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Exclusive local agent

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Name of Tenant Reporting Problem
First Last
Address
Street Address
The Problem
When did the problem occur?
Date Format: DD slash MM slash YYYY
Briefly outline the repair needed or problem identified
What caused the issue?
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Address of land*
Email*
Phone*
When would be a good time to call you?*
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Location*
Email*
Phone*
When would be a good time to call you?
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Location*
Email*
Phone*
When would be a good time to call you?
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Are you looking to rent or buy?
- I am looking to rent
- I am looking to buy
Location*
Email*
Phone*
When would be a good time to call you?
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Is this property for rent or for sale?*
- For sale
- For rent
Address of property*
Email*
Phone*
When would be a good time to call you?*
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Address of rental property*
Email*
Phone*
When would be a good time to call you?*
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

Name*
Address of property for sale*
Email*
Phone*
When would be a good time to call you?*
Please tell us anything else you think might be relevant
*
I agree and consent to my data being processed as per the terms & privacy policy *

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