Saskatchewan

Ministry of
Justice and
Attorney General
Condition of Premises Checklist
IMPORTANT - LANDLORD & TENANT:
Complete at beginning and end of tenancy and each keep a signed copy.
Name of Landlord: Address:
Name of Tenant(s):
Premises Address:
Move - In Move - Out
Describe Damage and Cleaning Deficiencies Describe Damage and Cleaning Deficiencies
OR Check o if OK OR Check o if OK

Kitchen
Stove/Hood o o
Refrigerator o o
Cupboards & Doors o o
Countertops & Sink o o
Floor o o
Ceiling o o
Walls & Trim o o
Other o o
Bathroom
Bathtub/Shower o o
Toilet o o
Sink/Vanity/Mirror o o
Electrical o o
Floor Covering o o
Ceiling/Fan o o
Walls/Trim o o
Other o o
Living Room/Dining Room
Drapes/Rods o o
Flooring/Carpet o o
Ceiling o o
Walls & Trim o o
Other o o
Bedroom - Master
Drapes/Rods o o
Flooring/Carpet o o
Ceiling o o
Walls & Trim o o
Closets & Doors o o
Other o o
 Move - In Move - Out
Describe Damage and Cleaning Deficiencies Describe Damage and Cleaning Deficiencies
OR Check o if OK OR Check o if OK

Bedroom #1
Drapes/Rods o o
Flooring/Carpet o o
Ceiling o o
Walls & Trim o o
Closets & Doors o o
Other o o
Basement
Furnace/Filter o o
Electrical/Fixtures o o
Windows/Screens o o
Floors/Walls o o
Other o o
Hall & Stairwell
Doors/Closets/Landings o o
Floor Covering o o
Walls & Trim o o
Other o o
General
Windows/Screens/Doors o o
Garage/Parking o o
Yard o o
Balcony o o
Electrical o o
Other
o o
Move - In Comments Move - Out

Date of Move-In: Date of Move-Out:

Date Checklist Completed: Date of Checklist Completed:
Number of Keys to Tenant: Date Keys Returned to Landlord:

Tenant(s) Signature: Tenant(s) Signature:

Landlord’s Signature: Landlord’s Signature:

Tenant(s) Forwarding Address & Phone Number:

SECURITY DEPOSIT CONSENT

(to be signed only at the end of the tenancy and not for use for Social Services Guarantee)
The tenant(s) hereby agree to surrender $ of their security deposit and interest to landlord.

Date: Tenant(s) Signature

Rev. 04/05