Landlord Residential Closing Statement

Landlord Information

Landlord Full Name:                                 _____________________________________

Rental Property Address:                             _____________________________________

                                                                     _____________________________________

                                                                     _____________________________________

Tenant Information

Tenant(s) Full Name:                                ______________________________________

                                                                    ______________________________________

Forwarding Address:                                  ______________________________________

                                                                    ______________________________________

                                                                    ______________________________________

Contact Information:                                  ______________________________________

                                                                    ______________________________________

Additional Information:                             ______________________________________

                                                                    ______________________________________

Security Deposit

Amount Paid for Security Deposit:          $______________________________________

Other Deposits Given:                                            ______________________________________

Rent Credits (if any):                                  ______________________________________

Charges to Deposit and Credits

Cleaning Charges:                                       ______________________________________

Damage Repairs to be Completed:             ______________________________________

                                                                    ______________________________________

                                                                    ______________________________________

Unpaid Rent:                                             $_____________________________________

Uncollected Late Charges:                        $_____________________________________

Uncollected Interest                                  $_____________________________________

TOTAL CREDIT                                      $_____________________________________

Total Charges

Amount Due to Tenant:                             $_____________________________________

Amount Retained by Landlord:                 $_____________________________________

Amount Due to Landlord:                         $_____________________________________

Additional Comments and Information:      _____________________________________

                                                                     _____________________________________

Check Enclosed:

Number:         _______________________   Amount:      $________________________

Amount Due to Landlord:                           _____________________________________

Landlord Signature:                                  _____________________________________

Date:                                                            ___________, _____________, ___________

For any amount due to the Landlord, payments can be forwarded in the full amount to the Landlord at:                                               _____________________________________

                                                                     _____________________________________

                                                                     _____________________________________