Maintenance Request Form

Tenant Maintenance Request Form Please FAX to :(508) 359-5346 or Email to: mainstreetrealty@verizon.net
Today's Date:	Tenant Name:
Property Address: Unit #	City:
Home Phone Number:	Work Phone Number
AUTHORIZATION TO ENTER PROPERTY IN OCCUPANT’S ABSENCE WITH KEY: Check one ________YES ________NO
Describe Your Maintenance Request (be detailed):




Have you reported this problem before?_______YES ________NO
BY REQUESTING THIS WORK TO BE COMPLETED, THE RESIDENT ACKNOWLEDGES THAT IF THE REPAIR IS FOUND TO BE DUE TO MISUSE, THE RESIDENT MAY BE RESPONSIBLE FOR PAYMENT OF THE REPAIR, PER THE LEASE AGREEMENT. TENANT SIGNATURE:________________________________________________________
OFFICE USE ONLY: ____ WALK-IN ____ MAILED ____FAXED____PHONED-IN ____EMAILED RECEIVED BY:_________________________________________ DATE RECEIVED:_______________________ TENANT MOVE-IN DATE___________________ HOA WARRANTY WORK AUTHORIZED DATE:____________________ BY:_____________________ VENDOR ASSIGNED:__________________________ PO#:____________________ __________________ NAME REPAIR DENIED; REASON:_____________________________________________________________ HOME WARRANTY REPAIR IS COSMETIC AND IS NOT THE RESPONSIBILITY OF THE LANDLORD __________________ COMPANY OTHER:____________________________________________________________________________ CALL BACK_____________________________________________________________________________ __________________ COPY MAILED TO TENANT; DATE:____________________________ VENDOR