Cleaning Report Form
Work Order Number
Date Completed
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Property Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cleaning Service Type:
Move-In/Out
New Property
Touch Up
Other
Any Photos Taken
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Please evaluate the following places in terms of cleanliness.
Rows
Very Clean
Requires Minimal Cleaning
Very Dirty
Comments/Notes
Living Room/Entry
1
2
3
Dining Room
4
5
6
Kitchen Room
7
8
9
Master Bathroom
10
11
12
Master Bedroom
13
14
15
2nd Bathroom
16
17
18
2nd Bedroom
19
20
21
3rd Bedroom
22
23
24
Other Rooms
25
26
27
Laundry Room
28
29
30
Garage/Out Buildings
31
32
33
Trash Removal:
Carpets:
Stained
Odor
Damage
Other
Vinyl:
Stained
Odor
Damage
Other
Odors Presenet:
Somoke
Pet
Other
Health/Safety Issues:
Yes
No
Other
Additional Notes
Reporting Person
First Name
Last Name
Reporting Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
Submit
Should be Empty: