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Security Deposit Refund

This free template can be used to document and issue refunds for security deposits. After the tenant has vacated the rental unit, complete this form to determine the amount to be refunded or the amount owed. Line items are included for common repairs where each dollar amount is entered. Total all deductions and subtract from the initial security deposit to determine the amount to be refunded.







Sample Lease Agreement Form
Security Deposit Agreement
Security Deposit Refund Letter




RESIDENT INFORMATION
NAME DATE
ADDRESS APARTMENT #
CITY EMAIL
STATE PHONE


ZIP CODE MOVE IN MOVE OUT

SECURITY DEPOSIT INFORMATION
DEPOSIT PAID DEPOSIT REFUNDED
DATE OF PAYMENT DATE OF REFUND

SECURITY DEPOSIT DEDUCTIONS
UNPAID RENT REPAIRS
PAINTING CLEANING
CARPET OTHER
KEYS TOTAL DEDUCTIONS
LANDLORD'S SECURITY DEPOSIT DISPOSITION STATEMENT TO TENANT


[X] CHECK # _____ IS ENCLOSED FOR THE AMOUNT OF $____________. THANK YOU.

[ ] PLEASE MAKE YOUR CHECK PAYABLE FOR THE AMOUNT OF $ _________ TO _________________________ AND MAIL TO ___________________________________ WITHIN 14 DAYS OF RECEIVING THIS STATEMENT. THANK YOU.

OWNER/LANDLORD/AGENT SIGNATURE


_______________________________________________
SIGNATURE

_______________________________________________
NAME OF OWNER/LANDLORD/AGENT

______________________
DATE






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