Real Estate Deposit Claim

REAL ESTATE DEPOSIT CLAIM

Claimant / Respondent Identification

Property Identification

Property Address:

Parcel / APN Number:

Deposit Details

Deposit Amount: $

Date Deposit Paid:

Form of Deposit:

Held By (Escrow/Agent):

Contract Reference and Related Dates

Contract Date:

Agreed Closing Date:

Possession Date (if different):

Basis of Claim (Check applicable boxes and explain)

Buyer Default / Breach of Contract

Seller Default or Failure to Close

Contract Termination Pursuant to Contingency or Notice

Other (explain below)

Attachments (Check and list)

Purchase Agreement / Contract enclosed

Escrow Instructions / Receipt enclosed

Proof of Payment (check, wire, bank record) enclosed

Demand for Relief and Release Authorization

The undersigned Claimant hereby demands immediate release of the deposit in the amount of $ from Respondent or escrow holder to Claimant for the reasons stated above. If partial release is proposed, specify amount: $

Claimant authorizes Respondent to release the deposit to Claimant upon receipt of this signed claim unless Respondent asserts a competing claim in writing within days and provides supporting documentation. If Respondent elects to interplead or refuse release, Respondent shall retain the deposit pending resolution and provide notice to Claimant describing the claimed basis and legal authority.

Indemnity, Calculation of Interest and Costs

Claimant certifies that to the best of Claimant's knowledge the facts set forth herein are true and accurate. Claimant agrees to indemnify and hold Respondent harmless from any liability, claims, losses or expenses (including reasonable attorneys' fees and court costs) arising from Claimant's asserted right to the deposit if such indemnity is required by law or by Respondent's escrow instructions.

Interest on deposit: . Claimant asserts entitlement to interest accrued from to date of release, if permitted by applicable escrow instructions or law.

Dispute Resolution and Governing Law

Any dispute arising out of this claim shall be governed by the laws of the state where the property is located. Claimant and Respondent agree that the prevailing party in any legal action to enforce or defend this claim shall be entitled to recover reasonable attorneys' fees and costs.

Certification and Notice

I certify under penalty of perjury under the laws of the state in which the property is located that the statements made in this claim are true and correct to the best of my knowledge. I further certify that I am authorized to make this claim on behalf of the named Claimant.

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