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Form #9 : CHECK-IN/CHECK-OUT REPORT

 

Required entries are indicated by blue icons or *

et al (and all others)

 
Poor(P) Fair(F) Good(G) Excellent(E) New(N) Attach additional sheets for extra rooms, items or more detailed explanations.
 

GENERAL ITEMS

Walls

Windows/Screens

Drapes/Curtains/Shades

Rods

Floor

Carpets/Rugs

Wood/Linoleum

Light Fixtures/Bulbs

Doors/Woodwork

Knobs/Locks

Ceilings

Electrical Outlets

Garbage Cans

TV Antenna/Cable
 

LIVING ROOM

Fireplace
 

KITCHEN

Stove

Broiler Pans/Racks

Refrigerator

Ice Trays

Shelves/Drawers

Disposal

Dishwasher

CounterTops

Cabinets

Sink
 

BATHROOM

Towel Bars

Sink & Vanity

Toilet

Tub/ Shower

Shower Rod

Paper Holder

Soap Dish

Mirror
 

ESSENTIAL SERVICES

Plumbing

Heating

Electricity

Hot Water

CO. & Smoke Alarm
 

BEDROOM 1

Walls

Windows/Screens

Drapes/Curtains/Blinds

Rods

Floor

Carpets/Rugs

Wood/Linoleum

Light Fixtures/Bulbs

Doors/Woodwork/Trim

Knobs/Locks

Ceilings

Outlets
 

BEDROOM 2

Walls

Windows/Screens

Drapes/Curtains/Blinds

Rods

Floor

Carpets/Rugs

Wood/Linoleum

Light Fixtures/Bulbs

Doors/Woodwork/Trim

Knobs/Locks

Ceilings

Outlets
 

BEDROOM 3

Walls

Windows/Screens

Drapes/Curtains/Blinds

Rods

Floor

Carpets/Rugs

Wood/Linoleum

Light Fixtures/Bulbs

Doors/Woodwork/Trim

Knobs/Locks

Ceilings

Outlets
 

Further Explanation of Above Condition:
 

Utility companies to be notified by Tenant:
 

Number of keys provided to Tenant:
 

Number of garage door openers provided to Tenant:
 

 
I/we accept this rental unit in the above condition:
I/we left the rental unit in the above condition:
 
 
 
Tenant Date
 
Tenant Date
 
Tenant Date
 
Tenant Date
 
Forwarding Address

I/we agree that all personal property remaining in the rental unit or on the property may be disposed of by the Owner/Agent without complying with the requirements of ORS 90:
 
        
Tenant Date   Tenant Date

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1462 Commercial St. NE, Salem, OR 97301
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