On-line Maintenance Application

Date: *	/ /
Address: *
Concern: *	Enter maintenance issue here
Would you classify this problem as: *	Urgent Non-urgent
ACCESS DETAILS
Tenant Name(s): *
Phone Home: *
Phone Work:
Phone Mobile:
Access to property *	Take office key Tenant wil be home
Tenant preferred time and date: *
Tenant Authorises entry? *	Yes
I hereby authorise your office and/or the tradespeople to enter the property with the keys in order to carry out the repair or view the repair.
Do you have pets at home? *	Yes No
What precautions for constraining pet/s will you take - if required? *
I/we confirm and acknowledge that if I/we make an appointment with a tradesperson to meet me at the property to allow access, and I/we fail to meet them as arranged, I/we will be liable for a callout charge. *	Yes, I confirm & Agree
Please enter your full name as a digital signature *
Word Verification	Please type the characters you see in the picture below.