Your Details:

Date

Property Address

Tenant Name

Phone (Mobile)

Phone (Home)

Phone (Work)

Fax

Email

Repair Details:

Is the repair urgent? YesNo

Has it been an ongoing problem? YesNo

When did you first notice the need for this repair?

Day: ---MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Date: ---12345678910111213141516171819202122232425262728293031
Month: ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

What is the nature of the repair request?

Is it an electrical appliance? YesNo

Appliance type: GasElectric

Appliance (e.g. oven, cooktop)

Brand

Model

Is it a leaking tap? YesNo

Water type: HotCold

Leak type: DripStream

Access Arrangements:

Do you want to be present when the repairs are undertaken? YesNo

I am willing to allow a tradesperson to enter the premises to carry out the repairs required:
YesNo

My best contact number is:

Please note

• We may be collecting personal information about you by various methods throughout the tenancy to enable us to manage and maintain the premises as per the Residential Tenancies Act. We may disclose personal information about you to the Owner or the property and to contractors (approved and authorised by Rachael Goldsworthy Realty Pty Ltd) in the course of our day to day duties. You have the right to access personal information that we hold about you by contacting Rachael Goldsworthy Realty.
• Should a tradesperson be called out and the problem is found to be related to the appliance being incorrectly used or one of your appliances was proven to be faulty, you may be liable for the service call out fee.
• If a tradesperson is called without permission for anything other than an emergency repair, you may be responsible for the payment of the account.

I acknowledge that I have read and agree to the above terms.