Street Address*
Suburb*
Post Code
Name*
Mobile*
Phone*
Email*

Maintenance/Repairs requiring attention (provide as much detail as possible)*

Is there any threat to life or property? If yes please dial Emergency Services on 000*
YesNoOther

The appointed Tradesperson or the Landlord has our permission to access the home with prior notice.
Note: any registered pet dog on the premises must be restrained
YesNoOther

I acknowledge, * All information provided on this form is true to the best of knowledge; * My contact information may be provided to either the appointed contractors or the owner of the property to facilitate contact in order to carry out the repairs; * Any maintenance reported has been caused by general wear and tear. I am aware that any maintenance caused by accidental or deliberate misuse of the property is solely my responsibility and I must rectify these at my cost. * The Landlord is not obliged to approve any maintenance issue, unless maintenance is deemed as 'urgent' under the terms of the Residential Tenancies Act or to keep the premises in reasonable repair, considering the age of, the amount of rent paid for and the prospective life of the premises.
Conditions of Reporting Maintenance
I AgreeI DisagreeOther

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