Maintenance Request

Please complete this form to submit a routine maintenance request.

If you have an emergency situation, like a burst water pipe, no heating or cooling, or other immediate hazard situations, please call 614-496-5141.

Date / Time Submitted *

Name (Last, First) *

Street Address *

City *

Phone Number (primary) *

Phone Number (alternate)

Email Address *

Fax Number

Detailed Description of Problem: *

Landed Gentry Rentals