Name *

First Name

Last Name

Do you have a pet, burglar alarm, or will there be an unattended minor at your home? *

Yes

No

Please be sure to familiarize yourself with the terms of your lease, items that are your responsibility (clogged drains, HVAC filter replacement every 1-3 months, etc.) will be charged back to you. Unnecessary maintenance requests, at the sole discretion of the maintenance technician and property manager, will also be charged back to you. By completing this form, I request, and give my permission for the appropriate maintenance technician to enter my residence to repair the item(s) listed above. I acknowledge that if the maintenance technician cannot gain access by reasons within my control, or I fail to meet the technician for a pre-arranged appointment, the vendor may impose a trip charge and there will be a $75 administrative charge billed to my account. *

I acknowledge