Minnesota Standard Residential Lease LEASE

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

Minnesota Standard Residential Lease L

EASE / PAGE 1 of 10

MINNESOTA STANDARD RESIDENTIAL LEASE

©

CONSULT WITH A LAWYER TO DETERMINE THAT THIS CONTRACT ADEQUATELY PROTECTS YOUR LEGAL RIGHTS. Minnesota State

Bar Association disclaims any liability arising out of use of this form.

The Office of the Minnesota Attorney General certifies that this contract complies with the requirements of Minn. Stat. §325G.31 (1999).

CERTIFICATION OF A CONTRACT BY THE MINNESOTA ATTORNEY GENERAL UNDER THE PLAIN LANGUAGE CONTRACT ACT IS NOT

OTHERWISE AN APPROVAL OF THE CONTRACT’S LEGALITY OR LEGAL EFFECT.

Landlord and Tenant agree to the following terms.1

TENANTS. (Each adult who signs this Lease is a "Tenant.”) 2

3

OTHER OCCUPANTS. 4

5

LANDLORD. 6

The Premises (“Premises”) includes dwelling unit number 7

at (street address) (city) MN (zip code)8

and garage no. , storage unit no. , parking stall no. 9

Term of Lease. (Write number of months or "month-to-month.") 10

Starting Date of Possession Ending Date of Possession (if known) 11

Monthly Rent $ Security Deposit $ 12

Late Fee $ (In no case may the late fee exceed 8.0% of the overdue rent payment. Minn. Stat. Section 504B.177.)13

OTHER CHARGES (specify)14

15

RECEIPT. RECEIVED FROM TENANT BY LANDLORD AT THE SIGNING OF THIS16

LEASE:17

AMOUNT

FIRST MONTH’S RENT PAID IN ADVANCE18

FIRST MONTH’S UTILITIES PAID IN ADVANCE (See Choices 3 and 4 below.)19

LAST MONTH'S RENT PAID IN ADVANCE20

SECURITY DEPOSIT PAID IN ADVANCE21

FIRST MONTH’S RENT FOR GARAGE PAID IN ADVANCE22

FIRST MONTH’S RENT FOR STORAGE UNIT PAID IN ADVANCE23

OTHER (Specify) , PAID IN ADVANCE24

TOTAL RECEIVED FROM TENANT:25

26

Notice. Under Minnesota law, the landlord of a single-metered residential building is the bill payer responsible and shall be the27

customer of record contracting with the utility for utility services. Utilities and Services will be paid as follows.28

UTILITIES:29 Included in Rent Not Included in Rent; Paid or Billed Separately

30 Choice No. 1 Choice No. 2 Choice No. 3 Choice No. 4

31

32

33

34

35

36

UTILITY OR37

SERVICE 38

LANDLORD PAYS

SERVICE PROVIDER

(Utilities and services are

included in rent.)

TENANT PAYS

DIRECTLY TO

SERVICE PROVIDER

(Tenant’s Premises has a

separate meter and

separate billing or

account in Tenant’s

name.)

TENANT PAYS

LANDLORD

(Reimbursement for

separately metered utility or

for service for Tenant’s

Premises with separate

billing or account in

Landlord’s name.)

(ADDED TO RENT.)

TENANT PAYS

LANDLORD FOR A

PORTION OF

UTILITIES OR

SERVICES

(Tenant’s Premises does

not

have a separate

meter.)

(ADDED TO RENT)

39

>>>>>>> CHECK ONLY ONE COLUMN FOR EACH UTILITY OR SERVICE <<<<<<<

Natural Gas

40

Water & Sewer41

Electricity42

Fuel Oil43

Garbage44

Collection45

Telephone46

Cable47

Communication48

Association Fees49

Other Utility or50

Service (Specify)51

NOTE: If either Choice No. 3 or Choice No. 4 is checked for any utility or52

service, Landlord must complete Part 35 of this Lease before Tenant signs. 53

Caution: Minneapolis and other cities might prohibit the apportioning of54

utilities (Choice No. 4).55

» SEE NOTE IF CHOICE NO. 3 OR CHOICE NO.

