Housing Conditions Checklist: Complete this form in duplicate as soon as you move in. Fill out, date, sign this document and keep a copy and give a copy to the landlord.

Address: ______________________ Apt. #____

Landlord_______________________________

Tenants________________________________

KEY: G-Good, F-Fair, P-Poor, D-Damaged, M-Missing

AREA	G	F	P	D	M	COMMENTS
Living Room
Floor
Walls
Ceiling
Doors
Windows
Screens
Carpet
Curtains
Lights
Blinds
Outlets
Dining Room
Floor
Walls
Ceiling
Doors
Windows
Screens
Carpet
Curtains
Lights
Blinds
Outlets
Hallway
Walls
Floor
Ceiling
Windows
Screens
Blinds
Closets
Stairs
Outlets
Kitchen
Floor
Walls
Ceiling
Doors
Windows
Screens
Carpet
Curtains