Leaseholder's Housing Repair Report
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Leaseholder’s Details
Items marked
must be completed
Use Of The Form
Form Ref. No.
This form can be completed on-line.
When completed it should be submitted electronically back to the Council.
Please do not use this form for urgent or out-of-hours repairs. You should telephone us for these.
Leaseholder’s Details
Title
Forenames
Surname
Please provide:
Telephone
Email Address
so we can come back to you if we have any queries
Address Line 1
Address Line 2
Address Line 3
Town / City
County
Postcode
Customer reference number (5 digit number)
Are the Leaseholder’s details the same as the Reporter's?
Yes
No
