Maintenance Request

Today's Date: NOTE: Enter all dates mm-dd-yyy, (example 03-12-2010).

Rental Property Address:

Unit Number City:

First Name: Last Name:

Best Contact Phone: Email:

Describe the exact nature of the problem:

Authorization to enter the unit for the requested repairs. Authorization expires after 7 days unless repairs are in progress.

Advise if Management needs to contact tenant for access: Select One Yes No Pets in residnece: Select One Yes No

We will endeavor to make repairs as soon as possible. If you have any questions you can contact your apartment manager or Reliance Management Office at (503) 244-1359 or e-mail: maintenance@reliancepminc.com.

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