Casino Slot Machine Inspection Form
Please complete the following inspection form for the slot machine.
Inspector's Full Name
First Name
Last Name
Date of Inspection
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Slot Machine ID or Serial Number
Machine Location
Operational Status
Operational
Needs Repair
Out of Service
Cash Box Status
Empty
Partially Full
Full
Unknown
Physical Condition
Excellent
Good
Fair
Poor
Any Malfunctions or Issues Observed
Inspector's Signature
Submit
Should be Empty: