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 *
Please Note: Fields on this form
are NOT calculated automatically.
Section #1 - Deposits Paid
Section #2 - Last Month’s Rent Deposit, Prepaid Rent
Section #3 - Rent Proration
Section #4 - Rent Deposit or Prepaid Rent
(Skip this if Section #2 is $0)
Section #5 - Deductions to Security Deposit
Section #6 - Pet Deposit Balance
(Skip this if Pet Deposit from Section #1 is $0)
Section #7 - Other Deposit Balance
(Skip this if Other Deposit from Section #1 is $0)
Section #8 - Other Deposit Balance
(Skip this if Other Deposit from Section #1 is $0)
Section #9 - Security Deposit Balance
(Skip this if Security Deposit from Section #1 is $0)
Section #10 - Final Balance Due Owner/Agent
Section #11 - 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.
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| Owner/Agent Signature: |
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Date: |
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In accordance with ORS 90, Owner/Agent may claim: unpaid Rent, utilities/services, Fees, cleaning, landscaping damages, damages to Rental Unit, pet damages and recover Rent for the days necessary to prepare the Rental Unit for re-renting.
