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FORM #23 - Actual Damages Invoice


  • Tenant(s):
  • Tenant(s):
  • Address: Unit:
  • City: , OREGON Zip:

Owner/Agent has sustained the following damages:

  • Breach of Contract:
  • Action Taken:
  • Date Action Taken:
Repair
Materials
quantity
X
materials cost
=
Time Incurred
hours/minutes
X
charge per hour
=
Forms
# of forms
X
forms cost
=
Copying/Printing
quantity
X
cost
=
Total Mileage
total miles
X
IRS mileage rate
=
First Class Postage
total miles
X
IRS mileage rate
=
TOTAL AMOUNT DUE FROM TENANT

Owner/Agent Signature: ___________________________ Date: __________________

  • Owner/Agent:
  • Address:
  • City: , State: Zip:
  • Telephone: Email:
In accordance with Oregon Revised Statute 90.401(2): Remedies available to landlord. In addition to the remedies provided in ORS 90.392, 90.394, 90.396 and 90.398, a landlord may recover damages and obtain injunctive relief for any noncompliance by the tenant with the rental agreement or ORS 90.325 or 90.740.

     

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1462 Commercial St. NE, Salem, OR 97301
Phone: 503-364-5468 | Fax: 503-585-8119

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