Residential House Lease Application

Yes No Notes LIVING ROOM Walls Baseboard Carpet Drapes, Rods, Hooks Door Lock Coat Closet DINING AREA Walls Baseboard Carpet Light Fixture Windows Screens KITCHEN Walls Baseboards Light Fixture Stove Drip Pans Oven Broiler Pan Hood, Fan Light Refrigerator Defrosted Ice Trays Hydrator Cover Dishwasher Cupboards Drawers Counter Sink Disposal Stopper Floor HALL Walls Baseboards Carpet/Floor Light Fixture Linen Closet BATHROOM - 1 Walls Baseboard Sink Counter Cabinets/Mirror Toilet Bath Tub/Shower Light Fixture Floor Tissue Holder/Towel Bars BATHROOM - 2 Walls Baseboard Sink Counter Cabinets/Mirror Toilet Bath Tub/Shower Light Fixture Floor Tissue Holder/Towel Bars BEDROOM - 1 Walls Baseboard Windows Screens Drapes, Rods Hooks Light Fixtures Carpet Closet Floor BEDROOM - 2 Walls Baseboard Windows Screens Drapes, Rods Hooks Light Fixtures Carpet Closet Floor DEN or BEDROOM - 3 Walls Baseboard Windows Screens Drapes, Rods Hooks Light Fixtures Carpet Closet Floor BASEMENT/FURNACE ROOM Furnace Washer Dryer Water Storage Tank MISCELLANEOUS Balcony/Patio Storage Area Garage Mailbox OTHER FURNITURE INVENTORY (If the furniture is provided by Landlord) Item Nbr Item Nbr LIVING ROOM BEDROOM 1 Couch Beds Chairs Dressers Lamps Mirror Coffee Table Nightstands End Table Lamps DINING AREA BEDROOM 2 Table Beds Chairs Dressers Hutch Mirror Nightstands KITCHEN Lamps Stove Oven BEDROOM 3 Refrigerator Beds Dishwasher Dressers Table Mirror Chairs Nightstands Lamps LAUNDRY/UTILITY ROOM Washer DEN / STUDY Dryer Desk Chairs Tables OTHER Bookcases Lamps The parties acknowledge that the above inspection was made on , and that the conditions of the premises and the inventory of furnishings and appliances is as shown above..