Transcription of Final Statement of Security Deposit Account
1 11-01-2016 Final Statement of Security Deposit Account Community Name _____ Date _____ Tenant/Resident Name _____ Site # _____ Move-In Date _____ Move-Out Date _____ Forwarding Address _____ City, State, Zip _____ Reason for Vacating (Select one) Change of Ownership (COO) Eviction Removed Home Lease Expiration Title Turn-In Lender Repossession Dealer Repossession Default Community Purchased Home (Triad) Abandonment Other _____ Security Deposit Amount + _____ Security Deposit Interest + _____ Other Credits + _____ Sub-Total of Credits = A _____ Less Charges / Adjustments (if applicable) Unpaid Rent _____ Unpaid Utilities _____ Late Fees _____ Legal Fee and/or Court Costs _____ Lease Termination Fee (Corporate use only) _____ Property Damaged & Estimated Cost Per the Notice to Vacate & Move-In Checklist (COR) _____ _____ Other Costs _____ _____ Sub-Total of Charges / Adjustments = B _____ Balance Due to: (Circle one) Resident / Community = A B _____ * * The total must agree with the resident s ledger in ManageAmerica, unless the resident is receiving a refund check, in which case the MA ledger balance will be $ and the balance on the Final Statement of Security Deposit will be a credit in the amount of the refund.
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