Date: _________________, 20___
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. Amount Owed (line 3 minus the sum of lines 4 and 5)
___ a. Total Amount Tenant Owes Landlord: $____________________
___ b. Total Amount Landlord Owes Tenant: $____________________
Comments:
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
