Notice Of Intention To Impose Claim On Security Deposit
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1NOTICE OF INTENTION
TO IMPOSE CLAIM ON SECURITY DEPOSIT
TO:
__________________________________
DATE_______________________
Tenant(s) Name
_____________________________________
Tenant(s) last known address
_____________________________________
This is a notice of the Landlord's intention to impose a claim for damages upon your security deposit.
It is sent to you as required by section 83.49(3), Florida Statutes. You are hereby notified that you
must object in writing to this deduction from your security deposit within fifteen (15) days from the
time you receive this notice or the Landlord will be authorized to deduct its claim from your security
deposit. Your objection must be sent to the Landlord at the address shown below.
__________________________________________
Landlord/Agent Name
__________________________________________
Address
__________________________________________
City
State
Zip
AMOUNTS HELD BY LANDLORD
Security Deposit
Last Month’s rent
Interest, if due
Other
Total amount held by
Landlord/Agent
►
AMOUNTS OWED BY TENANT TO LANDLORD
Rent
*
rent may continue to accrue if you
vacated prior to end of the lease
Damages (including
extraordinary cleaning)
Other:
Other:
(complete
Other:
only one of
Total amount owed by
the boxes
Tenant(s)
►
below)▼
Amount due to Tenant(s)
►
OR
Amount due to Landlord
►
Sent certified mail #______________________on _______________________20_____
Mailed by: ____________________________________
Note: This notice does not waive or limit any of landlord's rights to damages or amounts due
which may exceed the security deposit or the amounts listed on this form.
Form provided to owner or agent by:
LAW OFFICES OF HEIST, WEISSE & DAVIS, P.A.
1-800-253-8428
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