1.Parties
Name of Landlord or Property Manager:
Name of Tenant:
2.Lease Details
Date of Lease Termination:
Monthly Rent Amount: $
3.Deposit Information
Location of Deposit (Trust Account):
Amount of Deposit Held: $
4.Accounting Timeline
This accounting is being delivered within:
If the 60-day box is checked, this accounting is an interim accounting. A final accounting with any remaining balance due will be provided within the time required by NC GS § 42-52.
5.Deductions
The Landlord or Agent has assessed the following deductions against the security deposit for past due rent, fees owed under the lease agreement, and/or damages to the premises beyond normal wear and tear:
Itemized Deductions:
6.Date & Delivery
This the Day of , 20.
Signature of Delivering Party
Delivered by:
Tenant Forwarding Address: