Tenant Name
*
First Name
Last Name
Property Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Submit
Date of Inspection
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Date
Email
example@example.com
Exterior
Exterior
Rows
Not Applicable
Poor
Fair
Good
Front Door
Back Door
Driveway
Garage Door(s)
Siding/Brick
Roof
Windows
HVAC Unit
Kitchen
Kitchen
Rows
Not Applicable
Poor
Fair
Good
Refrigerator
Oven
Dishwasher
Microwave
Walls
Sink
Under Sink
Counters
Cabinets
Flooring
Lights
Living Room
Living Room
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Dining Room
Dining Room
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bedroom 1
Bedroom 1
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bedroom 2
Bedroom 2
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bedroom 3
Bedroom 3
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bedroom 4
Bedroom 4
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bathroom 1
Bathroom 1
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bath/Shower
Toilet
Exhaust Fan
Sink
Under Sink
Bathroom 2
Bathroom 2
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Bath/Shower
Toilet
Exhaust Fan
Sink
Under Sink
Laundry
Laundry
Rows
Not Applicable
Poor
Fair
Good
Walls
Ceiling
Doors
Windows
Flooring
Lights
Other
Other
Rows
Not Applicable
Poor
Fair
Good
Air Filters
Smoke Detectors
General Comment
Pictures
We encourage you to take pictures of any areas of concern to accompany this inspection form. To keep the file size manageable, please upload all pictures and email them to info@jonesassurancepm.com.
Acknowledgements
Signature
*
Should be Empty: