:   What   kind of animals/pets do you have?:    
What   may interrupt your income or ability to pay rent?      

If accepted the following persons will be living with me

1.) 4.)
2.) 5.)
3.) 6.)

Credit References                                                                                                            

           Lender        Purpose of Loan     Balance       Monthly Payment Do   you have a Checking Account?:
1.) Do   you have a Savings Account?:
2.) Do   you own Real Estate?:

EMERGENCY CONTACTS including help to pay rent

                    NAME                                           ADDRESS                                                          PHONE                       RELATIONSHIP

LIST Vehicles & Trailers your household will possess: ______________________________________________________________

HOW DID YOU FIND THIS HOME: (friend, yard sign, etc.) _____________ Your requested move-in date: _____________________

Do You want Rent with Option to Buy or Rent to Own? _________    How much Cash do You Have: $_____________


Other comments   or explanations:


This agreement made this date by and between William J. Laughner, manager for the Owner, hereinafter “Property Manager” and the below signed, hereafter “Applicant”. The Applicant shall pay to the Property Manager nonrefundable fee upon the execution of this agreement in the amount listed on application to cover the administrative costs, expenses, and time of the Property Manager to verify information submitted by the Applicant. Applicant authorizes the Property Manager, his employees, agents, or representatives to make any and all inquiries necessary to verify the information provided herein, including but not limited to direct contact with Applicant’s employer, Property Managers, credit, neighbors, police, government agencies and any and all other sources of information which the Property Manager may deem necessary and appropriate within his sole discretion. The Applicant represents to the Property Manager that the application has been completed in full and all the information provided for herein is true, accurate and complete to the best of the Applicant’s knowledge and further, agrees that if any such information is not as represented, or if the application is incomplete the Applicant may, at the Property Manager’s sole discretion, be disqualified. The Applicant provides the information contained on this form. Property Manager is not liable to the Applicant, his heirs, executors, administrators, or assigns for any damages of any kind, actual or consequential by reason of the verification by the Property Manager of the information provided by the Applicant, and Applicant hereby releases the Property Manager, his agent, employees and representatives from any and all actions, causes of action of any kind or nature that may arise by virtue of the execution or implementation of the agreement provided herein. This property requires a Security Deposit equivalent to one month’s rent plus $50.00 that must be paid in full before any rental agreement is made.  Animal deposit(s) are in addition to security deposit. Applicant, once approved, must obtain renter’s insurance and Property Manager will attempt to contact the Applicant by the phone numbers listed on this application. Applicant has 48 hours from time of approval to fulfill rental agreement by producing all monies required and signing all rental agreement papers. If Applicant fails to perform within 48 hours of Property Manager’s approval, Applicant may be disqualified and Property Manager may rent this home to the next qualified Applicant.

Our required standards for qualifying to rent a home are simple and fair. They are:

–          All homes are offered without regard to race, color, religion, national origin, sex, disability or familial status.

–          Each adult occupant over 18 years of age must submit a completed application and pay application fee.

–          Your gross monthly income must equal approximately three times or more the monthly rent

–          A favorable credit history.

–          Be employed and be able to furnish acceptable proof of the required income.

–          Good references, housekeeping, and property maintenance from your previous Property Managers.

–          Limit the number occupants to 2 per bedroom.

–          Compensating Factors can include additional requirements such as double deposit or rent paid in advance for applicants who fall short of above criteria.


The Applicant authorizes release of all information to Property Manager.  I represent that the information provided in this application is true and correct to the best of my knowledge.  Furthermore, by signing Rental Application I have read, understand and agree to ALL terms and conditions set forth in this application.


I understand that this application is not a rental agreement and that this application does not create any obligation on the Property Manager.




APPLICANT: _____________________________     DATE: _________

OFFICE USE ONLY, Do NOT Write Below This Line

Received By:

App Fee

Viewed Property

Picture ID Copy




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