Notice To Impose A Claim On Security Deposit Form (Page 2 of 2) in pdf

Notice To Impose A Claim On Security Deposit Form Page 2

(Tenant's Name and Address)

Dear ______________________________

(Tenant's Name)

Th is is a notic e of my in ten tion to imp o se a c laim f or d a ma g es in the amo un t of

$ ____________________________ upon your security deposit due to _____________________________

(insert amount of damages)

______________________________________________________________________________________

(insert damage done to premises or other reason for claiming security deposit)

This notice is sent to you as required by §83.49(3), Florida Statutes. You are hereby notified that you must

object inwriting to this deduction from your security deposit within 15 days from the time you receive this

notice or I will b e authorized to deduct my clai m from your security deposit. Your objection must

be sent to

______________________________________________________________________________________

(insert Landlord's address)

Landlord's Name ____________________________________

Address ___________________________________________

Phone Number ______________________________________

Approved for use under rule 10-2.1(a) of

the Rules Regulating The Florida Bar

The Florida Bar 2010

This form was completed

with the assistance of

Name:

Address:

Telephone Number:

FORM 12

Notice To Impose A Claim On Security Deposit Form Page 2