Security Deposit Release Form

Security Deposit Release Form
Date
MonthDayYear
Date
Address of Property
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Name of Terminating Lessee
First NameLast Name
Name of New Lessee
First NameLast Name
Effective Date
MonthDayYear
Date
Present Lease Dated
MonthDayYear
Date
Current Lease End Date
MonthDayYear
Date
Remaining Lessees
SECURITY DEPOSITS ACKNOWLEDGEMENT
According to the Security Deposit Acknowledgement by signing below I acknowledge the following:
1) New and Remaining Lessee(s) agree to accept the unit in its present condition and assume responsibility for expenses incurred for cleaning or damage per the lease agreement.

2) Security Deposit of funds shall be done between the New and Terminating lessees. Any additional refund will be processed within twenty one (21) days of the Terminating Lessee’s vacate date.

3) Terminating Lessee’s responsibility to see that all funds and signed documents are delivered to Lessor should be conducted within defined due date.
Forwarding Address of Terminating Lessee
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Name of New Lessee
First NameLast Name
Signature of New Lessee
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Date
MonthDayYear
Date

Rows	Terminating Lessee	New Lessee
Security Deposit: Less Funds for Cleaning or Damages
Security Deposit: Prepaid, First and/or Last Month’s Rent
Dates Covered
Prorated / Current Month's Rate (Number of Days * $ per day)