Legal Forms
Security Deposit Itemized Return
Statement
This statement accounts for the security deposit of $ held for ("Tenant") for the premises at . Tenancy ended on , 20.
Parties
Landlord / Agent
Tenant Forwarding Address
Move-Out Date
Original Deposit ($)
Amount Refunded
Amount Refunded to Tenant ($)
Refund Method
Check enclosed
Electronic transfer
Balance due from tenant (deductions exceed deposit)
Landlord / Agent Signature
Confidential ยท Legal FormsSecurity Deposit Itemized Return