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BEDROOM #1 Move-In Move-Out Cost DINING ROOM Move-In Move-Out Cost
Floor Floor
Walls Walls
Ceiling Ceiling
Doors Doors
Windows Windows
Screens Screens
Closet
Shades/Blinds FRONT PORCH Move-In Move-Out Cost
Elec Fix. Elec Fix.
Light bulbs Light bulbs
BEDROOM #2 Move-In Move-Out Cost BACK PORCH Move-In Move-Out Cost
Floor Elec Fix.
Walls Light bulbs
Ceiling
Doors GARAGE Move-In Move-Out Cost
Windows Floor
Screens Walls
Closet Ceiling
Shades/Blinds Elec Fix.
Elec Fix. Light bulbs
Light bulbs
MECHANICAL Move-In Move-Out Cost
BEDROOM #3 Move-In Move-Out Cost Water Heater
Floor Smoke Det.
Walls Thermostat
Ceiling Furnace
Doors A/C
Windows
Screens # OF KEYS Move-In Move-Out Cost
Closet Front Door
Shades/Blinds Mailbox
Elec Fix. other: __________
Light bulbs
Comments:
ENTRANCE/HALL Move-In Move-Out Cost
Floor
Walls
Ceiling
Doors
Windows
Screens
Closet
Shades/Blinds
Elec Fix.
Light bulbs
Move-In
Move-Out
Date: _____________ Signature: _______________________ / _______________________ Date: _____________
Date: _____________ Signature: _______________________ / _______________________ Date: _____________
Date: _____________ Signature: _______________________ / _______________________ Date: _____________
I/We (the tenant(s)) understand that unless otherwise noted, all discrepancies will be the tenant's
tenant's responsibility and will be deducted from the security deposit at the time of move-out.
Move-In
Move-Out
Date: _____________ Date: _____________
Landlord/Agent Signature: ___________________________ Landlord/Agent Signature: ___________________________
Landlord and Tenant acknowledge that video and/or Tenant's Forwarding Address:
photos (digital or otherwise) have been taken of the __________________________________________
premises. The original copies/files are in the possession
of the Landlord / Tenant. __________________________________________
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