REQUEST FOR REPAIR: Please remember that service requests must be in writing unless it is an emergency

ADDRESS:_____________________________________________UNIT #____________________

REQUESTED BY:__________________________________________________________________

HOME #__________________________WORK #_____________________EXT#______________

INSIDE PET: Dog___________________ Cat _________________ Other _____________________

Authorization to release key to vendor: Yes_________ No __________
If no, Resident must be available and flexible to schedule appointment with vendor. If vendor is stood up, Resident will be responsible for trip charge cost.

Repair Needed:_____________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

If appliance, please note the following:
Item:___________________ Make:__________________ Model#____________________________

Please sign below:

I am aware that per my lease, I am responsible for all repairs to be made to any part of the leased premises whenever damage results from any misuse or neglect on the part of the Resident or members of family or guests.

Vendor:_______________________Date Issued:____________ WO #_________________________
By: hand (      ) phone (      ) mail (      ) fax (      )
NOTES:__________________________________________________________________________
_________________________________________________________________________________
__________________________
Initials