AOA Form No. 133 (Rev. 04/06) Copyyrigh 2006 Aparrtmen Owners Association of California wwwwaoausa.com ▪ San Fernando Valley (818)9889220 ▪ Los Angeles (323)9378881 ▪ Long Beach (562)5972442 ▪ Garden Grove (714)5396000 ▪ San Diego (619)2807000 ▪ Northern California (510)7697552 SECURITY DEPOSIT REFUND To: _________________________________________________________________ For Premises Located at::____________________________________________________________________ Apt.:_____ City:___________________________________________ Zip:_______________ SECURITY DEPOSIT.................................................................................................$ __________________ INTEREST ON DEPOSIT @__________ % ..............................................................$ __________________ TOTAL SECURITY DEPOSIT.....................................................................................$ __________________ Rent Due From ___________________ to __________________ $___________ Late Fees Due....................................... ........................................$___________ CIeaning................................................ ........................................$___________ Carpets ................................................. ........................................$___________ Painting................................................. ........................................$___________ Drapes .................................................. ........................................$___________ Other:________________________________________________ $___________ TOTAL CHARGES .....................................................................................................$ __________________ BALANCE DUE OWNER ...........................................................................................$ __________________ BALANCE DUE RESIDENT.......................................................................................$ __________________ Please remit your check for balance due, if any, to: Name: ____________________________________________________________________________ Address: __________________________________________________________________________ City, State, Zip:_____________________________________________________________________ Pursuant to Civil Code 1950.5, Owner, on the _____ day of________________, 20_____ hereby furnished the above statement of security deposit disposition of monies to former residents . Owner/Agent__________________________________________________________Date______________________