Landlord gas safety record check

Property confirmed *

Record attached to the property *

Date of check *

Engineer's name and Gas Safe registration number recorded and checked on the Gas Safe register *

Landlord or agent name and address on the record

Every landlord-owned gas appliance listed with its location *

Every flue serving a landlord-owned appliance listed *

Each appliance shows a result and any defect or action *

Appliances flagged at risk or immediately dangerous have a job raised

Check carried out within 12 months of the previous one, or within the two-month window keeping the original expiry *

Next check due *

Copy given to existing tenants within 28 days (date) *

Copy given to any new tenant before they moved in

Previous record kept (two-year retention) *

Manager signature *