Video Game Console Hardware Evaluation Form
Use this form to evaluate the hardware condition and functionality of a video game console. Please provide accurate and thorough information for each section.
Console Model
*
Serial Number or Device ID
*
Evaluator Name
*
First Name
Last Name
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall Physical Condition
*
Please Select
Like New
Excellent
Good
Fair
Poor
Does the console power on successfully?
*
Yes
No
Video/Audio Output Functionality
*
Both working
Video only
Audio only
Neither working
Accessories Included
Power Cable
Controller(s)
HDMI/AV Cable
Other
Notes on Performance or Issues
Overall Hardware Rating
*
1
2
3
4
5
Submit Evaluation
Should be Empty: