VIRGINIA ASSOCIATION OF REALTORS RESIDENTIAL MOVE IN MOVE OUT INSPECTION REPORT
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1 VIRGINIAASSOCIATIONOFREALTORS RESIDENTIALMOVEINMOVEOUTINSPECTIONREPORT This MoveIn MoveOut Inspection Report is by and between, Landlord, and Tenant(s), and Agent for Landlord, dated forpropertydescribedas (the Dwelling Unit ), in accordance with theleaseagreementbyandbetweentheparties. The Dwelling Unit is being delivered at MoveIn by Landlord to Tenant in a clean, sanitary and good working conditionwithnospots,stains,marksordamages,unlessotherwiseindicatedonthisreport. DateofOccupancy:,20 DateofVacating:,20 ROOMSTOBEINSPECTED OK OCCUPANCY VACATE OK NOTES NOTES KITCHEN Doors Walls&Ceiling Floor Windows&Screens Drapes LightFixtures&Outlets WallCabinets&Hardware BaseCabinets&Hardware Range Fan Light (Broiler Pan) Refrigerator IceTrays Sink&Disposal DININGROOM Walls&Ceiling Floor&Carpet Woodwork LightFixtures&Outlets Windows&Screens Drapes Doors LIVINGROOM&HALLWAY Walls&Ceiling Floor&Carpet Woodwork LightFixtures&Outlets Windows&Screens AMOUNT VARFORM1100REV.08/11 Page1of6
2 ROOMSTOBEINSPECTED OK OCCUPANCY VACATE OK NOTES NOTES LIVINGROOM&HALLWAY(con t.) Drapes Doors Closet StairRailings BEDROOM#1 Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets BEDROOM#2 Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets BEDROOM#3 Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets BEDROOM#4 Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors AMOUNT VARFORM1100REV.08/11 Page2of6
3 ROOMSTOBEINSPECTED OK OCCUPANCY VACATE OK NOTES NOTES BEDROOM#4(con t.) LightFixtures&Outlets Closets BEDROOM#5 Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets BATHROOM#1 Walls&Ceiling Floor Woodwork LightFixtures&Outlets ShowerFixtures Rods&SoapDishes MedicineCabinet Tub WaterCloset&Seat Lavatory Door TissueHolder Fan BATHROOM#2 Walls&Ceiling Floor Woodwork LightFixtures&Outlets ShowerFixtures Rods&SoapDishes MedicineCabinet Tub WaterCloset&Seat Lavatory Door TissueHolder Fan AMOUNT VARFORM1100REV.08/11 Page3of6
4 ROOMSTOBEINSPECTED OK OCCUPANCY VACATE OK NOTES NOTES BATHROOM#3 Walls&Ceiling Floor Woodwork LightFixtures&Outlets ShowerFixtures Rods&SoapDishes MedicineCabinet Tub WaterCloset&Seat Lavatory Door TissueHolder Fan MISCELLANEOUS HeatingUnit AirConditioningUnit SmokeDetector DeadboltLocks WindowLocks SlidingGlassDoorSecondary LockingDevice OTHER: Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets OTHER: Walls&Ceilings Floor&Carpet Woodwork Windows&Screens Drapes Doors LightFixtures&Outlets Closets AMOUNT VARFORM1100REV.08/11 Page4of6
5 ROOMSTOBEINSPECTED OK OCCUPANCY VACATE OK NOTES NOTES AMOUNT GARAGE EXTERIOR Occupancy Statewhetherthereisanyvisibleevidenceofmold inthedwellingunit: Yes Ifso,statethelocation No IfYes,dateofreinspectionafterremediation: Statewhetherthereisanyvisibleevidenceofmold inthedwellingunituponreinspection: Yes No KeysReceived: FrontDoor #received: MailBox #received: LaundryRoom #received: StorageRoom #received: TenantSignature Date TenantSignature Date Statewhetherthereisanyvisibleevidenceofdisturbedpaint surfacesinthedwellingunit: Yes Ifso,statethelocation No IfYes,dateofreinspectionafterrepair: Statewhetherthereisanyvisibleevidenceofdisturbedpaint surfacesinthedwellingunituponreinspection: Yes No OtheritemsreceivedbyTenant(s): PoolPass: #received: GarageOpener: #received: : #received: : #received: TenantSignature Date Landlord/AgentSignature Date VARFORM1100REV.08/11 Page5of6
6 VACATE ForwardingAddress: LeasePeriodFulfilled:Yes No WrittenConfirmationofpaymentinfullofallapplicableutility charges?yes No TenantSignature Date TenantSignature Date TenantSignature Date Landlord/AgentSignature Date DEPOSITS Deposits: $ DelinquentRent: $ UtilitiesCharges: $ Repairand/orCleaningCharges: $ Dueto/ FromTenant: $ COPYRIGHT 2011bytheVIRGINIAASSOCIATIONOFREALTORS.Allrightsreserved.Thisformmaybeusedonlyby membersingoodstandingwiththevirginiaassociationofrealtors.thereproductionofthisform,inwhole orinpart,ortheuseofthename"virginiaassociationofrealtors ",inconnectionwithanyotherform,is prohibitedwithoutpriorwrittenconsentfromthevirginiaassociationofrealtors. VARFORM1100REV.08/11 Page6of6
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