Security Deposit Refund
Small Claims Template
1. Plaintiff Information
Full Name
Address
Phone
Email
2. Defendant (Landlord) Information
Full Name or Company
Address
3. Rental Property Information
Rental Property Address
Lease Dates (Start–End)
Security Deposit Amount
Date Paid
4. Claim Details
Amount Owed
Describe the facts and basis for this claim
5. Attempts to Resolve
Attempts made to resolve the issue with the landlord
6. Signature
Name
Date