(734) 483-2240

fax: (734) 483-0265
121 Perrin - Office
Ypsilanti, MI 48197

Office Hours: 10:00am to 5:00pm, Monday - Friday, and by appointment

You may either print this form off and bring it in to the office or submit it electronically.

Maintenance Request

Flo-Mar Apartments: 119 Perrin, Box 980352, Ypsilanti, MI 48198
(734) 483-2240

Your Address Apartment # Phone Email

Repair Requested for Following (describe fully) For FLO-MAR USE Only

1. 1.________ Date/Init._______

2. 2.________ Date/Init._______

3. 3.________ Date/Init._______

4. 4.________ Date/Init._______

5. 5.________ Date/Init._______

By signing this request, I (we) authorize the personnel or agents of FLO-MAR APARTMENTS to enter my (our) apartment to complete the above repairs. FLO-MAR may enter for this purpose in my (our) absence and without providing further notice. I (we) understand that FLO-MAR may need to enter the apartment several times during the course of one or more days.

I (we) understand that by signing this request, I am (we are) releasing FLO-MAR from being required to provide subsequent notice of entry for the above repairs. I (we) realize that I am (we are) entitled to receive a duplicate copy of this notice, which has been acknowledged by FLO-MAR. If the office is closed when the request is submitted, I (we) may call 483-2240 to request a copy.
I understand that I am waiving my presence (we understand that we are waiving our presence) while repairs are being made and that the maintenance staff may visit my apartment as early as 8:00am unless otherwise noted below.

NOTICE: This request must be completed and signed. If you want to be present during repairs, you must call for an appointment. Do we have your permission to enter your apartment to make repairs if you are not home? Yes No

Tenant Name (one or more must sign) Date

Acknowledged by Flo-Mar

___________________________________________ ____________________

For Flo-Mar Use Only

Date called ___________________________ Time ________________