First Name
*
Last Name
*
Street Address
*
Phone Number #1 (type as XXX-XXX-XXXX)
*
Phone Number #2 (optional)
Email Address
*
Fax Number (optional)
Preferred method of contact.
*
Call (at the number listed above)
Text (at the number listed above)
Email (as written above)
Is the alarm armed (if any)?
*
Yes
No
Has the lock been changed?
*
Yes
No
Are there any extra locks installed?
*
Yes
No
Is the fence gate locked?
*
Yes
No
Do we have access to the inside?
*
Yes
No
Do we have permission to enter?
*
Yes
No
Please specify if you would like someone to be present.
*
Yes, I would like someone to be present during the repair visit.
No, I do not need anyone to be present during the repair visit.
If this is a water heater, heater, or electrical problem - have you checked the breaker?
*
Yes, I have check the breaker
not a water heater, heater, or electrical problem
Please describe the problem as much as possible.
*
Repair cost may be charged to Tenant as applicable per Lease.
*
I understand the lease term.
A $60 fee may be charged to the tenant as applicable per Lease Para.20.C.
*
I have read this statement and understand.
Submit
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