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Security Deposit Itemization

(Deductions for Repairs, Cleaning and Unpaid Rent)

Date: _________________, _____

To: ____________________

From: ____________________

Property Address: ___________________________________

Rental Period: ______________________________________

1. Security Deposit Received:

$____________________

2. Interest on Deposit (if required by lease or law): $____________________

3. TOTAL CREDIT (sum of lines 1 and 2):

$____________________

4. Itemized Repairs and Related Losses:

_________________________________________________________

Total Repair Cost:

$__________________

5. Necessary Cleaning:

_________________________________________________________

Total Cleaning Cost:

$__________________

6. Defaults in Rent Not Covered by Any Court Judgment (list dates and rates):

_________________________________________________________

Total Rent Defaults:

$__________________

7. Amount of Court Judgment for Rent, Costs, Attorney Fees:

Security Deposit Itemization