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Resident's Maintenance/Repair Request

Date: ____________________ Address: __________________________________________________ Resident's Name: ______________________________________________ Phone (home): ____________________ Phone (work): ____________________ Problem (be as specific as possible):

Best time to make repairs: ___________________________ Other comments:

I authorize entry into my unit to perform the maintenance or repair requested above, in my absence, unless stated otherwise above. Resident: ____________________________________________ ---------------------------------------------------------------------------------------------------- FOR MANAGEMENT USE Work done: ________________________________________________ Time spent: ____________________ hours Date completed: _________________, 19___ Unable to complete on _________________, 19___ because: _________________________________________________________. Notes and comments:

Date: ______________ Landlord/Manager: __________________________