SEVCO´S FACILITIES

Office Manager resources

Ana Cecilia Chavez Template ID Number Building & Apartment Number
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Email
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bmunnis0@addthis.com Check-In Date

Sept 3, 2022
September 4, 2000 04:49

Contratos
I understand that I am responsible for the condition of this facilities and any damage or loss that may incur during my occupancy.
FTE and interns are also held collectively responsible for damage to common areas. Additional charges may be made after check-
out if additional cleaning or damage charges are assessed. I am able to appeal damage charges for 60 days

Signature Today's Date

Monday, September 4, 2000

Apartment Condition
Entryway

Condition In Condition Out Same/NWT Charge

Floor Tile

Lights

Doors/Knobs/Locks

Knocker/Peephole

Coat Closet

Condition In Condition Out Same/NWT Charge

Floor Tile

Doors/Knobs/
Locks

Vents

Walls/Baseboard

Ceiling

Shelf

Clothes Rod

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Living Room

Condition In Condition Out Same/NWT Charge

Carpet

Baseboards

Walls

Ceiling

Patio/Balcony Door

Mini Blinds (Door)

Cable/Phone Jack

Switches/Outlets/Li
ghts

Thermostat

Windows/Screens/
Blinds

Heat/Cool Vent

Patio/Balcony (Front)

Condition In Condition Out Same/NWT Charge

Railing

Floor

Walls

Light

Storage Door/Lock

Storage Walls

Storage Light

Kitchen

Condition In Condition Out Same/NWT Charge

Breakfast Bar

Floor Tile

Baseboards

Patio/Balcony Door

Mini Blinds (Door)

Walls

2
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 Condition In Condition Out Same/NWT Charge

Ceiling

Countertops

Cabinets

Switches/Outlets/
Lights

Sink/Faucet

Garbage Disposal

Stove Top/Drip
Pans

Fire Stops (above

stove)

Exhaust Hood

Refrigerator

Pantry

Condition In Condition Out Same/NWT Charge

Doors/Knob

Floor Tile

Light

Baseboards

Walls

Hot Water Heater

Furnace

Fire Extinguisher

Patio/Balcony (Back)

Condition In Condition Out Same/NWT Charge

Railing

Floor

Walls

Light

Storage Door/Lock

Storage Walls

Storage Light

3
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 Condition In Condition Out Same/NWT Charge

Vent Cover

Hall

Condition In Condition Out Same/NWT Charge

Walls/Corners

Baseboards

Switches/Lights

Floors/Carpet

Smoke Alarm

Bathroom

Condition In Condition Out Same/NWT Charge

Door/Knob/ Lock

Tile Floor

Baseboards

Walls

Ceiling

Sink/Faucet

Countertop

Exhaust Fan

Cabinet

Toilet

Tub/Faucet

Shower Walls

Switches/Outlets/
Lights

Medicine Cabinet

Mirror

Shower Rod

Towel Rods

Toilet Paper Holder

Select the bedroom which you will occupy:

Option 2

4
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Bedroom 1/A

Condition In Condition Out Same/NWT Charge

Door/Knob/ Lock

Carpet

Baseboards

Walls

Ceiling

Switches/Outlet/
Lights

Heat/Cool Vent

Cable/Phone Jack

Window/Screens

Blinds

Clothes Rod

Closet Shelf

Bedroom 2/B

Condition In Condition Out Same/NWT Charge

Door/Knob/ Lock

Carpet

Baseboards

Walls

Ceiling

Switches/Outlet/
Lights

Heat/Cool Vent

Cable/Phone Jack

Window/Screens

Blinds

Clothes Rod

Closet Shelf

Check-Out Information
Check-out Date Monday, September 4, 2000

5
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Apartment Keys Returned 7

Mailbox Keys Returned 7

Are you returning to UCM Housing? Option 2

Forwarding Address 5260 Texas Trail, 6 Iowa Alley

White Plains, New York, 10633
United States

Damage Charges
Resident Signature

Date Monday, September 4, 2000

Staff Signature

Date Monday, September 4, 2000

Damage Assessment/Charges
Additional Charges/Notes
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Itemized Charge Total Housing Office

7
Deposit Amount Date
Key Charge Total
7

Improper Checkout Fee Refunded/Forfeited/Transferred Staff

7

Charge Total
7

Select this box if an estimate is needed and charges are not finalized
Estimate Needed (Noted Above)
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 Option 2

7
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