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: ____________________________________________
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Work done: ________________________________________________
Time spent: ____________________ hours
Date completed: _________________, 20___
Unable to complete on _________________, 20___ because:
_________________________________________________________.
Notes and comments:
Date: ______________
Landlord/Manager: __________________________
