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BEMIDJI STATE UNIVERSITY Department of Residential Life ROOM CONDITION INVENTORY NAME HALL Last First MI TECH ID or SS ITEM ROOM CHECK-IN CONDITION CHECK-OUT CONDITION BILL STUDENT Bed spring headboards loft kit Mattress Desk/Bulletin Board Desk Chair Closet Closet Doors Bookshelves Cabinets/Dressers Lounge Chair/Couch Phone Cable TV Computer Jacks Mirror Towel Bar Window Hardware Window Screen Window Blinds Light Fixtures Electric Switches/Outlets Ceiling Floor Tile/Carpet Walls Radiator/Cover Room Door inside/outside Smoke Detector Shower Toilet Bathroom Tile Sink Room Cleaned CHECK-IN AGREEMENT OF ROOM CONDITION CHECK-OUT AGREEMENT OF ROOM CONDITION ant have inspected the room prior to occupancy and certify that the above information is complete and correct. RA Name Print Legibly Date I the resident certify that the above form accurately states the condition of my room at the time I checked in. I accept responsibility as of this date for these items and the conditions and understand I will be charged for all damages incurred during my occupancy. BEMIDJI STATE UNIVERSITY Department of Residential Life ROOM CONDITION INVENTORY NAME HALL Last First MI TECH ID or SS ITEM ROOM CHECK-IN CONDITION CHECK-OUT CONDITION BILL STUDENT Bed spring headboards loft kit Mattress Desk/Bulletin Board Desk Chair Closet Closet Doors Bookshelves Cabinets/Dressers Lounge Chair/Couch Phone Cable TV Computer Jacks Mirror Towel Bar Window Hardware Window Screen Window Blinds Light Fixtures Electric Switches/Outlets Ceiling Floor Tile/Carpet Walls Radiator/Cover Room Door inside/outside Smoke Detector Shower Toilet Bathroom Tile Sink Room Cleaned CHECK-IN AGREEMENT OF ROOM CONDITION CHECK-OUT AGREEMENT OF ROOM CONDITION ant have inspected the room prior to occupancy and certify that the above information is complete and correct. RA Name Print Legibly Date I the resident certify that the above form accurately states the condition of my room at the time I checked in* I accept responsibility as of this date for these items and the conditions and understand I will be charged for all damages incurred during my occupancy. In rooms with multiple occupancy I understand each resident will be held jointly responsible for losses and damages. I have read the Residence Hall section of the Student Guide and the Residence Hall Contract and am aware of other administrative charges for which I may be held responsible including failure to properly check-out. Room Key Check-Out Damages Returned Proper No Improper Yes Damages to be Billed to Resident I the Resident Assistant have inspected the room at check- out and Resident Signature I the resident have noted the above check-out condition of my FORWARDING ADDRESS OF RESIDENT AFTER CHECK-OUT Revised 7/03 D64. RA Name Print Legibly Date I the resident certify that the above form accurately states the condition of my room at the time I checked in* I accept responsibility as of this date for these items and the conditions and understand I will be charged for all damages incurred during my occupancy. In rooms with multiple occupancy I understand each resident will be held jointly responsible for losses and damages.