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Deposit Receipt & Agreement
RECEIVED on [Date] from [Name] of [Address], hereinafter referred to as "Applicant", the sum of [$------] for the purpose of verifying information submitted on the application and for holding the rental dwelling commonly known as [Enumerate] until [Date] or such earlier time as the undersigned owner/manager is able to complete a verification of the information submitted to on the Applicant's rental application.
This dwelling will be rented to the Applicant provided that
(a) The applicant's rental application and credit history satisfy the owner;
(b) Within 24 hours of being approved, the Applicant signs the rental agreement offered by the Owner/Manager, a copy of which the Applicant has received, read and approved; and
(c) Within 24 hours of being approved, the Applicant pays all the sums necessary to move in.
Should the applicant be approved to rent this dwelling and meet all three of the conditions above, this entire deposit will be refunded except for the sum of [$------], which shall be used to pay for verification of the Applicant's rental application.
Should the Applicant be approved to rent this dwelling and not do so, none of this deposit will be refunded.
Should the Applicant not be approved to rent this dwelling, the Owner/Manager will refund all of this deposit except for the sum [$------], which shall be used to pay for verification of the Applicant's rental application.
Neither party has made any representations nor promises, other than those contained in this agreement or in some further writing signed by the party making the representation or promise.
The parties agree to execute and deliver any other instruments necessary to effectuate this Agreement.
IN WITNESS WHEREOF, the parties have executed this agreement the day and year as first above written at [City], [State].
Time: 00.00 A.M./P.M.
This Section for Notary:
STATE OF -------)
) ss: [date]
COUNTY OF ------)
On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
[Name of Notary Public]
My commission expires: [date]