Check In/Out Form Tenants should complete this form, have it signed by the landlord or manager if possible, make one copy, and return the original to the landlord within 7 days of moving into the rental unit. Address: Date: Tenant(s):   Address: Date: Kitchen Condition Bathroom Condition Range   Medicine Cabinet/Mirror   Hood Fan   Tile/Caulk   Dishwasher   Towel Rack(s)   Refrigerator   Tub/Shower   Sink/Faucets   Walls/Ceiling   Cabinets   Floor   Floor   Window   Hardware   Fan   Light Fixtures   Door   Furniture   Other ____________   Other ____________   Other ____________   Other ____________   Other ____________   Dining Room Condition Bedroom 1 Condition Floor/Carpet   Floor/Carpet   Door   Walls/Ceiling   Walls/Ceiling   Windows   Light Fixtures   Light Fixtures   Furniture   Furniture   Windows   Closet   Closet   Other ____________   Other ____________   Other ____________   Living Room Condition Bedroom 2 Condition Floor/Carpet   Floor/Carpet   Door   Walls/Ceiling   Walls/Ceiling   Windows   Light Fixtures   Light Fixtures   Furniture   Furniture   Windows   Closet   Closet   Other ____________   Other ____________   Other ____________   Other Items/Areas Condition Bedroom 3 Condition     Floor/Carpet       Walls/Ceiling       Windows       Light Fixtures       Furniture       Closet       Other ____________       Other ____________   Tenant Signature:___________________________________ Date:_________________ Tenant Signature:___________________________________ Date:_________________ Tenant Signature:___________________________________ Date:_________________ Tenant Signature:___________________________________ Date:_________________ Received by Landlord:_______________________________ Date:_________________ Witness To Check-In:________________________________ Date:_________________

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