Appliance Checklist Form

Appliance CheckList

Control
Depot: *
JOB NUMBER*
Date

DayMonthYear
Client Name

First NameLast Name
Phone Number
Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
ADVISE SECTION

Minimum Requirements to check:

Televisions/Monitors: Turns on and there is no physical damage to the screen or the picture (no pixel damage).

Fridges/Freezers - Turns on, no unusual noises are apparent drained and wiped dry and cleaned by the customer.

Washing Machine - Light turns on and customer has secured the bowl, wiped dry and cleaned by the customer.
ITEM 1
Pre - Existing Damages
Photos Attached
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ITEM 2
Pre - Existing Damages
Photos Attached
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ITEM 3
Pre - Existing Damages
Photos Attached
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ITEM 4
Pre - Existing Damages
Photos Attached
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ITEM 5
Pre - Existing Damages
Photos Attached
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ITEM 6
Pre - Existing Damages
Photos Attached
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ITEM 7
Pre - Existing Damages
Photos Attached
Take photo or add photos

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ITEM 8
Pre - Existing Damages
Photos Attached
Take photo or add photos

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Agreement:

All toll jobs must be noted on EICR comments Appliance checklist completed and uploaded on uplift or delivery.

I declare that I have helped the crew inspect the items above and confirm any pre-existing damages listed in this document:
Customer Signature:

Clear
Should be Empty:

Appliance CheckList