Security Deposit Dispute Form

Security Deposit Dispute Form
At Lux Management Group at Keller Williams Realty Phoenix, we do our best to complete all security deposit dispositions fairly and in accordance with state law, but we do make mistakes. We take your below dispute seriously and if we made an error we will correct it. Our dedicated board of directors will meticulously examine each disputed item to ensure that tenants are only charged for damages that occurred to the premises during their possession and/or any obligations as outlined in their lease agreement, adhering strictly to the principles of justice and accountability.

In accordance with ARS § 33-1321(D), this Form must be submitted within sixty (60) days of receiving your Security Deposit Disposition.

The form below provides you this opportunity to state each item that you disagree with and state why you disagree so that our board of directors and/or attorneys can review and make a final determination. If you don’t submit a dispute for an item, that means that you have agreed to that charge. If you have any evidence to support your dispute, such as date-stamped photos or videos, please remember to attach those below so that they can be included in the review. If you do not submit any additional evidence, then we will only be able to rely upon the inspection forms, photos, and videos (if applicable) that we already have.

Once this form is submitted please allow up to 30 days for our staff to review all available information. If any adjustments need to be made based on the provided information you will receive a mutual release form that will need to be signed with the terms of our findings which could include an additional refund or invoice owed.

We thank you for your tenancy and we promise that we will review your below comments and respond fairly and timely.

Tenant Information
Submitting Tenant's Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
PROPERTY Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MAILING Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Dispute Information
Please list the disputed charges and how much you were charged for these items. Also include evidence that this damage existed prior to your tenancy (photos, videos, inspection form, emails, etc). The more detail and evidence you submit, the easier it will be to determine if we made a mistake.
Disputed Item #1*
Item #1 evidence such as photo or video (only one file per disputed item)*

Cancelof
Disputed Item #2
Item #2 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #3
Item #3 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #4
Item #4 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #5
Item #5 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #6
Item #6 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #7
Item #7 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #8
Item #8 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #9
Item #9 evidence such as photo or video (only one file per disputed item)

Cancelof
Disputed Item #10
Item #10 evidence such as photo or video (only one file per disputed item)

Cancelof

Additional Information
Additional information you would like us to consider:
Tenant's Name*

First NameLast Name
By filling out and completing this form, you ("Tenant") agree to allow our Board of Directors to review the evidence and concerns presented in the timeline noted above.
Tenant's Signature*

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Carlie Goulet, Agent of Lux Management Group Keller Williams Realty Phoenix

First NameLast Name
Agent's Signature*

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Date*

MonthDayYear
Date
Should be Empty: