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Sterling Associates, Inc.

Apartment Name

Resident's Name 1

SOC.SEC#

Resident's Name 2

SOC.SEC#

Forwarding Address

Term Of Lease

Date Apt Rerented

Date written notice Recive

Date Apartement vacated

Did Resident

Skip Transfer Asked to vacate Evicted

Termination Fee

Amoutn 1

Lack Of 30 Day Notice Fee

Amoutn 2

Rent Arrearrage:(LIST MONTHS)

Amoutn 3

Late Charges

Amoutn 4

Warrant Charges If Money Judment Recive Attach Fifa

Amoutn 5

Damages:LIst Total From Move-in Move-Out Inspection From

Amoutn 6

Key Not Returned

Amoutn 7

Clening

Amoutn 8

Nsf's:(Send Original Check)

Amoutn 9

Total Amount

Check List

Collection From Completed And Signed Resident Application Attached Copy Of Lease Attached Copy of Move-in Move-out Inspection From Attached Fifa Attached