4 IS CHECKED FOR ANY UTILITY OR SERVICE.

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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CHECK APPLIANCES INCLUDED 56

REFRIGERATOR57

KITCHEN STOVE 58

MICROWAVE 59

DISHWASHER 60

TRASH COMPACTER61

CLOTHES WASHER

CLOTHES DRYER

WINDOW UNIT AIR CONDITIONER

GAS GRILL

OTHER

The person authorized to manage the Premises is

62

Name 63

Street Address, (not P.O. Box) 64

City, State, Zip code Telephone 65

The Landlord or agent authorized to accept service of process and receive and give receipts for notices is66

Name 67

Street Address, (not P.O. Box) 68

City, State, Zip code Telephone 69

List any additional agreements here. Attach a copy of each additional agreement to each copy of the Lease. 70

71

72

73

74

75

TERMS OF THIS LEASE.76

77

1. OCCUPANCY AND USE. Only the Tenants and Occupants listed above may live in the Premises, except as allowed78

by law. The Premises, Utilities and Services shall be used only for common residential uses.79

80

2. RENT. Tenant shall pay Rent in advance on or before the first day of every month. Tenant shall pay the Rent at 81

or other reasonable place requested by Landlord.82

83

3. LATE FEE AND RETURNED CHECK FEE. If Landlord does not receive the rent by the fifth day of the month,84

Tenant must pay any late fee listed above as additional rent if requested in writing by Landlord. Tenant shall also pay85

$20.00 for each unpaid check returned by Tenant's bank. Rent is “paid” when Landlord receives it, not when mailed or86

sent by Tenant. 87

88

4. SECURITY DEPOSIT. Landlord may use the security deposit 89

A. To cover Tenant’s failure to pay rent or other money due Landlord.90

B. To return the Premises to its condition at the start of the tenancy except for ordinary wear and tear. 91

92

Within 21 days after the tenancy ends and Tenant gives Landlord a forwarding address, Landlord shall return the full93

security deposit with interest or send a letter explaining what was withheld and why.94

95

5. EACH TENANT RESPONSIBLE. Each Tenant is responsible for all money due to Landlord under this Lease, not96

just a proportionate share.97

98

6. TENANT PAYS FOR DAMAGE. Tenant shall pay for all loss, cost, or damage (including plumbing trouble)99

caused by the willful or irresponsible conduct of Tenant or by a person under Tenant’s direction or control. 100

101

7. LANDLORD’S NON-WAIVER. Payments other than rent are due when Landlord demands them from Tenant.102

Landlord’s failure or delay in demanding payments is not a waiver. Landlord may demand payments before or after103

Tenant vacates the Premises. 104

105

8. ATTORNEY’S FEES. The court may award reasonable attorney’s fees and costs to the party who prevails in a106

lawsuit about the tenancy.107

108

9. PREMISES INSPECTION. Landlord and Tenant inspected the Premises together and signed an inspection sheet109

before signing this Lease. A copy is attached. When the Lease ends, Landlord and Tenant shall inspect again and110

complete a second inspection sheet.111

112

10. LANDLORD’S PROMISES. 113

A. The Premises and all common areas are fit for the use intended by Landlord and Tenant. 114

B. Landlord shall make necessary repairs. Landlord need not repair damage caused by the willful or irresponsible115

conduct of Tenant, Tenant’s guests, or a person under Tenant’s direction or control. 116

C. Landlord shall keep the Premises up to code unless a violation of the codes has been caused by the willful or117

irresponsible conduct of Tenant, Tenant’s guests, or a person under Tenant’s direction or control. 118

119

11. TENANT’S PROMISES. 120

A. Tenant shall not allow damage to the Premises.121

B. Tenant shall not allow waste of the Utilities or Services provided by Landlord. 122

C. Tenant shall make no alterations or additions. 123

D. Tenant shall remove no fixtures.124

E. Tenant shall not paint the Premises without Landlord’s written consent. 125

F. Tenant shall keep the Premises clean and tidy. 126

G. Tenant shall not unreasonably disturb the peace and quiet of others.127

H. Tenant shall not interfere with the management of the property and shall not allow Tenant’s guests to do so.128

I. Tenant shall use the Premises only as a private residence.129

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J. Tenant shall not use the Premises in any way that is unlawful, illegal, or dangerous.130

K. Tenant shall not use the Premises in any way that would cause a cancellation, restriction or increase in premium in131

Landlord's insurance. 132

L. Tenant shall not use or store in or near the Premises any inflammable or explosive substances in an unsafe manner.133

M. Tenant shall notify Landlord in writing of any repairs to be made. 134

N. Tenant shall recycle or dispose of trash in the outside containers provided for those purposes.135

136

12. TENANT’S TELEPHONE. Tenant shall give Landlord the Tenant’s home phone number within 2 days after137

service is started or the phone number is changed.138

139

13. RESTRICTIONS. 140

A. WATERBEDS. Tenant shall not have water beds or other water-filled furniture on the Premises.141

B. PETS. Tenant shall not have animals or pets on the Premises without Landlord’s prior written approval. 142

C. LOCKS. Tenant shall not add or change locks. At Tenant’s request, Landlord will change the locks or have the143

lock cylinders re-keyed at Tenant’s expense. If the locks do not meet current municipal codes or regulations,144

