Notice Of Intention To Impose Claim On Security Deposit Page 3
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4NOTICE OF INTENTION
TO IMPOSE CLAIM ON SECURITY DEPOSIT
__________________________________________
(date
____________________________________________
(names of all residents)
____________________________________________
(Apartment street address & number)
____________________________________________
(city, county, state, zip)
This is a notice of Landlord’s intention to impose a claim for damages upon your security deposit
as indicated below. It is sent to you as required by Section 83.49(3), Florida Statutes. You are
hereby notified that you must object in writing to this deduction from your security deposit within
15 days from the time you receive this notice or the landlord will be authorized to deduct its
claim from your security deposit. Your objection must be sent to the landlord at the address
shown below.
_____________________________
________________________________
(community name)
(signature)
_____________________________
________________________________
(street address)
(name and title)
_____________________________
________________________________
(city)
(telephone number)
Amount of Security Deposit
$ _______________
Interest (if due)
$ _______________
Total security deposit and interest (if due)
$
_________________
Less damages and rent due:
_______________________________________
$ ______________
_______________________________________
$ ______________
_______________________________________
$ ______________
_______________________________________
$ ______________
_______________________________________
$ ______________
Total damages and rent due:
$
_________________
Total due to:
[ ] landlord
$
_________________
[ ] tenant
$
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