Common use of IN CHECKLIST Clause in Contracts

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unit. You should keep the other copy for your records. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unit. You should keep the other a copy for your records. You must notify the landlord in writing after you move of a forwarding address where you can be reached and where you will receive mail; otherwise your landlord shall be relieved of sending you an itemized list of damages and the penalties adherent to that failure. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unit. You should keep the other copy for your records. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord within 5 days after obtaining possession of the rental unit. You should keep the other copy for your records. You are also entitled to request and receive a copy of the last termination inventory checklist which shows what claims were chargeable to the last prior tenants. You must notify the landlord in writing within 5 days after you move of a forwarding address where you can be reached and where you will receive mail; otherwise your landlord shall be relieved of sending you an itemized list of damages and the penalties adherent to that failure. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies This is a statement of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unitpremises you have leased or rented. You should keep read it carefully in order to see if it is correct. If it is correct you must sign it. This will show that you agree that the other copy for list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your records. failure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other DINING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. YOU SHOULD COMPLETE THIS CHECKLIST, NOTING THE CONDITION OF THE RENTAL PROPERTY, AND RETURN IT TO THE LANDLORD WITHIN 5 DAYS AFTER OBTAINING POSSESSION OF THE RENTAL UNIT. YOU ARE ALSO ENTITLED TO REQUEST AND RECEIVE A COPY OF THE LAST TERMINATION INVENTORY CHECKLIST WHICH SHOWS WHAT CLAIMS WERE CHARGEABLE TO THE LAST PRIOR TENANTS. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord within 5 days after obtaining possession of the rental unit. You should keep the other copy for your records. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. YOU SHOULD COMPLETE THIS CHECKLIST, NOTING THE CONDITION OF THE RENTAL PROPERTY, AND RETURN IT TO THE LANDLORD WITHIN 5 DAYS AFTER OBTAINING POSSESSION OF THE RENTAL UNIT. YOU ARE ALSO ENTITLED TO REQUEST AND RECEIVE A COPY OF THE LAST TERMINATION INVENTORY CHECKLIST WHICH SHOWS WHAT CLAIMS WERE CHARGEABLE TO THE LAST PRIOR TENANTS. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord within 5 days after obtaining possession of the rental unit. You should keep the other copy for your records. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures KITCHEN Other DINING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BEDROOM NO. 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BASEMENT/STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other GARAGE/PARKING AREA Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies This is a statement of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unitpremises you have leased or rented. You should keep read it carefully in order to see if it is correct. If it is correct you must sign it. This will show that you agree that the other copy for list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your records. Landlordfailure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit Xxxxxxxx’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT Move-Out Date: KITCHEN Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other DINING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BEDROOM NO. 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BASEMENT/STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other HALLWAY(S) Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other GARAGE/PARKING AREA Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewersewer NUMBER OF KEYS RECEIPT FOR INVENTORY CHECKLIST AND LEASE Tenant acknowledges a copy of two Inventory checklists and a signed copy of the Lease for Premises located at TENANT DATE ITEMIZED LIST OF CHARGES TENANT DATE MAILED FORWARDING ADDRESS

