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Real Estate Agent Request for Service

This form should only be completed by Real Estate Agents and Landlords.

Request from:

Real Estate company name*
Address* Date*
City* Postcode State*
Billing Address if different to company address:
Contact Name: Home Phone: Mobile:
Email Address: Fax Number:

Tenant details:
Tenant Name:
Address*:
City* Postcode* State*
Home phone: Mobile phone
Repair unit on first visit:
Quote only to repair unit:
Quote to repair if over $

NOTE: Technicians CANNOT call from site for authority (authority must be in writing)
Type of building:*
Roof type:*

Heating

Cooling
Model number Serial number Type of controller*
Name of installer Date of installation Any previous service calls:*
Type of fault:*
Other information:

Proof of purchase will be required at the time of service to be verified for all warranty claims.

Please Note: Warranty service requests MUST have supporting documentation sent with the request. Service calls will NOT be booked without the documentation. Service calls will NOT be booked without the documentation. Examples of acceptable documentation include - proof of purchase/invoice, occupancy certificate for new homes, compliance certificate from unit installation and a copy of the warranty page from owners manual. (Return requests to below email address or Fax #)

* Mandatory fields