Landlord shall change the locks at Landlord’s expense. 145

D. VEHICLES. Tenant shall have no motor home, camper, trailer, boat, recreational vehicle, unlicenced vehicle,146

inoperable vehicle, vehicle on blocks, or commercial truck on the Premises or on the common area or curtilage of147

the Premises, except in a garage. [“Curtilage” means the grounds surrounding the building in which the Premises148

is located.] A commercial truck is any truck in commercial service or larger than a pickup truck. Permitted vehicles149

shall be parked in designated areas only. Three days after giving notice to Tenant, Landlord may remove and store150

the offending vehicles. Tenant shall pay reasonable removal and storage expenses as additional Rent. 151

152

14. LANDLORD’S RIGHT TO ENTER. Landlord may enter the Premises for a reasonable business purpose.153

Landlord must first make a good faith effort to give Tenant reasonable notice of the intent to enter. Landlord may enter154

the Premises in an emergency. Landlord must disclose the date, time and purpose of the emergency entry in writing.155

The writing must be left in a conspicuous place in the Premises. 156

157

15. DAMAGE OR INJURY TO TENANT OR TENANT’S PROPERTY. Landlord is not responsible for any158

injury or damage that was not caused by a willful or negligent act or failure to act of Landlord. Tenant may obtain159

Renter's Insurance 160

161

16. NOTICE OF DANGEROUS CONDITIONS. Tenant shall promptly notify Landlord of any conditions that162

might cause damage to the Premises or waste Utilities or Services provided by Landlord. The notice may be oral or in163

writing.164

165

17. SUBLETTING. Tenant shall not sublet part or all of the Premises without Landlord’s written consent. Tenant166

shall not assign this Lease without Landlord’s written consent. The consent shall not be unreasonably withheld or167

delayed.168

169

18. MOVING OUT OR HOLDING OVER. Tenant must move out not later than 11:59 p.m. on the Ending Date.170

If Tenant occupies the Premises after the Ending Date with Landlord’s permission and this Lease has not been renewed171

nor a new Lease made, this Lease becomes a month-to-month lease under its original terms.172

173

19. NOTICE IF LEASE BECOMES MONTH-TO-MONTH. If this Lease is or becomes month-to-month, written174

notice is required by Landlord or Tenant to end the Lease. The notice must end the lease on the last day of a month and175

must be received before the first day of that month. For example, to end a month-to-month lease on April 30, the notice176

must be received on March 31 or earlier.177

178

20. VACATING. When moving out, Tenant must:179

A. Leave the Premises in the same condition as at the start of the Lease, except for ordinary wear and tear and fire or180

casualty loss.181

B. Completely vacate the Premises, including storage units, garage and parking stalls.182

C. Give Landlord a forwarding address. 183

D. Give Landlord all keys and personal property issued to Tenant for Tenant’s use such as garage door openers, and184

tools. If Tenant does not return all keys within 24 hours of vacating, Landlord may change the locks and charge185

reasonable costs to Tenant. 186

187

21. PREMISES DESTROYED, UNINHABITABLE OR UNFIT FOR OCCUPANCY.188

A. If the Premises is destroyed or becomes totally uninhabitable or completely unfit for occupancy through no fault189

or neglect of Tenant or a person under Tenant’s direction or control, either Landlord or Tenant may end this Lease.190

To end the lease, Tenant or Landlord shall give prompt written notice to the other. Rent shall be prorated as of the191

date the Premises became unfit for occupancy.192

B. If the Premises is destroyed or becomes totally uninhabitable or completely unfit for occupancy through the fault193

or neglect of Tenant or a person under Tenant’s direction or control, Landlord may end this Lease. Landlord shall194

give prompt written notice to Tenant.195

196

22. BREACH OF LEASE [RE-ENTRY CLAUSE]. If Tenant materially breaches this lease, Landlord may do these197

things.198

A. Demand in writing that Tenant immediately give up possession of the Premises. If Tenant does not give up199

possession, Landlord may bring an eviction action (unlawful detainer action).200

B. Demand in writing that Tenant give up possession of the Premises to Landlord at a certain date in the future. If201

Tenant does not give up possession on that date, Landlord may bring an eviction action (unlawful detainer action).202

