The Claimant claims under section 214(1)(a) of the Housing Act 2004 that the deposit of £_____ required by the tenancy agreement dated [date] in respect of the premises at [address] made between the Claimant and the Defendant was not paid into an appropriate tenancy deposit scheme (in breach of section 213(1) of the Housing Act 2004), or that the Claimant did not receive the prescribed information concerning which Tenancy Deposit Scheme was holding the deposit within 14 days of the Defendant's receipt of the deposit (in breach of section 213(3) of the Housing Act 2004).
And the Claimant asks that the court make an order:
1. That the person who appears to the court to be holding the deposit do repay it to the Claimant, in accordance with section 214(3) of the Housing Act 2004.
2. That the Defendant do pay to the Claimant, within 14 days of the making of the order, a sum of money equal to three times the amount of the deposit, in accordance with section 214(4) of the Housing Act 2004.
3. The Claimant claims interest under section 69 of the County Courts Act 1984 at the rate of 8% a year, from [date deposit should have been returned] to [date court claim submitted] of £______ [worked out using the court's interest rate calculator on their website], and interest at the same rate up to the date of judgment or earlier payment at a daily rate of £_______ [worked out using the court's interest rate calculator on their website].
The Claimant is therefore seeking payment of £______ [four times the amount of the Deposit], plus the court fee and interest.
) initial receipt.