SECURITY DEPOSIT ITEMIZATION & SETTLEMENT STATEMENT

(Vermont – 9 V.S.A. § 4461 Compliance)

[// GUIDANCE: This template is drafted as a letter-agreement that satisfies Vermont’s statutory requirement to provide the tenant with an itemized statement of any deductions from the security deposit and to return any undisputed balance. Customize bracketed fields, attach supporting documentation, and review local ordinances (e.g., Burlington) for any additional interest-payment obligations.]

I. DOCUMENT HEADER

Date: [DATE]

From (Landlord):
[LANDLORD LEGAL NAME]
[LANDLORD MAILING ADDRESS]
[EMAIL] | [PHONE]

To (Tenant):
[TENANT LEGAL NAME]
[FORWARDING ADDRESS]
[EMAIL] | [PHONE]

Re: Security Deposit Disposition for the Premises located at [RENTAL PROPERTY ADDRESS] (the “Premises”) under that certain Residential Rental Agreement dated [LEASE DATE] (the “Lease”).

II. DEFINITIONS

For purposes of this Statement, the following capitalized terms have the meanings set out below. Any term not defined herein has the meaning ascribed to it in the Lease or under applicable Vermont law.

1. “Deposit” means the security deposit in the original amount of $[ORIGINAL DEPOSIT AMOUNT] paid by Tenant to Landlord pursuant to 9 V.S.A. § 4461 and Section [__] of the Lease.
2. “Normal Wear and Tear” means deterioration that occurs without negligence, carelessness, accident, or abuse of the Premises by Tenant, an occupant, invitee, or pet.
3. “Termination Date” means [VACATE DATE], the date on which Tenant surrendered possession of the Premises.
4. “Statement” means this Security Deposit Itemization & Settlement Statement, inclusive of all schedules and attachments.

III. OPERATIVE PROVISIONS

3.1 Statutory Timeframe

Pursuant to 9 V.S.A. § 4461(c), Landlord is required to deliver this Statement and any refund of the Deposit within fourteen (14) calendar days after the Termination Date (or sixty (60) days in the case of a seasonal occupancy, if applicable).

3.2 Itemization of Deductions

Below is a good-faith, itemized accounting of all amounts Landlord reasonably and actually expended or accrued that are chargeable to Tenant under 9 V.S.A. § 4461(b) and the Lease. Supporting invoices, receipts, and photographic evidence (where applicable) are attached hereto as Schedule A.

3.3 Deposit Reconciliation

Original Deposit:                $[ORIGINAL DEPOSIT AMOUNT]
Less Total Deductions (¶ 3.2):         – $[TOTAL DEDUCTIONS]

Net Amount Owing to Tenant        $[REFUND]

[// GUIDANCE: If negative balance results, insert “Net Amount Owing to Landlord” and demand payment within a specific timeframe or proceed under the Lease’s default provisions.]

3.4 Method of Refund

Enclosed herewith is (check one):
☐ A check payable to Tenant in the amount of $[REFUND]  Check # []
☐ An electronic funds transfer confirmation evidencing deposit to Tenant’s designated account ending in [_].

3.5 Tenant Review & Contest Rights

Tenant may contest any or all deductions by delivering written notice—detailing the specific item(s) disputed and the grounds therefor—to Landlord at the address above within thirty (30) days of Tenant’s receipt of this Statement. Failure to timely contest shall constitute acceptance, without prejudice to any non-waivable statutory rights.

IV. REPRESENTATIONS & WARRANTIES

1. Accuracy. Landlord represents that each deduction listed herein reflects (i) an expense actually incurred or a charge lawfully accrued, (ii) reasonable market rates, and (iii) compliance with 9 V.S.A. § 4461(b).
2. Receipts & Records. Landlord warrants that true and correct copies of all bills, invoices, or other substantiating documents are retained for not less than three (3) years and are available for inspection upon reasonable request.
3. No Unauthorized Deductions. Landlord has not retained any portion of the Deposit for ordinary cleaning or for damage attributable to Normal Wear and Tear.

The foregoing representations survive Tenant’s acceptance of this Statement.

V. COVENANTS & RESTRICTIONS

1. Further Cooperation. Tenant shall promptly endorse or negotiate any refund instrument and, upon request, provide Landlord with updated contact information for future correspondence related to the Lease.
2. No Assignment of Claims. Tenant shall not assign any claim arising from this Statement without Landlord’s prior written consent, except as required by law.

VI. DEFAULT & REMEDIES

1. Tenant Non-Payment. If Tenant owes a net balance to Landlord and fails to pay within ten (10) days after written demand, such amount shall accrue interest at the lesser of (a) 12% per annum or (b) the maximum rate permitted by law, and Landlord may seek recovery in a court of competent jurisdiction.
2. Statutory Penalties. Landlord acknowledges that wrongful retention of any portion of the Deposit may subject Landlord to damages equal to twice the amount wrongfully withheld, plus reasonable attorneys’ fees, under 9 V.S.A. § 4461(e).

VII. RISK ALLOCATION

[// GUIDANCE: Indemnification and broad liability caps are not applicable under the user’s metadata. The statutory penalty framework in ¶ 6.2 satisfies Risk Allocation requirements.]

VIII. DISPUTE RESOLUTION

1. Governing Law. This Statement and any dispute arising herefrom shall be governed by the laws of the State of Vermont, without regard to its conflict-of-laws principles.
2. Forum Selection. Exclusive venue shall lie in the [INSERT COUNTY] Unit of the Vermont Superior Court, Civil Division (Housing Court).
3. Arbitration. The parties expressly exclude arbitration.
4. Jury Trial. Nothing herein constitutes a waiver of either party’s constitutional right to a jury trial.
5. Relief. The parties’ remedies are limited to money damages except as otherwise provided by statute.

IX. GENERAL PROVISIONS

1. Notices. Any notice given under this Statement shall be in writing and deemed delivered upon (a) personal delivery, (b) certified U.S. mail (return receipt requested), or (c) nationally recognized overnight courier, in each case addressed as set forth in the Document Header (or as later designated in writing).
2. Entire Agreement. This Statement constitutes the entire agreement of the parties with respect to the disposition of the Deposit and supersedes any prior or contemporaneous oral statements.
3. Amendments. No modification of this Statement is effective unless in writing and signed by both parties.
4. Severability. If any provision of this Statement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.
5. Counterparts; Electronic Signatures. This Statement may be executed in counterparts, each of which is deemed an original; electronic signatures have the same force and effect as wet ink signatures under applicable law, including the Vermont Uniform Electronic Transactions Act.

X. EXECUTION BLOCK

LANDLORD:

[AUTHORIZED SIGNATORY NAME]
[Title / Capacity]
For: [LANDLORD LEGAL NAME]

Date: ________

TENANT (Acknowledgment of Receipt Only):

☐ I hereby acknowledge timely receipt of this Statement and any refund identified herein. 
☐ I dispute the deductions noted in items [__]. (Attach separate statement.)

[TENANT LEGAL NAME]

Date: ________

[// GUIDANCE: Tenant signature is advisable but not required under 9 V.S.A. § 4461. Landlord should retain proof of mailing or delivery (e.g., USPS certified mail or courier tracking) to establish compliance with the 14-day statutory deadline.]

Schedule A – Supporting Documentation

[Attach copies of receipts, invoices, photographs, and any move-out inspection reports.]