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Form12 : DEPOSIT ACCOUNTING

Please Note: This version of the "Deposit Accounting" form is for use with Rental Properties outside of the City of Portland, Oregon ONLY.
To switch to the City of Portland version of this form click the button below.

 

Required entries are indicated by blue icons or *

et al (and all others)

 

Please Note: Fields on this form are NOT calculated automatically.

 
Section #1 -Deposits Paid

Pet Deposit

Other Deposit

Other Deposit

Security Deposit
 
Section #2 - Last Month’s Rent Deposit, Prepaid Rent

Last Month's Rent Deposit

Prepaid Rent

Total Rent Deposit and Prepaid Rent
 
Section #3 - Rent Proration

Rent
 
divided by 30 days = Daily Rent

Rent due from
 
to
 
=

 
x Daily Rent
 
= Rent Due
 
Section #4 - Rent Deposit or Prepaid Rent
(Skip this if Section #2 is $0)

Total Rent Deposit and Prepaid Rent

Rent Due
(Subtract from above)

Credit/Debit
(Copy to Section #5 if debit from Tenant(s), copy to Section #11 if credit to Tenant(s))
 
Section #5 - Deductions to Security Deposit

Rent Due (if Debit from Tenant, Section #4)

Past Due Utilities/Services

Other Utilities/Services

Fees/Noncompliance Charges

Fees/Noncompliance Charges

Fees/Noncompliance Charges

Cleaning

Cleaning

Carpet Cleaning

Landscaping

Landscaping

Damages

Damages

Damages

Other

Other

Other

Pet Damage (if no Pet Deposit)

Additional days to prepare for re-renting:
x Daily Rent
 
=

Total Security Deposit Deductions
 
Section #6 - Pet Deposit Balance
(Skip this if Pet Deposit from Section #1 is $0)

Pet Deposit Amount

Damages Caused by Pet(s)
(Subtract from deposit)

Balance

(If deductions are more than the deposit, .

If there is a positive balance )

 
Section #7 - Other Deposit Balance
(Skip this if Other Deposit from Section #1 is $0)

Other Deposit Amount

Deductions for:
(Subtract from deposit)

Balance

(If deductions are more than the deposit, .

If there is a positive balance )

 
Section #8 - Other Deposit Balance
(Skip this if Other Deposit from Section #1 is $0)

Other Deposit Amount

Deductions for:
(Subtract from deposit)

Balance

(If deductions are more than the deposit, .

If there is a positive balance )

 
Section #9 - Security Deposit Balance
(Skip this if Security Deposit from Section #1 is $0)

Security Deposit Amount

Total Deductions
(Subtract from deposit)

Balance

(If deductions are more than the deposit, .

If there is a positive balance )

 
Section #10 - Final Balance Due Owner/Agent

Rent Due Owner/Agent

Amount due Owner/Agent

Amount due Owner/Agent

Amount due Owner/Agent

Amount due Owner/Agent

Total Owed to Owner/Agent By Tenant(s)
 
Section #11 - Refund Due Tenant(s)

Rent Refund Due Tenant(s)

Deposit Refund Due Tenant(s)

Deposit Refund Due Tenant(s)

Deposit Refund Due Tenant(s)

Deposit Refund Due Tenant(s)

Total Refund Due Tenant(s)
 

If Tenants are due a refund (see Section #11), a check is enclosed for the total amount of the refund. Depositing or cashing the check constitutes acceptance as payment in full.

If there is a balance due the Owner/Agent (see Section #10), the total amount owing is due immediately and must be paid within 10 days. If payment in full is not received within 10 days, appropriate legal and/or other actions may be taken to collect the amount owed. Actions may include, but are not limited to; filing a Small Claims suit, Wage Garnishment, assigning to a Collection Agency and/or reporting to a Credit Reporting Agency.

 
 

If you can not make the payment in full within 10 days, the Owner/Agent may be willing to make payment arrangements. Contact Owner IMMEDIATELY for payment options.

 

Please Note: Signature field must be filled in and signed after printing.

Owner/Agent Signature:   Date:

MAKE PAYMENTS TO:


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PO Box 20862, Keizer, OR 97307
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