Amberlands Realty Corp.
Maintenance Request Form

FOR EMERGENCY REPAIRS CALL BRIAN IMMEDIATELY (914)774-7692
If you would like to request maintenance online, please fill out the form provided below.
You will be contacted within 24 hours to schedule service.

Requested By:

First Name: *

Last Name: *

Building # : *

Apartment : *

E-mail: *

Daytime Phone: *

Do we have permission to enter the Apartment ? *

Are there pets in the Apartment ? *

What do you need Repaired ? Clogged Bathroom Sink
Clogged Kitchen Sink
kitchen sink drains slowly
Bathroom sink drains slowly
Closet Door off track
Front Door Lock not opening
Leak under Bathroom Sink
Leak under Kitchen Sink
Dishwasher not working
Stove not working
Refrigerator not working
Screen door
Patio Door does not open
Patio Door Handle Broken
Toilet keeps running
Toilet will not flush
Bathroom light not working
Kitchen light not working
Hall light not working

Is this your first maintenance request for this item? *

If your maintenance need is not on the list, needs further explanation, or if you have more than one request, please write a detailed description:

Rate our Property ?

Rate our Maintenance Dept ?

Thank you for your request.

Our Maintenance Dept. will be notified of the repair and respond to the maintenance request as soon as possible.

If your problem is not solved within 2 days, please contact Brian at : (914) 774-7692