SAMPLE CHECK LIST FOR HOUSING CONDITIONS
Apartment Building ___________________________________________________ Address:__________________________________ Apt #:____________ Name of Landlord:____________________________________________________ Name of Tenant(s):___________________________________________________ ******************************************************************

ITEM	CONDITION	CONDITION
	MOVING IN	MOVING OUT
BEDROOM

Paint:
Walls:	\|_______________________________	\|_______________________________
Ceiling:	\|_______________________________	\|_______________________________
Carpet or Floor:	\|_______________________________	\|_______________________________
Curtains:	\|_______________________________	\|_______________________________
Bed Frame:	\|_______________________________	\|_______________________________
Mattress:	\|_______________________________	\|_______________________________
Dresser:	\|_______________________________	\|______________________________
Closet:	\|_______________________________	\|_______________________________
Light Fixtures:	\|_______________________________	\|_______________________________
Chairs:	\|_______________________________	\|_______________________________
Other:	\|_______________________________	\|_______________________________
BATHROOM

Walls:	\|_______________________________	\|_______________________________
Ceiling:	\|_______________________________	\|_______________________________
Carpet or Floor:	\|_______________________________	\|_______________________________
Bathtub:	\|_______________________________	\|_______________________________
Faucets	\|_______________________________	\|_______________________________
Sink	\|_______________________________	\|_______________________________
Bathtub	\|_______________________________	\|______________________________
Toilet	\|_______________________________	\|_______________________________
Light Fixtures:	\|_______________________________	\|_______________________________
Shower Curtain:	\|_______________________________	\|_______________________________
Towel Rack:	\|_______________________________	\|_______________________________
Other:	\|_______________________________	\|_______________________________
LIVING ROOM

Paint:
Walls:	\|_______________________________	\|_______________________________
Ceiling:	\|_______________________________	\|_______________________________
Carpet or Floor:	\|_______________________________	\|_______________________________
Curtains:	\|_______________________________	\|_______________________________
Light Fixtures:	\|_______________________________	\|_______________________________
Sofa:	\|_______________________________	\|_______________________________
Chairs:	\|_______________________________	\|______________________________
Tables:	\|_______________________________	\|_______________________________
Bookcase:	\|_______________________________	\|_______________________________
Desk:	\|_______________________________	\|_______________________________
Other:	\|_______________________________	\|_______________________________
KITCHEN

Paint:
Walls:	\|_______________________________	\|_______________________________
Ceiling:	\|_______________________________	\|_______________________________
Carpet or Floor:	\|_______________________________	\|_______________________________
Refrigerator:	\|_______________________________	\|_______________________________
Stove:	\|_______________________________	\|_______________________________
Burners:	\|_______________________________	\|_______________________________
Oven:	\|_______________________________	\|______________________________
Cabinets:	\|_______________________________	\|_______________________________
Curtains:	\|_______________________________	\|_______________________________
Light Fixtures:	\|_______________________________	\|_______________________________
Table:	\|_______________________________	\|_______________________________
Chairs:	\|_______________________________	\|_______________________________
Sink and Faucets:	\|_______________________________	\|_______________________________
Dishwasher:	\|_______________________________	\|_______________________________
OTHER

___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|______________________________
___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|_______________________________
___________	\|_______________________________	\|_______________________________

APPROVAL AT CHECK-IN:	APPROVAL AT CHECKOUT:
_________________________	_________________________
Signature of Landlord	Signature of Landlord
_________________________	_________________________
Signature of Tenant	Signature of Tenant
_________________________	_________________________
Date	Date