Form 68 - Notice Of Intention To Impose Claim On Security Deposit Page 2

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(Tenant's Name and Address)
Dear ______________________________
(Tenant's Name)
Th is is a notic e of my in ten tion to imp o se a c laim f or d a ma g es in the amo un t of
$ ____________________________ upon your security deposit due to _____________________________
(insert amount of damages)
______________________________________________________________________________________
(insert damage done to premises or other reason for claiming security deposit)
It is sent to you as required by §83.49(3), Florida Statutes. You are hereby notified that you must object in
writing to this deduction from your security deposit within 15 days from the time you receive this notice or
I will be authorized to deduct my claim from your security deposit. Your objection must be sent to
______________________________________________________________________________________
(insert Landlord's address)
Landlord's Name ____________________________________
Address ___________________________________________
Phone Number ______________________________________
This form was completed
with the assistance of
Name:
Address:
Telephone Number:
CT FD 68

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