Landlord may accept rent for the period up to the date possession is to be transferred without giving up Landlord’s203

right to evict.204

C. Bring an eviction action immediately (unlawful detainer action).205

206

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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23. DUTY TO PAY RENT AFTER EVICTION OR SURRENDER. Rent is due under this Lease even if Tenant207

surrenders the Premises or is evicted by Landlord. Landlord shall make good faith efforts to mitigate damages. 208

209

24. SUBORDINATION. This lease is subordinate to any mortgage against the Premises. No new owner or lender shall210

disturb Tenant's occupancy, but shall have Landlord's remedies if Tenant defaults. Tenant shall sign documents211

reasonably requested by Landlord. Tenant appoints Landlord as attorney-in-fact to sign such documents for any212

mortgagee. 213

214

25. EXERCISE OF RIGHTS AND REMEDIES. Either party may use any or all of its legal rights and remedies. The215

use of one or more rights or remedies is not an election of remedies.216

217

26. SUBROGATION. Tenant and Landlord give up all rights of subrogation against the other for loss or damage218

covered by insurance.219

220

27. TERMS. Where appropriate, singular terms include the plural and plural terms include the singular.221

222

28. MISREPRESENTATIONS. Any materially false statement made by either Landlord or Tenant to the other that223

induces the signing of this Lease is a breach of this Lease. 224

225

29. ATTACHMENTS ARE PART OF LEASE. NO ORAL AGREEMENTS. Attachments to this Lease, such as226

Landlord’s building rules, if any, are a part of this Lease. No oral agreements have been made. This Lease with its227

attachments is the entire agreement between Landlord and Tenant.228

229

30. NOTICES. A notice or demand mailed to or handed to any one of the Tenants named above is notice to all Tenants.230

231

31. NOTICE OF PROHIBITION AGAINST UNLAWFUL ACTIVITIES. 232

A. Landlord and Tenant shall not unlawfully allow controlled substances in the Premises or in the common area or233

curtilage of the Premises. The Premises will not be used by Tenant or persons under Tenant’s control to234

manufacture, sell, give away, barter, deliver, exchange, distribute or possess with the intent to sell, give away, barter,235

deliver, exchange, or distribute a controlled substance in violation of any local, state or federal law.236

B. Landlord and Tenant shall not allow prostitution or prostitution-related activity as defined in MINN. STAT. §617.80,237

Subdivision 4, to occur on the Premises or in the common area and curtilage of the Premises.238

C. Landlord and Tenant shall not allow the unlawful use or possession of a firearm in violation of MINN. STAT.239

§609.66, Subdivision 1a, §609.67, or §624.713 on the property, its lands, or common area.240

241

The following notice is required by MINN. STAT. §504B.305. A seizure under §609.5317, Subd. 1, for which there is242

not a defense under §609.5317, Subd. 3, constitutes unlawful detention by Tenant.243

244

32. LEAD PAINT WARNING AND DISCLOSURE. HOUSING BUILT PRIOR TO 1978. 245

246

Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips and dust can pose health hazards247

if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting248

pre-1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the249

dwelling. Lessees must also receive a federally-approved pamphlet on lead poisoning prevention.250

251

A. Hazards Disclosed. Landlord knows of the following lead-based paint or lead-based paint hazards on the Premises252

(If none, state “none.”)253

254

255

256

B. Reports Disclosed. Landlord has provided Tenant with the following, which are all records and reports available257

to Landlord pertaining to lead-based paint or lead-based paint hazards on the Premises. (If no such records or reports258

are available to Landlord, state “none.”)259

260

261

262

C. Tenant’s Acknowledgment. Tenant has received the records or reports noted in paragraph B., above and a copy263

of the pamphlet, Protect Your Family from Lead in Your Home, EPA publication EPA747-K-94-001.264

265

Tenants’ initials ___________________ ____________________266

267

D. Agent’s Acknowledgment. Agent has informed Landlord of Landlord’s obligations under 42 U.S.C. 4852(d) and268

is aware of agent’s responsibility to ensure compliance.269

270

Agent’s initials ___________________ ____________________271

272

By signing below, Landlord, Tenant and Agent certify the accuracy of the statements in the above paragraph.273

