Holding Deposit Receipt

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HOLDING DEPOSIT RECEIPT
Move-In Date: _____________________________
Applicant’s Name: ___________________________________Phone#:_____________________
Current Address: ________________________________________________________________
The applicant agrees to rent housing accommodations located at: ________________________
___________________________________________________ (street/apt#/city/state/zip code)
for a period of one year from scheduled move-in-date. The applicant posts a holding deposit in
the amount of $___________. This holding deposit shall be applied toward the tenant’s
security deposit after the application process is complete and the prospect is approved for
residency. In the event the application for residency is not approved or if the residence is not
ready for occupancy, the deposit will be returned to the applicant. If the applicant fails to sign
the rental agreement, fails to provide additional funds required for occupancy, or does not take
occupancy on the scheduled move-in-date above, all of the holding deposit will be retained by
the owner/manager.
By signing below, applicant acknowledges receipt of a copy of this notice.
Date: ____________________ Monies received $_______________ by check #______________
SCREENING DISCLOSURE
1. Disclosure. The owner intends to investigate the information that you have set forth on your application.
This may include obtaining a credit report or other report from a credit bureau or tenant screening service
confirming information that you have set forth in your application. The landlord may also contact prior
landlords, employers, financial institutions, and personal references.
2. Screening Fees. Before the owner will conduct this review of your application, you must pay a tenant
screening fee. The owner/manager charges a fee of $_______. The owner/manager acknowledges
receipt of this fee. This fee represents payment for costs incurred for a credit report or other screening
report, long-distance phone calls, and for time spent calling landlords, employers, financial institutions
and personal references.
3. Applicant Rights. You have a right to dispute the accuracy of the information provided by the tenant
screening service, credit bureau, or the entities listed on your application who will be contacted for
information about you. The credit bureau utilized by the corporation is Experian and/or Transunion.
4. Copy Received. By signing below, applicant acknowledges receipt of a copy of this notice.
Applicant____________________________________________ Date: ____________________________________
Applicant_____________________________________________ Date:____________________________________
Manager_____________________________________________ Date: ____________________________________

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