Maintenance Request Form

1

Name (must be on the lease)* This field is required.

First Name

Last Name

2

Email

example@example.com

3

Date* This field is required.

Request Date

4

Property Address* This field is required.

Address

5

Phone Number

Please enter a valid phone number.

6

1. In the event that the service provider states that the maintenance call was not valid, the expense will be the responsibility of the leased tenant. * This field is required.

7

2. In the event that the leased tenant arranges a time with TI Rentals to provide access, then fails to provide access, the tenant is responsible for the contractors time, and the cost incurred. * This field is required.

8

Please specify, in detail, the maintenance request.* This field is required.

Please be specific.

9

If the request is regarding an appliance, please use the space below to include: 1. Is the appliance Gas or Electric? 2. The Make & Model # of the appliance.

If an Appliance: Gas/Electric, Make & Model #

10

Please check the option below to indicate how you wish to proceed with the maintenance request.* This field is required.

AUTHORIZED ACCESS- I authorize the TI Rental's contracted maintenance provider to gain access using a spare key or a code provided, to carry out the required maintenance at the property listed above.

UNAUTHORIZED ACCESS- I wish to personally provide access to TI Rental's contracted maintenance provider to the above listed property. I understand that if I make arrangements, then fail to provide access, I am personally liable for the contractors time and cost incurred. Please fill out below the best days and times available.

Other

11

OTHER: please explain below

Other

12

ONLY FOR UNAUTHORIZED ACCESS: Please provide the best days & times you will be able to provide access for TI Rentals' contracted service provider.

13

ONLY FOR AUTHORIZED ACCESS: By signing below, the resident authorizes the contractor to enter the premises without notice, at reasonable times, to preform maintenance/repairs. We will contact you immediately to let you know when the provider will be coming.

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14

Authorized Access Code Entry

Please provide access code here if applicable