Vacating Occupier - Check-Out Form

• Vacating Occupier:

• Building/ Unit Number:

• Property Address:

• Tenancy End Date:

  Date

• Check-Out Form Completion Date:

  Date

GENERAL

• Has the exiting tenant returned all known access badges, codes & keys?

  Yes

  No

  N/A

• Are perimeter fence & gates secure?

  Yes

  No

  N/A

• Is the site clear of combustible materials/ fly tipping?

  Yes

  No

  N/A

• Is there any evidence of travellers on site?

  Yes

  No

  N/A

• Is the car park condition okay?

  Yes

  No

  N/A

• Is there a build up of weeds?

  Yes

  No

  N/A

• Are there any gas/ oxygen cylinders present?

  Yes

  No

  N/A

• Are there any tyres left on site?

  Yes

  No

  N/A

• Are there any discarded fridges/ freezers on site?

  Yes

  No

  N/A

• Are there any uncovered man holes?

  Yes

  No

  N/A

• Are the drains running clear?

  Yes

  No

  N/A

BUILDING/ UNIT EXTERNAL

• Is the building/ unit secure?

  Yes

  No

  N/A

• Is the building/ unit water/ wind tight?

  Yes

  No

  N/A

• Is there any graffiti/ vandalism?

  Yes

  No

  N/A

• Is the roof & guttering intact?

  Yes

  No

  N/A

• Are letter boxes secure & do you hold the key?

  Yes

  No

  N/A

• Is there a key safe & can access be gained?

  Yes

  No

BUILDING/ UNIT INTERNAL

• Is the ceiling in a good state of repair, clean & stain free?

  Yes

  No

  N/A

• Do all light fittings function and are fittings generally clean?

  Yes

  No

  N/A

• Have all wall boards & pictures been removed?

  Yes

  No

  N/A

• Are the wall coverings in a good state of repair with both walls and skirtings clean & undamaged?

  Yes

  No

  N/A

• Are floor coverings clean & undamaged?

  Yes

  No

  N/A

• Are there any trip hazards present?

  Yes

  No

  N/A

• Is there any furniture present?

  Yes

  No

  N/A

• Is there any internal graffiti/ vandalism?

  Yes

  No

  N/A

• Is the sprinkler system intact?

  Yes

  No

  N/A

• Are all windows intact/ locked?

  Yes

  No

  N/A

• Are all internal doors intact with escape doors fully functional?

  Yes

  No

  N/A

• Are all copper pipes intact & lagged?

  Yes

  No

  N/A

• Are all radiators/ wall heaters intact?

  Yes

  No

  N/A

• Are all kitchen units intact?

  Yes

  No

  N/A

• Are all bathroom fittings intact?

  Yes

  No

  N/A

• Are all areas clear of combustible materials?

  Yes

  No

  N/A

• Are all parts clear of any sharps or chemicals?

  Yes

  No

  N/A

SERVICES

• Is the electricity disconnected?

  Yes

  No

  N/A

• Have all fuses been removed?

  Yes

  No

  N/A

• Has all plumbing been isolated?

  Yes

  No

  N/A

• Has all plumbing been drained down?

  Yes

  No

  N/A

• Are water heaters isolated?

  Yes

  No

  N/A

• Has the gas supply been disconnected?

  Yes

  No

  N/A

• Are all isolation valves secure?

  Yes

  No

  N/A

• Has the heating been disconnected?

  Yes

  No

  N/A

• Is there any evidence of leakage?

  Yes

  No

  N/A

• Has any air conditioning been set to standby?

  Yes

  No

  N/A

• Is there an intruder alarm?

  Yes

  No

  N/A

• Is there a fire alarm?

  Yes

  No

  N/A

• Are any alarms remotely monitored? Please detail if applicable

  Yes

  No

  N/A

THINGS TO CONSIDER

• When taking back a property you should consider the following for ongoing compliance, requesting copies of documents from the vacating occupier where required:
  - Flushing/ Tap Monitoring Records & Ongoing Monitoring in Place
  - Alarm Testing
  - Key Holding
  - Asbestos Documentation
  - Fire Panel Records
  - Emergency Lighting Records
  - Fixed Electrical Inspection
  - Ongoing Property Inspections & Meter Readings

OTHER

• Add any other information/ notes here:

METER READINGS:

• Water Meter Photgraph (if applicable)

  Media

• Water Meter Reading (if applicable)

• Gas Meter Photograph (if applicable)

  Media

• Gas Meter Reading (if applicable)

• Electricity Meter Photograph (if applicable)

  Media

• Electricity Meter Reading (if applicable)

KEYS/ PASSES

• List key number, quantity and corresponding door if known:

DOCUMENTS AND MANUALS

• List documents available and their location:

CHECK-OUT COMPLETED BY

• Print Name:

• Company:

• Signature:

  Sign