V1.108/2016

SECURITYDEPOSITRECEIPTThisContractisIntendedtobeaBindingRealEstateContract

©2016byChicagoAssociationofREALTORS®-AllrightsreservedDateofReceipt:_________________________PropertyAddress:________________________________________________________________DescriptionoftheProperty:________________________________________________________(Ex:2bed,2bathcondo)

Landlord:_________________________________________________________________Tenant:_________________________________________________________________________ReceivedBy:____________________________________________________________________PRINTNAMEofpersonreceivingthesecuritydeposittotransmittoLandlordAcceptedBy:____________________________________________________________________SIGNATUREofpersonreceivingthesecuritydeposittotransmittoLandlordTenantherebyacknowledgesandagreestothefollowing:

1. Tenant provided a security deposit (the “Security Deposit”) payable to Landlord on date listed above in the amount of$______________. Tenant understands and agrees that__________________________________________(“Brokerage”)willnotretaintheSecurityDepositand isacceptingtheSecurityDeposit fromtheTenantsolelytosendthesametotheLandlordtofacilitatethecompletionoftheleasetransaction.

2. THAT LANDLORD IS SOLELY RESPONSIBLE FOR COMPLYING WITH ALL STATE AND LOCAL LAWS AND REGULATIONSRELATING TO THE SECURITY DEPOSIT; AND TENANT HEREBY WAIVES AND RELEASES ALL CLAIMS, KNOWN ANDUNKNOWN, PRESENT AND FUTURE, AGAINST THE BROKERAGE AND ITS AFFILIATES, LICENSEES, SHAREHOLDERS,DIRECTORS, OFFICERS, MEMBERS, MANAGERS, EMPLOYEES, AGENTS, REPRESENTATIVES, SUCCESSORS, AND ASSIGNSFROMANYANDALLCOSTS,EXPENSES,CLAIMS,DEMANDS,LIABILITIES,ANDFEESRELATINGTOORARISINGOUTOFTHESECURITYDEPOSIT.

IacknowledgereceivingacopyofthisSecurityDepositReceiptandagreetotheaboveterms:_________________________________________________________________________SignatureofTenant Date

CopyofCheck(OPTIONAL)