Rent and Security Deposit Receipt Template

[Landlord / Property Management Company Name]
[Street Address]
[City, State/Province, ZIP/Postal Code, Country]
Phone: [Phone Number]
Email: [Email Address]

1. Receipt Information

Receipt Title: Rent and Security Deposit Receipt
Receipt No.: [Receipt Number]
Receipt Date: [MM/DD/YYYY]
Location: [City, State/Province, Country]

2. Parties

Landlord / Property Manager (Recipient)
Name or Business Name: [Landlord or Company Name]
Contact Person (if business): [Contact Name]

Tenant (Payer)
Tenant Name(s): [Tenant Full Name(s)]
Tenant Mailing Address (if different from rental address): [Tenant Mailing Address]
Phone: [Tenant Phone Number]
Email: [Tenant Email Address]

3. Rental Property Details

Property Type: [Apartment / House / Room / Commercial Unit / Other]
Property Address: [Street Address]
Unit / Apartment / Suite No.: [Unit Number]
City, State/Province, ZIP/Postal Code, Country: [City, State/Province, ZIP/Postal Code, Country]

Lease / Rental Agreement No. (if any): [Agreement Number]
Lease / Rental Agreement Date: [MM/DD/YYYY]

4. Rent Payment Details

Date Rent Payment Received: [MM/DD/YYYY]

Rent Amount Paid Today: [Currency and Amount]
Rent Period Covered by This Payment:
From: [Start Date of Rent Period]
To: [End Date of Rent Period]

Rent Due for This Period: [Currency and Amount]
Rent Still Outstanding for This Period (if any): [Currency and Amount]

5. Security Deposit Details

Security Deposit Amount Received Today: [Currency and Amount]
Total Security Deposit Held After This Payment: [Currency and Amount]

Type of Security Deposit:
☐ General security deposit
☐ Damage deposit
☐ Cleaning deposit
☐ Other: [Description]

Date Security Deposit Received: [MM/DD/YYYY]

Short Description of Security Deposit Purpose:
[Example: “Security deposit held under lease for [Property Address], to cover damage beyond normal wear and unpaid rent as allowed by law and the lease.”]

6. Payment Method

Payment Method (select or describe):
☐ Cash
☐ Check – Check No.: [Check Number]
☐ Bank Transfer – Reference: [Transfer Reference]
☐ Credit Card – Last 4 digits: [XXXX]
☐ Debit Card – Last 4 digits: [XXXX]
☐ Money Order – No.: [Money Order Number]
☐ Other: [Payment Method Description]

7. Total Amount Received and Allocation

Total Amount Received Today (Rent + Deposit + Fees): [Currency and Amount]

Allocation of Today’s Payment:

• Applied to Current Rent: [Currency and Amount]

• Applied to Past-Due Rent (if any): [Currency and Amount]

• Applied to Security Deposit: [Currency and Amount]

• Applied to Other Fees / Charges (if any): [Currency and Amount]
  Description of Other Fees / Charges: [Description]

8. Notes (Optional)

Notes:
[Examples: “Security deposit will be held in a separate account as required by law.” / “Deposit may not be used as last month’s rent unless agreed in writing.” / “Any deductions from the security deposit will be itemized in writing within [Number] days after move-out.”]

9. Acknowledgment and Signatures

Landlord / Property Manager (Recipient)

Name: [Recipient Name]
Title / Role (if business): [Title or Role]

Signature: _______________________________
Date: [MM/DD/YYYY]

Tenant (Payer) – Optional Signature

I acknowledge that the rent and security deposit amounts described above have been paid and correctly recorded on this receipt.

Tenant Name: [Tenant Full Name]

Signature (if used): _______________________________
Date: [MM/DD/YYYY]