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Date
Landlord or landlord’s agent name
Landlord/agent address

Dear (Landlord’s/Agent’s title & name):
I/we are vacating Apartment (#) at (apartment address) as of (date). I/we are also returning the keys to the apartment to you at this time. This letter is to notify you of the forwarding address to which my/our security deposit and/or itemized list of deductions may be sent. I/we request that the check be made out to (tenant name). The check and/or list of deductions should arrive at the address listed below within 30 days after receipt of this notice, as required by Connecticut Landlord and Tenant Law, Chapter 831 Sec. 47a-21(d). I/we request that you return my/our deposit to the following address:
(address)

Sincerely,
(Signature)

Keys and notice received for landlord by:
(Landlord or landlord’s agent signature, date)

(Note: This letter should be handed to the landlord or agent upon checkout/final walk-through of the apartment. The keys should also be turned over at this time. A duplicate copy of the letter should also be signed at this time and kept in your records. You may also want to give the landlord or agent a copy of the inspection checklist you both signed).


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