Non-Refundable Holding Deposit Form

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NON-REFUNDABLE HOLDING DEPOSIT
I, _________________,_____________________ received $__________representing the
a non-refundable holding deposit for _______________Apt#___, Chicago, Illinois. This
holding deposit shall be credited to tenant’s security deposit upon move-in. It will be
deposited into __________________Bank. However, if tenant does not move in for any
reason, other than Landlord’s decision not to rent the apartment, this holding deposit shall
be forever forfeited and shall not be refunded. Lastly, I retain the right to not rent to this
apartment for any reason and in my own sole discretion, however, if I so exercise my
discretion not to rent this apartment I will return the holding deposit in full.
____________________, __________
Landlord Signature
Date
By my signature(s) below, I request that the landlord accept $_______ as a holding
deposit for _________________ Apt#___ , and the payment of such deposit shall result
in the Landlord not accepting any other tenant(s) for rental of this apartment up and until
the commencement of my lease on __________. I understand that this deposit will be
credited to my security deposit when I move in.
I further understand and agree that if I should change my mind or become unable to move
in for any reason, other than Landlord exercising discretion not to rent the apartment, this
holding deposit will be forfeited by me, and I will receive no refund of the deposit.
Monthly rent per lease will be due upon move in the amount of $__________.
I acknowledge and agree by my signature below that the additional security deposit I will
owe at the time of move in is calculated as follows:
Total security Deposit Per Lease of $__________.
Less Holding Deposit of $__________
Equals $_________, which is the amount of security deposit due upon move in.
Lastly, I agree and acknowledge that Landlord may choose not to rent to me for any
reason, however, upon Landlord so electing not to rent to me, I will be entitled to a full
refund of the holding deposit .
____________________, __________
Tenant 1 Signature
Date
___________________, __________
Tenant 2 Signature
Date

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