Maintenance Request Form
Date and Time
Name
Phone
Email
Location
Apartment Number/Letter
Best Time to Contact
Type of service needed	Select One Heating & Cooling Plumbing Electrical Carpeting Appliance Locks Other
Describe the problem clearly and completely
Please describe any steps you have already attempted to resolve the problem:
When did the problem start?
May our maintenance staff enter your apartment to repair your maintenance problem?	Yes No
Have you reported this problem previously?	Yes No
If so, when and to whom?

Do you have a problem that you would like our maintenance staff to look at? Please fill out this form completely and describe your problem in detail. Remember, we can't fix a problem we don't understand.

Only use this form for NON-EMERGENCIES. Emergencies should be reported to the main office at (812) 339-2859 during normal business hours or to the numbers on your emergency call list after business hours.

Examples of emergency service include:

• no heat
• broken water pipe
• gas leaks (contact Vectren at 1-800-227-1376 immediately from a neighbor’s phone or from a cell phone used OUTSIDE the apartment)
• any other condition which affects life, safety or is necessary to preserve the condition of the apartment

A clogged toilet, when you have more than one, is NOT an emergency. Please see What is an emergency, and what ISN’T?

Before completing the form, you might review our list of common problems and solutions in order to avoid unnecessary call outs (and perhaps feeling silly when the solution is simple!).