Fill and Sign the Security Deposit and Landlords Responsibilities Form

[Date] [Landlord’s Name] [Landlord’s Address]Re: Notice to Landlord: Failure of Landlord to return all prepaid but unearned rent, and security deposit recoverable by Tenant.Dear : [Landlord’s Name]I am your tenant at the following premises: [Address of premises]This letter is to provide you with legal notice of your failure to-date to return all of the prepaid but unearned rent I paid to you for the month of _______________, 20___, and my security deposit- all of which is recoverable by me.The circumstances of my departure from the leased premises, as you know, were as follows [describe]: Because my departure resulted from your breach of our Lease Agreement and/or other wrongful conduct by you contrary to applicable landlord-tenant law, I am due a refund of all prepaid but unearned rent in the amount of $__________. Furthermore, my security deposit must be returned in good faith by you, including sufficient documentation (including receipts for repairs) of any amount not returned.I have not heard from you on this matter. If you fail to return the amounts owed, I will take all possible action against you under applicable law, including seeking substantial punitive damages against you for your knowing and intentional failure to comply with the law.Sincerely,Tenant: ______________________________________ Date: _________________ [signature] Proof of Delivery This Notice delivered to Landlord or Landlord’s authorized agent:[ ] by personal delivery [ ] certified/registered mail, return receipt requested[ ] other form of notice pursuant to Lease Agreement: Signed: ______________________________________ Date: __________________________