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies This is a statement of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unitpremises you have leased or rented. You should keep read it carefully in order to see if it is correct. If it is correct you must sign it. This will show that you agree that the other copy for list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your records. failure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other KITCHEN Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BEDROOM NO. 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BASEMENT/STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other GARAGE/PARKING AREA Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. YOU SHOULD COMPLETE THIS CHECKLIST, NOTING THE CONDITION OF THE RENTAL PROPERTY, AND RETURN IT TO THE LANDLORD WITHIN 5 DAYS AFTER OBTAINING POSSESSION OF THE RENTAL UNIT. YOU ARE ALSO ENTITLED TO REQUEST AND RECEIVE A COPY OF THE LAST TERMINATION INVENTORY CHECKLIST WHICH SHOWS WHAT CLAIMS WERE CHARGEABLE TO THE LAST PRIOR TENANTS. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord within 5 days after obtaining possession of the rental unit. You should keep the other copy for your records. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other DINING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BEDROOM NO. 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BASEMENT/STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other Doors Walls/ceiling & paint Floors Windows Railings Other GARAGE/PARKING AREA Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies This is a statement of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unitpremises you have leased or rented. You should keep read it carefully in order to see if it is correct. If it is correct you must sign it. This will show that you agree that the other copy for list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your records. Landlordfailure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit Xxxxxxxx’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range KITCHEN Other DINING ROOM Air conditioner Windows & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint screens Carpet/floor Curtains or draperies Windows & screens Light fixture Furniture Closets Shelves Doors Plumbing fixtures Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Doors Windows & screens Walls/ceiling paint Carpet/floor Closets Furniture Shelves Other BEDROOM NO. 1 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture WallsBASEMENT/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies This is a statement of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord after obtaining possession of the rental unitpremises you have leased or rented. You should keep read it carefully in order to see if it is correct. If it is correct you must sign it. This will show that you agree that the other copy for list is correct and complete. If it is not correct, you must attach a separate signed list of any damage which you believe exists in the premises. This statement must be returned to the lessor or his agent within fifteen days after you receive this list or within fifteen days after you move in, whichever is later. If you do not return this list, within the specified time period, a court may later view your records. failure to return the list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range KITCHEN Other DINING ROOM Air conditioner Windows & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint screens Carpet/floor Curtains or draperies Windows & screens Light fixture Furniture Closets Shelves Doors Plumbing fixtures Other LIVING ROOM Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other BATHROOM Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet BEDROOM NO. 1 Doors Windows & screens Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other BEDROOM NO. 1 2 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture WallsBASEMENT/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other STORAGE Windows Walls/ceiling & paint Closets Floors Doors Other HALLWAY(S) Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other GARAGE/PARKING AREA Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewersewer NUMBER OF KEYS RECEIPT FOR INVENTORY CHECKLIST AND LEASE Tenant acknowledges a copy of two Inventory checklists and a signed copy of the Lease for Premises located at TENANT DATE ITEMIZED LIST OF CHARGES TENANT DATE MAILED FORWARDING ADDRESS

IN CHECKLIST. INVENTORY CHECKLIST FOR __________________________________________ You are being provided with two copies of the Inventory Checklist. You should complete one checklist, noting the condition of the rental property, and return it to the landlord within 5 days after obtaining possession of the rental unit. You should keep the other copy for your records. You are also entitled to request and receive a copy of the last termination inventory checklist which shows what claims were chargeable to the last prior tenants. You must notify the landlord in writing within 5 days after you move of a forwarding address where you can be reached and where you will receive mail; otherwise your landlord shall be relieved of sending you an itemized list of damages and the penalties adherent to that failure. Landlord’s name and address __________________________________________ Security deposit deposited at __________________________________________ Name(s) of the tenant(s) __________________________________________ MOVE-IN Move-In Date: MOVE-OUT MoveOUTMove-Out Date: Refrigerator Range & oven Broiler Range hood & fan Sink & counter Garbage disposal Cabinets Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows & screens Furniture Closets Shelves Doors Plumbing fixtures Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor Curtains or draperies Light fixture Furniture Closets Shelves Other Thermostat Air conditioner Door Windows & screens Walls/ceiling & paint Carpet/floor TV cord & adaptor Curtains or draperies Light fixture Furniture Closets Shelves Other Bathtub/shower Sink & counter Medicine cabinet Vent fan Ceramic tile Light fixture Walls/ceiling & paint Carpet/floor Curtains or draperies Windows Closets Shelves Doors Toilet Other BEDROOM NO. 1 Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Doors Windows & screens Light fixture Walls/ceiling paint Carpet/floor Closets Curtains or draperies Furniture Shelves Other Windows Walls/ceiling & paint Closets Floors Doors Other Doors Walls/ceiling & paint Floors Windows Other STAIRWELL Doors Walls/ceiling & paint Floors Windows Railings Other Windows Walls/ceiling Shelves Paint Doors Other DATE UTILITIES NOTIFIED Gas company Electric company Water & sewer