Fillable Printable Receipt of Security Deposit

Receipt of Security Deposit

Date: ___________________________

Tenant's Name: ___________________________________________________________________

The Landlord/Landlord's Agent hereby acknowledges payment in the amount of $____________, not

to exceed four (4) weeks rent, from the above Tenant for the security deposit for the rental premises

located at:

_________________________________________________________________________________

The above rental premises is owned by _________________________________________________

(insert name of legal owner of rental premises) whose address is:

_________________________________________________________________________________

_______________________________________

(Landlord/Owner or Landlord's Agent Signature)

Please note that this document is for reference purposes. You may wish to check with your local landlord

association or obtain legal advice to make sure information is appropriate for your state.