form updated December 26, 2010
TENANTS
Name _________________________________________________
Unit address _________________________________________________
_________________________________________________
Forwarding address _________________________________________________
_________________________________________________
Date 30 day notice was received __________________________________
Was 30 days notice given? ___ yes __ no
If no, how many days lacking? __________ Tenants will be responsible to pay rent for these days unless new tenant has been
found and is paying rent for these days.
Deposit collected
Minus:
Unpaid rent
Unpaid late charges
Unpaid utilities
Rent for days until new tenant was found,
if broke lease or insufficient notice given
Advertising costs (if lease broken)
Cleaning fee
Lawn mowing/trimming ($50)
Other charges _________________
Other charges _________________
Other charges _________________
Total deductions
Total returned to tenant
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
_________________________________________ _______________
signature of property manager date