SECURITY DEPOSIT REFUND FORM
SECURITY DEPOSIT REFUND FORM
Resident's Name: ____________________________________________________________________ Address: __________________________________________________________ Apt. No.__________ City: _____________________________________ State: ____________ Zip: ________________
FORWARDING Address: _____________________________________________ Apt. No.__________ City: _____________________________________ State: ____________ Zip: ________________
The following is an itemized statement of your deposit account: 1. Date tenancy began:_______________________ Date keys turned in:_______________________ 2. Total of all deposits paid:$___________________ 3. Deductions:
TYPE Repairs
DESCRIPTION
COST
Painting: Cleaning: Carpet Cleaning: Drape Cleaning: Miscellaneous:
Unpaid Rent: Court Judgment:
Total Deductions
t Your check is enclosed in the amount of $____________. t Please make your check in the amount of $____________ payable to ________________________
_______________________________________ within 21 days of receipt of this statement.
"AS REQUIRED BY LAW, YOU ARE HEREBY NOTIFIED THAT A NEGATIVE CREDIT REPORT REFLECTING ON YOUR CREDIT HISTORY MAY BE SUBMITTED TO A CREDIT REPORTING AGENCY IF YOU FAIL TO FULFILL THE TERMS OF YOUR CREDIT OBLIGATIONS," CC1785.26(c) (2)
______________________________________ Date
________________________________________ Owner/Manager
UNAUTHORIZED USE PROHIBITED For Members Only Approved Form #22.0 1999
Santa Barbara Rental Property Association
EQUAL HOUSING OPPORTUNITY
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