Tenant Security Deposit Return
Tenant Name
*
First Name
Middle Name
Last Name
Suffix
Property Address
*
Date of Checkout
*
-
Month
-
Day
Year
Date
Reminder: Have you
reviewed and completed all pertinent items on the vacating instructions and provided cleaning receipts to the property manager?
turned in all keys, fobs, remotes, etc. in your possession?
turned off all utilities in your name?
set up mail forwarding with USPS?
turned off automatic rent payments?
Forwarding Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please note any unreported items the property manager should be aware of (either wear and tear or damages):
*
If none, type none.
How would you prefer your security deposit to be returned?
*
Mailed
Direct Deposit ($5 fee)
Make check out to:
*
Same as Forwarding Address?
*
Yes
No
Mail to:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Financial Institution Name
*
ABA Routing Number
*
Must be 9 numbers
Account Type
*
Checking
Savings
Account Number
*
Verify Account Number
*
Please verify that account number is correct.
Please upload an image of a voided check or other official bank record that verifies your name on account, ABA routing number, and account number.
*
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I hereby authorize Realty Brokerage LLC to deposit into my account via bank ACH transfer and agree to the $5 fee to do so. I will check for my deposit and notify my property manager right away if the deposit is missing or incorrect.
*
Signed
*
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: