房屋附属设施清单

坏□有损坏____________□茶几数量:__________________ □无损坏□有损坏____________Р□梳妆台数量:__________________ □无损坏□有损坏____________□茶几数量:__________________ □无损坏□有损坏____________□椅子数量:__________________ □无损坏□有损坏____________Р□其它______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Р其它Р□钥匙(共___套,每套___把) □电费卡□气费卡□门禁卡___张Р□其它____________________________________________________________________________________________________________________________Р甲方(出租方)(签章):_________ 乙方(承租方)(签章)___________Р 授权代表(签字):_________ 授权代表(签字)__________Р _____年_____月____日_____年_____月____日