Free gas safety certificate template (CP12) and boiler service record
Two free printable records for Gas Safe registered engineers: a landlord gas safety record (often called a CP12 or gas safety certificate) and a boiler service record. Both are laid out like the certificates HiveSuite produces. Print them or save them as a PDF. No sign-up needed.
Free to usePrint or save as PDFA4 layout
What this template is and is not
A landlord gas safety record is the document a Gas Safe registered engineer completes after the annual gas safety check on the gas appliances and flues a landlord provides. Only a Gas Safe registered engineer can carry out the checks and issue the record. This blank template is for those engineers to fill in by hand.
This template and HiveSuite are not produced, approved or endorsed by Gas Safe Register or HSE. Gas Safe Register does not produce its own form. The gas safety record is designed around the information a record must contain under regulation 36(3)(c) of the Gas Safety (Installation and Use) Regulations 1998. The engineer who issues it is responsible for checking the completed record is accurate and suitable for the work carried out.
Choose a record to print
This record follows HiveSuite's standard Landlord Gas Safety Record (CP12 / LGSR) template: the same sections, labels and result options as the PDF HiveSuite issues.
HiveSuite does not include a ready-made gas boiler service template. This record follows the sections of its standard Oil Boiler Service Certificate (customer, appliance, service, combustion analysis, outcome and issuer), adapted for gas boilers.
Landlord Gas Safety Record (CP12 / LGSR)
Business name Address Phone and email| Certificate number | |
|---|---|
| Check date | |
| Next check due | |
| Record reference |
Property and landlord / agent
| Property address | |
|---|---|
| Landlord / agent | |
| Landlord / agent address | |
| Tenant / occupier |
Gas installation checks
| Emergency control valve accessible | YesNoN/A |
|---|---|
| Tightness test / soundness | SatisfactoryUnsatisfactoryN/A |
| Pipework visual inspection | SatisfactoryUnsatisfactoryN/A |
| Equipotential bonding | SatisfactoryUnsatisfactoryNot checkedN/A |
| Comments |
Appliance-by-appliance safety check record
One row for each appliance or flue checked. Results: S = Satisfactory, U = Unsatisfactory, N/A. Classification: Safe to use, At Risk, Immediately Dangerous, Not to current standards, N/A.
| # | Appliance type / make / model | Location | Flue type / location | Operating pressure / heat input | Ventilation | Flue flow | Safety devices | Pass / fail | Classification |
|---|---|---|---|---|---|---|---|---|---|
| 1 | |||||||||
| 2 | |||||||||
| 3 | |||||||||
| 4 |
| # | Defects identified | Remedial action taken |
|---|---|---|
| 1 | ||
| 2 | ||
| 3 | ||
| 4 |
Unsafe situations and engineer declaration
| Warning notice / unsafe situation procedure issued | YesNo |
|---|---|
| Overall gas safety result | PassFailPass with advisory |
| Warning notice reference | |
| Unsafe situation notes / further remedial actions required | |
| Engineer declaration | I confirm that this record includes the checks required by regulation 26(9)(a) to (d) for each appliance or flue checked. |
| Business name | |
| Gas Safe registered engineer name | |
| Gas Safe registration number | |
| Engineer signature |
This record is intended to capture the property details, landlord or agent details, gas installation checks, appliance-by-appliance findings, defects, remedial actions and engineer declaration for a landlord gas safety check record. The issuing Gas Safe registered engineer remains responsible for ensuring the completed record is accurate and suitable for the work carried out. Landlords: give a copy to existing tenants within 28 days of the check and to new tenants before they move in, and keep it until two further checks have been carried out.
Boiler Service Record
Business name Phone and email| Certificate number | |
|---|---|
| Service date |
Customer
Appliance
Service
Service items completed Burner settings Flue checks Gas supply inspectionCombustion analysis
| CO2 reading (%) | CO reading (ppm) | CO / CO2 ratio | Flue gas temperature (°C) | Operating pressure / heat input |
|---|---|---|---|---|
Outcome
| Service result | PassFailPass with advisory |
|---|---|
| Advisories or defects found | |
| Next service due |
Issuer
A boiler service record is not a landlord gas safety record. If this visit also included a landlord gas safety check, complete a separate gas safety record.
the law
What must a gas safety record include?
