Apartment Checklist

Your Name:_____________________________________________________________
Street:_____________________________________Unit Number:__________________
City:______________________________________State:__________ Zip:___________
Home phone:___________________________Work Phone:_______________________
Other phone:___________________________Normal Rent date:___________________

Water Supply and Plumbing	Describe condition and location
No Water_______________________________________________________________
No Hot water____________________________________________________________
Inadequate amounts of Hot water:_____________________when?__________________
Water not hot enough:_____________________________________________________
Toilet leaks:______________________________________________________________
Toilet doesn't flush properly:_________________________________________________
Faucets defective:_________________________________________________________
Drain problems:___________________________________________________________
Other water/plumbing problems:______________________________________________
_______________________________________________________________________

Appliances		Describe condition
Stove:__________________________________________________________________
Refrigerator______________________________________________________________
Other appliance:__________________________________________________________
Other appliance problems:___________________________________________________
_______________________________________________________________________

Heat/Ventilation		Describe condition
NO HEAT:______________________________________________________________
Inadequate heat (below 70 degrees):___________________________________________
Defective furnace (loud, needs filters, gas fumes etc):_____________________________
Unvented Space heater:_____________________________________________________
Thermostat doesn't work properly:____________________________________________
TOO HOT!:_____________________________________________________________
Broken/defective vent fan:___________________________________where?__________
Other heat/ventilation problems:______________________________________________
______________________________________________________________________

Safety Problems		Describe condition and location
Building open to strangers:__________________________________________________
Inadequate Door locks:_________________________________where?______________
Need Window locks or bars:_________________________________________________
Smoke Detectors broken/missing:_____________________________________________
Non-residents loitering around the building:_____________________________________
where?_________________________________when?__________________________
Electrical		Describe condition and location
Bare/exposed wiring:______________________________________________________
No switch/socket plate:_____________________________________________________
Fuses blow out regularly:___________________________________________________
Lights flicker:____________________________________________________________
Shortage of wall outlets:____________________________________________________
Other electrical problems:___________________________________________________

Windows:				Describe condition and location
Broken windows:_________________________________________________________
Air comes in/around windows:_______________________________________________
Windows rattle in the wind:_________________________________________________
Chipped/peeling paint around windows:________________________________________
No screens:_____________________________________________________________
Other window problems:___________________________________________________

Walls/Floors/Ceilings		Describe condition and location
Chipping,peeling paint:_____________________________________________________
Holes in walls:___________________________________________________________
Need Paint:______________________________________________________________
Holes in floor:____________________________________________________________
Floor coverings:__________________________________________________________
Water stains:_____________________________________________________________
Water leaks:_____________________________________________________________
Other wall/floor/ceiling problems:_____________________________________________

Fixtures:		Describe condition
Bathroom sink:___________________________________________________________
Bathroom cabinents:_______________________________________________________
Bathroom tub/shower:______________________________________________________
Other bathroom fixtures:____________________________________________________
Kitchen sink:_____________________________________________________________
Kitchen cabinents:_________________________________________________________
Other fixtures:____________________________________________________________
_______________________________________________________________________

Common areas (hallways, stairs, and grounds around your unit):								Description and location
Chipping, peeling paint:_____________________________________________________
Inadequate lighting________________________________________________________
Inadequate cleaning/maintenance_____________________________________________
Stair railings:_____________________________________________________________
Floor/Wall/Ceiling problems:________________________________________________
Smoke detectors missing or defective:_________________________________________
Elevator problems:________________________________________________________
Broken windows/doors/fences:_______________________________________________
Broken sidewalks, driveways, other pavement:__________________________________
Play area provided but not maintained:_________________________________________
Other common area problems:______________________________________________
Laundry equipment not maintained:___________________________________________
Open electrical boxes/wires:________________________________________________
Criminal activity in/on common areas:_________________________________________
Other Common area problems:_____________________________________________________________________________________________________________________

Other Comments:
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I have the right to deposit my rent with the Clerk of Courts or to apply to the Courts for an order to compel repair or to terminate my rental agreement if these conditions with affect my health and safety are not corrected within a reasonable time, not to exceed 30 days.  Thanks for your cooperation in complying with this request.

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	Signature							Date