Tenant Maintenance Request Form

Date

First Name

Last Name

Home Phone

Work Phone

Mobile Phone

Email Address

Preferred Contact Method

Best Time to Call

Property Address

City/Suburb

State/Province

Postal/Zip Code

Location of the Issue:

Description of the Problem: (Please be as detailed as possible. Include specific details about what is happening, when it started, and how often it occurs.)

When did you first notice the problem?

Is this an emergency that poses an immediate threat to safety or property?

If Yes, please describe the emergency: (For emergencies such as fire, flooding, or gas leaks, please call 911 and then notify the landlord/property manager immediately by phone.)

Has the issue caused any damage to your personal belongings or the property?

If Yes, please describe the damage:

Have you taken any steps to address the issue? (e.g., turned off a water valve, unplugged an appliance)

Are you available for maintenance personnel to enter the property?

If Yes, please indicate any preferred days/times:

If No, are there specific instructions for access (e.g., key in lockbox, permission to enter with a key)?

Are there any pets that maintenance personnel should be aware of?

If Yes, please provide details (type, temperament, location in the property):

Preferred method of contact regarding this request:

I understand that I am responsible for any damage caused by my negligence or misuse of the property, and that repairs for such damage may be my responsibility as outlined in my lease agreement and applicable laws.

I authorize the landlord/property manager and their designated maintenance personnel to enter the premises to assess and perform necessary repairs.

Tenant Signature