MOVE-IN /MOVE-OUT INSPECTION FORM

1 MOVE-IN / move -OUT INSPECTION FORMThe "Uniform Residential Landlord and Tenant Act" contains certain requirements which a landlord must meet in order toretain any portion of a Tenant's deposit. First, a Landlord must notify Tenants of the bank account number in which thedeposit is kept. Second, a Landlord must provide Tenants with a listing of any damage to the property when asking aTenant to pay a deposit and an updated listing when the Tenant moves out. The following form can can be used forboth purposes. Property:_____ move in move outBEDROOM #1 Dirty or Damage? Dirty or Damage?CommentsWalls YesNoYesNoCeilingYesNoYesNoRugs / CarpetYesNoYesNoLight FixturesYesNoYesNoWindowsYesNoYesNoScree nsYesNoYesNoOtherYesNoYesNo move in move outBEDROOM #2 Dirty or Damage? Dirty or Damage?CommentsWalls YesNoYesNoCeilingYesNoYesNoRugs / CarpetYesNoYesNoLight FixturesYesNoYesNoWindowsYesNoYesNoScree nsYesNoYesNoOtherYesNoYesNo move in move outBEDROOM #3 Dirty or Damage?

2 Dirty or Damage?CommentsWalls YesNoYesNoCeilingYesNoYesNoRugs / CarpetYesNoYesNoLight FixturesYesNoYesNoWindowsYesNoYesNoScree nsYesNoYesNoOtherYesNoYesNo move in move outBEDROOM #4 Dirty or Damage? Dirty or Damage?CommentsWalls YesNoYesNoCeilingYesNoYesNoRugs / CarpetYesNoYesNoLight FixturesYesNoYesNoWindowsYesNoYesNoScree nsYesNoYesNoOtherYesNoYesNoInitials move in move outKITCHEN Dirty or Damage? Dirty or Damage?CommentsStove / OvenYesNoYesNoRefrigerator / FreezerYesNoYesNoDishwasherYesNoYesNoGar bage DisposalYesNoYesNoSinkYesNoYesNoCounter topYesNoYesNoLight FixturesYesNoYesNoWallsYesNoYesNoCeiling YesNoYesNoFloorYesNoYesNoWindowsYesNoYes NoScreensYesNoYesNoOtherYesNoYesNo move in move outBATHROOM #1 Dirty or Damage? Dirty or Damage?CommentsSinkYesNoYesNoCounter topYesNoYesNoTubYesNoYesNoShowerYesNoYes NoToiletYesNoYesNoToilet seatYesNoYesNoCabinetsYesNoYesNoMirrorYe sNoYesNoFloorYesNoYesNoWallsYesNoYesNoCe ilingYesNoYesNoOtherYesNoYesNo move in move outBATHROOM #2 Dirty or Damage?

3 Dirty or Damage?CommentsSinkYesNoYesNoCounter topYesNoYesNoTubYesNoYesNoShowerYesNoYes NoToiletYesNoYesNoToilet seatYesNoYesNoCabinetsYesNoYesNoMirrorYe sNoYesNoFloorYesNoYesNoWallsYesNoYesNoCe ilingYesNoYesNoOtherYesNoYesNoInitials move in move outLIVING ROOM Dirty or Damage? Dirty or Damage?CommentsWallsYesNoYesNoCeilingYes NoYesNoRugs / CarpetYesNoYesNoLight FixturesYesNoYesNoWindowsYesNoYesNoScree nsYesNoYesNoOtherYesNoYesNo move in move outGARAGE Dirty or Damage? Dirty or Damage?CommentsWallsYesNoYesNoCeilingYes NoYesNoFloorYesNoYesNoGarage DoorYesNoYesNo move in move outMISCELLANEOUS Dirty or Damage? Dirty or Damage?CommentsFront DoorYesNoYesNoBack DoorYesNoYesNoThermostatYesNoYesNoHeatin g / AirYesNoYesNoOutsideYesNoYesNoYardYesNoY esNoYesNoYesNoYesNoYesNoThe above conditions circled "Yes" in the " move in, Dirty / Damage" column to the left were in existence on the date that theTenant moved in and were not caused by the Tenant.

4 When the Tenant moves out, the Landlord may inspect the premiseswith the Tenant and any additional damages which were caused by the Tenant shall be deducted from the commentsMove in:TenantDateLandlordDateTenantDateMove out:TenantDateLandlordDateTenantDat