Maintenance Request
Date:
Name:
Address:
Apt. #
City:
ZIP Code:
Daytime Phone:
Describe your maintenance needs:
Signature
Type your complete name
* By giving permission to enter I authorize representatives of Bertolucci Management, Inc.(BMI) or contractors acting on behalf of BMI to enter my dwelling for the purpose of completing the requested repairs.
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FOR EMERGENCIES PLEASE CALL 503-585-2848 -- AT MEADOWLAWN CALL 503-508-7918