274

275

Landlord Date Tenant Date Agent Date276

277

33. CHANGES TO LEASE. Landlord and Tenant may change the terms of this Lease in writing.278

279

34. SMOKING. (check one) 9 Tenant may allow smoking on the Premises.280

9 Tenant shall not allow smoking on the Premises.281

282

35. UTILITIES SERVICE NOTICE. If any of the utilities or services on Page 1 of this Lease is rebilled to Tenant283

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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(Choice No. 3) or apportioned by Landlord and billed to Tenant (Choice No. 4), then this Part 35 becomes part284

of the Lease and must be completed by Landlord. 285

286

A. REBILLED UTILITIES (Under Choice No. 3). For each utility or service rebilled to Tenant under a meter or287

account that provides service exclusively to Tenant’s Premises, Landlord shall provide a copy to Tenant of each billing288

statement from the utility provider.289

290

B. APPORTIONED UTILITIES UNDER A SINGLE-METERED SERVICE (Under Choice No. 4). 291

(1) Landlord is the customer of record under contract with the utility or service provider and shall pay the provider292

directly.293

(2) Landlord may apportion the utility or service bill among the tenants of the building. The apportionment shall294

be by following this equitable method or formula [state the formula precisely here, including the frequency of billing295

for each apportioned utility or service]: 296

297

298

299

(3) Upon request, Landlord shall provide Tenant with a copy of each actual utility or service bill for the building300

along with each apportioned services bill.301

(4) Landlord must provide the following information for each apportioned utility billed to Tenant. For the most302

recent calendar year [state year here: ________], the actual utility bills in each month were:303

304

MONTH305 GAS ELECTRIC WATER/SEWER FUEL OIL GARBAGE OTHER

January306

February307

March308

April309

May310

June311

July312

August313

September314

October315

November316

December317

Column Total318

Monthly319

Average*320

*NOTE: If this Lease is for one year or more, then Landlord and Tenant may agree to use a monthly average as321

the good faith estimate of the monthly utilities bill as an annualized budget plan providing for level monthly322

payments. If Landlord and Tenant agree to a budget plan using monthly averages for payment of these utilities,323

initial here: 324

Landlord Tenant Tenant Tenant Tenant 325

In subsequent lease years, Landlord shall give Tenant updated information on apportioned utilities before changing326

Tenant’s budget plan amount.327

328

Instead of filling out the table above, Landlord may attach copies of the 12 monthly bills for each apportioned329

utility.330

331

(5) Upon Tenant’s request, Landlord shall provide Tenant with copies of the actual utility or service bills for any332

apportioned utility or service for the past two years. However, if Landlord acquired the building less than two years333

ago, Landlord shall provide copies of bills back to the date that Landlord bought the building.334

(6) If the gas, fuel oil, or electric charge is apportioned, Landlord shall notify Tenant by September 30 of each year335

that energy assistance (financial help from the government) may be available to pay for the gas, fuel oil, or electric336

bill. This notice shall include the toll-free telephone number of the agency which administers the energy assistance337

program.338

339

340

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36. ADDITIONAL TERMS.341

342

343

344

345

346

347

348

349

350

351

352

353

354

355

356

357

358

359

360

Landlord and Tenant agree to the terms of this Lease.

LANDLORD

Date

TENANTS

Date

RECEIPT BY TENANT(S)

I have received a signed original or copy of this Lease.

TENANTS:

Date:

Date: Date:

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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FIRST INSPECTION (MOVING IN) OF [ADDRESS]:

Condition (Check if OK)

Comments

LIVING ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

DINING ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

KITCHEN

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Refrigerator

Stove

Sink

Misc.

ENTRY

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BEDROOM #1

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BEDROOM #2

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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Condition (Check if OK)

Comments

BEDROOM #3

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BATHROOM #1

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BATHROOM #2

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

FAMILY ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

LAUNDRY ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

Washer

Dryer

SMOKE DETECTOR

We have inspected the Premises and have found it to be in the condition noted above.

LANDLORD:

Date signed:

TENANTS:

Date signed:

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

Minnesota Standard Residential Lease L

EASE / PAGE 9 of 10

LAST INSPECTION (MOVING OUT) OF [ADDRESS]:

Condition (Check if OK)

Comments

LIVING ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

DINING ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

KITCHEN

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Refrigerator

Stove

Sink

Misc.

ENTRY

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BEDROOM #1

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BEDROOM #2

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

M.S.B.A. Real Property Form No. 41 (2000, Revised 2011)

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EASE / PAGE 10 of 10

Condition (Check if OK)

Comments

BEDROOM #3

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BATHROOM #1

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

BATHROOM #2

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

FAMILY ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

LAUNDRY ROOM

Floor

Ceiling

Walls

Doors

Woodwork

Light Fixtures

Windows and Screens

Drapes or Curtains

Misc.

Washer

Dryer

SMOKE DETECTOR

We have inspected the Premises and have found it to be in the condition noted above.

LANDLORD:

Date signed:

TENANTS:

Date signed: