Repair Request Form


 LODGEMENT DETAILS Date Lodged Property Manager Name
 
 PROPERTY DETAILS Address*
 
 TENANT DETAILS Name*
 
   I am     A Lease Holder        Approved Occupant

   Home Phone Number                           Work Phone Number                            Mobile Phone Number:
                                                                        
   Email Address *
 
   Preferred method of contact

Home Phone Mobile Number
Work Phone Email Address

 REPAIR ADVICE  Type of request:
 

 URGENT - An emergency is if the Property or Person is in danger of damage or injury
    PLEASE CONTACT OUR AGENCY BY PHONE IMMEDIATELY
 NOT URGENT - Not an emergency

   Details of Maintenance
 
 IF APPLICABLE  Hot Water

 Gas  Electrical   Model:

   Stove

 Gas  Electrical   Model:

   Oven

 Gas  Electrical   Model:

 ACCESS FOR TRADESPERSON

  A dog is on the premises. Tenant/s agree to restrain or remove for access

 

  Use Agency key (Tradesperson to advise day of entry)

 

  Call to arrange access*

   Best Contact Number  Best Time and Day to call
   Day:  Time: 
 

We are an independently owned and operated business. We are bound by the National Privacy Legislation. We may be collecting personal information about you by various methods through the tenancy, to enable us to manage and maintain the premises as per the Residential Tenancies Act. We may disclose personal information about you to the owner of the Property and to Contractors (approved and authorised by Agency Name) in the course of our duties. You have the right to access personal information that we hold about you by contacting our Privacy Officer.


I agree to these terms (please tick):

* Required Fields:

Century21 Realestate Repair Request Form
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