Maintenance Request Form
Full Name:
*
First Name
Last Name
Street Address:
*
Jefferson House - 108 E Jefferson St, O'Fallon IL
Park House - 612 S Vine St, O'Fallon IL
Lindenwood House -17 S 30th St, Belleville IL
Mill House - 17 S 30th St R, Belleville IL
E-mail:
*
Phone Number
*
-
Area Code
Phone Number
Request Type:
*
HVAC
Plumbing
Electrical
Structure
Landscaping
Other
Please give us a brief detail about the issue.
*
Urgency of Request:
Please Select
Low: Prioritized as available
Medium: 4-10 business days
High: 1-3 business days
May we enter while no one is present on the property?
*
Please Select
Yes
No
Call me to set up a time.
If you have images please upload them.
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