Title Page
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Conducted on
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Prepared by
Tenant Info
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Tenant's Full Name (inc any middle names)
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Full Address
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DOB
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Contact Number
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Email
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Do you have any special requirements that we should be made aware of? (Including any mental/physical disabilities?)
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Do you require for anyone to act on your behalf at all?
Qualifying questions
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Landlord Type
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Council / Social Name
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When Did You Move In?
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Copy of Tenancy Agreement?
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Is this your current property?
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When was the first time you reported the issues?
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When did you most recently report the issues?
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When reporting the issues, what was the landlords response?
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How were the issues reported? phone, email, in person etc.
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How many times have you reported the issues?
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How often do you report the issues?
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How many inspections have been carried out by the landlord since you started reporting?
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Is The Tenancy Single or Joint?
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Rent Amount? Weekly/monthly
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Do You Have Rent Arrears?
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How much and is there a payment plan?
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Has a date been set for repairs or any future inspections?
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Are you due to move from the property or actively bidding?
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Do you have any intention of purchasing the property in the next 12 months?
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Have you currently or ever had any solicitors acting for you in relation to a housing disrepair claim?
Availability
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Are you currently employed?
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Do you have a preferred contact time?
Property Details
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Property Type
- Semi
- Detached
- Terraced
- Bungalow
- Flat
- Other
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If a flat, what floor is the property on?
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How Many Bedrooms?
Damage to Property
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Disrepair Details to Interior - Provide Detailed Description (Attach Photos & Videos)
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Living Room
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Hallway
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Kitchen
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Bathroom
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Bedroom 1
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Bedroom 2
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Bedroom 3
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Bedroom 4
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Landing
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Loft/Attic
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Porch
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Utility room
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WC
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Conservatory
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Disrepair Details to Exterior - Provide Detailed Description (Attach Photos & Videos)
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Additional Media (Exterior)
Identification
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ID
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POA
Accuracy and factual declaration
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Do you confirm that all of the information you have provided on this call is accurate and factual?
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Do you confirm that all of the photographic evidence provided relates to all of the issues discussed today?
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Lastly, do you confirm you do not have any inspections or repairs booked?
