Housing Disrepair Enquiry
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
To help us further understand the problems you are experiencing, please upload images of the areas affected:
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To support the images please also provide a brief history of the issues you have being experiencing, the areas of your property effected and the steps you have already taken to rectify the problem.
Please tick to confirm which best applies to your circumstances:
Local Authority Tenant
Privately Rented Tenant
Commercial Property Tenant
Home Owner in dispute with Construction Company
Housing Association Tenant
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