Existing Leaseholder?

Maintenance Request Form

Please Note: this form is only for reporting a maintenance query relating to the ‘common parts’ or structure of the building. If your query relates to the interior of your apartment you should ask the solicitor who acted for you in the purchase of your lease to find out who is responsible for remedying the problem (this could be you as the leaseholder, the developer or the developer’s insurer if you bought with a build warranty in place).

If in doubt please read the answer to ‘What type of problems should I report to my Block Management Agent?’ in the Leaseholders Frequently Asked Questions.

Required fields are indicated by an asterisk (*)

Contact Details
Property
Tenancy Reference Number
Reported by
Contact Email Address*
Contact Telephone Number
Fault Details
Nature of Fault
Location
Date of Occurrence (DD/MM/YYYY)	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 2006 2007 2008
Manufacturer (if available)
Model (if available)
Cause of Fault (if known)
Is this a known reoccurring fault?	Yes No
If yes, when did the fault previously occur? (DD/MM/YYYY)	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 2000 2001 2002 2003 2004 2005 2006 2007
Was this fault known to have been repaired by our maintenance contractor?	Yes No
Further Information
Please note that any change in circumstance must be reported immediately; any unnecessary costs incurred will become the liability of the related leaseholder. To report any change or cancel this request, please inform the representative named in your request confirmation.