TEMPLATE
Pennsylvania security deposit statement template
ReportDraft Landlord from $9 a month. 14-day free trial with your first report and up to 5 template downloads. Card required, nothing charged today, cancel anytime. Need just one? One security deposit statement for $19, no subscription.
Your Pennsylvania security deposit statement has one rule to meet. ReportDraft puts it on your checklist and checks your draft before you sign.
- The 30-day written list of damages with payment of the balance
A security deposit statement template set up for Pennsylvania. In Word and PDF.
REPORTDRAFT.COM
Pennsylvania Security deposit statement Template
Landlord or property manager
Tenant names
Rental unit address
Tenant's forwarding address
Date the tenant moved out
Date of this statement
Security deposit held
Download in Word or PDFIncluded with ReportDraft Landlord and its free trial.
Pennsylvania rules for this report
These rules are about how and when you report, not the template's fields. Check them before you deliver.
- Within 30 days after the lease ends, or after the premises are surrendered and accepted if that comes first, the landlord gives the tenant a written list of any damages the landlord claims the tenant is liable for, with payment of the deposit and interest that exceed the actual damages the tenant causedLandlord and Tenant Act of 1951 (68 P.S.), s. 512 (a)
- A landlord who does not give the written list within 30 days forfeits all rights to withhold any part of the deposit and interest, and to sue the tenant for damage to the premisesLandlord and Tenant Act of 1951, s. 512 (b)
- A landlord who does not pay the balance within 30 days is liable for double the amount by which the deposit and interest exceed the actual damages the tenant caused; the landlord bears the burden of proving those damagesLandlord and Tenant Act of 1951, s. 512 (c)
- A tenant cannot waive these deposit protections by contract or otherwise; they apply to residential leasesLandlord and Tenant Act of 1951, s. 512 (d) and (f) ยท Landlord and Tenant Act of 1951, s. 511.1 (e) and (f)
- A deposit for damages or unpaid rent may not exceed two months' rent in the first year of a lease, or one month's rent in the second and later years or on renewalLandlord and Tenant Act of 1951, s. 511.1 (a) and (b)
What is in it
- Itemized deductionsDeduction, Why it is charged, Supported by, Amount
- Move-out conditionTwo to four sentences from the notes on the unit's condition at move-out compared with move-in, including anything noted as normal wear and tear and not charged, and photos if the notes mention them. Never state amounts.
- Refund and questionsHow the refund is paid or the balance should be paid, and where (from the notes, such as a check mailed to the forwarding address), and that the tenant may contact the landlord with questions. Never state amounts: the accounting table shows them.
Rules last reviewed October 23, 2026. Read the full Pennsylvania security deposit statement requirements.