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Maintenance Request Form
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)
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28
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31
1
2
3
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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
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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 provide as much detail as possible when answering the questions; this will assist in the haste of any necessary repair and will reduce any potential liabilities for your tenancy.
Please note that any change in circumstance must be reported immediately; any unnecessary costs incurred will become the liability of the related tenancy.
To report such change or cancel this request, please inform the representative named in your request confirmation.
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