Maintenance Request Form
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Description of issue/maintenance required
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Please include as much information as possible including room in house, if an appliance is gas or electric, ducted or split system, where in yard etc.
When was the maintenance/issue discovered?
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Month
-
Day
Year
Date
Is the maintenance/issue a result of
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Accident
Wear& Tear
Vandalism/Break in
To assist in explaining to describe maintenance up to 5 photos (max) to be attached
*
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What is the maintenance order condition? Urgent issues only include things like burst water pipes, no hot water or electricity (not network blackouts), break-ins where there has been serious property damage.*Please note you may be liable for costs relating to repairs if not authorised by Agent.
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Urgent
No-Urgent (Standard)
In regards to access if you are unable to be in attendance do you give permission for the contractor/maintenance agent to enter your premises & attend to the maintenance?
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Yes
No
Are there dogs or other animals on the property that the contractor / maintenance agent should be aware of?
Yes
No
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