SECURITY DEPOSIT SETTLEMENT
Property Name:______
Name: / Apartment #:New Add.:
Resident Electric Account Close Date:
Move-in Date: / Non-Refundable Fee:
Move-out Date: / Non-Refundable Pet Fee:
Lease Expiration Date: / Refundable Security Deposit
Total
TOTAL AMOUNT OF REFUNDABLE DEPOSITS______
Kitchen
Replace Lights, Light Covers______
Replace Broiler Pan______
Replace Drip Pans______
Cleaning: Stove, Oven Fridge, Floor, Cabinets______
Miscellaneous: ______
Bathroom(s)
Replace Lights, Light Covers______
Replace Towel Racks______
Cleaning: Tub, Sink, Toilet, Floor______
Miscellaneous: ______
Bedroom (1)
Replace Lights, Light Covers______
Cleaning: Windows, Blinds, Heater______
Miscellaneous: ______
Bedroom (2)
Replace Lights, Light Covers______
Cleaning: Windows, Blinds, Heater______
Miscellaneous: ______
Living Room
Replace Lights, Light Covers______
Cleaning: Windows, Blinds, Heater______
Miscellaneous: ______
General Cleaning ______
Complete Repainting______
Touch-up Paint______
Confirm Residential Electric Account?______/ ______
Carpet Cleaning______
Carpet Damage______
Smoke Alarm______
Lanai/Storage Closet______
Miscellaneous Expense______
Unpaid Water-Sewer Bills______
Keys Not Returned______
Unpaid Rent/Late Fees______
Legal Fees______
Miscellaneous Refundable Monies______
Total Deductions------
DEPOSIT IS FORFEITED DUE TO NON-FULFILLMENT OF RENTAL AGREEMENT------
ÿ BALANCE DUE RESIDENT------
Paid by enclosed check #:______
ÿ BALANCE DUE OWNER------
DUE DATE: ______