William Peak Co-operative Homes Inc.
1990 Whites Road, Pickering, Ont L1V  Ph: (905) 837 2920 Fax: (905) 837 2922
MAINTENANCE WORK REQUEST FORM

All Maintenance Requests are to be submitted to the office.
After Hours: Put in the mail slot at the main office.

Member Name:______________________________________________Tel#:__________________________Unit #__________
Please Print

Requested By:_______________________________________________ Date:____________

My permission is hereby granted to the Management of this Co-op or their agent or contractor to enter my unit in my absence to perform the requested work.

Signature:__________________________________________________________

Or

Please call to arrange a date for this work to be carried out:

Member Name:____________________________________Signature:____________________________________________________

Phone # ________________________________________________________

Description of Work Required: _________________________________________________________

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FOR OFFICE USE ONLY

Actual Work Completed:
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Completed by:_________________________________________ Date Completed:_________________