Regulation 36(3)(c) of the Gas Safety (Installation and Use) Regulations 1998 says the record of a landlord gas safety check must include:
- The date the appliance or flue was checked
- The address of the property where the appliance or flue is installed
- The name and address of the landlord, or their agent where appropriate
- A description and the location of each appliance or flue checked
- Any safety defect identified, and any remedial action taken
- Confirmation that the check covered regulation 26(9): the effectiveness of any flue, the supply of combustion air, the operating pressure or heat input (or combustion performance where that is not reasonably practicable), and safe functioning
- The name and signature of the person who carried out the check
- The registration number of that person or their employer
Landlord duties that go with the record
- The check is due within 12 months of a new appliance or flue being installed, then at intervals of no more than 12 months
- It can be done up to 2 months before it is due and keep the original date, so records show a next check due date rather than an expiry date
- Give existing tenants a copy within 28 days of the check, and new tenants a copy before they move in
- Keep the record until two further checks have been carried out
- An electronic copy is fine if the tenant agrees to receive it that way and can access it, but they must get a paper copy if they ask
Sources: regulation 36, legislation.gov.uk and HSE: gas safety check records. This is a summary, not legal advice.
The HiveSuite record also has room for installation checks many engineers record, such as the emergency control valve, tightness test and equipotential bonding. The annual safety check itself is for the appliances and flues the landlord provides.
naming
CP12, LGSR or gas safety certificate?
Landlord gas safety record
The name HSE uses today. Often shortened to LGSR. This is the document landlords must have for each check.
CP12
An older name for the form. HSE notes the record was formerly called a CP12 form, and many landlords, agents and engineers still use the name.
Gas safety certificate
The everyday name most tenants and landlords search for. It means the same document. There is no single official form - any record works if it contains the required information.
two different jobs
Boiler service record vs gas safety record
HSE says you should not assume an annual service includes the points required by a safety check, or that a safety check is enough to keep an appliance properly maintained.
| Gas safety record (CP12 / LGSR) | Boiler service record | |
|---|---|---|
| What it shows | The safety checks on each gas appliance and flue the landlord provides | The maintenance carried out on one boiler |
| Legal requirement | Yes, for landlords, every 12 months | No set form or interval in the regulations; HSE strongly advises servicing at least annually |
| Covers | Every gas appliance and flue checked at the property | The boiler serviced, its readings and settings |
| Who keeps it | The landlord, with copies for tenants | The customer or landlord |
| Who completes it | A Gas Safe registered engineer | A Gas Safe registered engineer for gas boilers |
Many engineers do both on one visit and complete both records. Check the manufacturer's instructions for what a service of that boiler must include.
The same gas safety record, filled in on site
HiveSuite includes this Landlord Gas Safety Record (CP12 / LGSR) as a standard template on every plan. Your engineers issue it from the job on their phone, and the record stays with the job and the customer.
For boiler services, copy a standard template in Certificate Studio and change it for gas, or describe the record you want to HiveAssist.
See the Document Builder Gas engineer software- Property address, record reference, business name and engineer name filled in from the job
- One row per appliance or flue, with the same result and classification options as this template
- Engineer signs on screen, and the signature goes on the numbered PDF
- Next check due date recorded on the record and shown on the PDF
- Office staff email the record to everyone who gets the job's completion emails, such as the landlord or agent
- Optionally share the record in the customer portal
- Job types can require the record before a job can be completed
- Works offline in the native Android app; iPhone uses an installable web app (needs a connection) while the native iOS app awaits App Store approval
questions
Gas safety certificate template FAQ
Is this gas safety certificate template free?
Yes. Print either record or save it as a PDF from your browser and use it as often as you like. There is no sign-up. It is a blank template for Gas Safe registered engineers to fill in - it is not a gas safety record until a Gas Safe registered engineer has carried out the checks and completed and signed it.
Who can fill in a gas safety record?
Only a Gas Safe registered engineer can carry out a landlord gas safety check and issue the record. The record must show the engineer's name, signature and the registration number of the engineer or their employer. Landlords and letting agents cannot complete it themselves.
What must a landlord gas safety record include?
Under regulation 36(3)(c) of the Gas Safety (Installation and Use) Regulations 1998, the record must include the date of the check, the address of the property, the name and address of the landlord or agent, a description and location of each appliance or flue checked, any safety defect found and any remedial action taken, confirmation that the checks in regulation 26(9) were carried out, and the name, signature and registration number of the person who did the check.
Is a CP12 the same as a gas safety certificate?
Yes, in everyday use. HSE calls the document a landlord gas safety record, and notes it was formerly called a gas safety record, gas safety certificate or CP12 form. Gas Safe Register does not produce its own form, so records from different engineers can look different as long as they contain the required information.
How often does a landlord need a gas safety check?
Every 12 months. The check must be done within 12 months of a new appliance or flue being installed and then at intervals of no more than 12 months. HSE allows the check to be done up to 2 months before it is due while keeping the original date, which is why the record shows a next check due date rather than an expiry date.
Is a boiler service the same as a gas safety check?
No. HSE says you should not assume an annual service includes the points required by a safety check, or that a safety check is enough to maintain the appliance. Many engineers do both on one visit and fill in both records: the gas safety record for the landlord's legal duty and a boiler service record for the maintenance carried out.