Take On Form TSS

• Site Visit?

  Yes

  No

• Client Name:

• Address:

• Telephone:

• Mobile:

• Email:

• Date of Birth:

• Second Tenant Name:

• Second Tenant DOB:

• Why We Believe this is a Case:

• Other Solicitors Acting:

  Yes

  No

• If so please give details

Tenancy Details

• Landlord Type:

  Social Housing

  Private

• Landlord Name (council/housing association):

• When did your Tenancy Begin?

• Do you have a copy of your tenancy agreement?

• Is this tenancy Single or Joint?

  Single

  Joint

• Are you named on the tenancy?

  Yes

  No

• Is the accommodation temporary?

  Yes

  No

• How much rent do you pay?

• How often is this paid?

  Weekly

  Fortnightly

  Monthly

• Are you in reciept of Housing Benefit?

  Yes

  No

• If so, is this paid to yourself of landlord?

  Me

  Direct To Landlord

• Do you have any rent arrears?

  Yes

  No

• If so, do you have a payment plan set up, if so how much do you pay?

Property Details

• Property Type:

• How many Bedrooms?

• What Floor is the property on?

• Other information:

Rooms

• Room 1

• Room 2

• Room 3

• Room 4

• Room 5

• Room 6

• Room 7

• Room 8

• EXTERNAL

Extractor Fans

• Is the Kitchen Extractor Fan working?

  Yes

  No

• Is the Bathroom Extractor Fan working?

  Yes

  No

Boiler Issues

• Are you having issues with your boiler?

  Yes

  No

• What are the issues

• When did the issues start

• When did you Report the issues

• What is the service History?

• Are you having issues with the heating?

  Yes

  No

• Are you having issues with hot water?

  Yes

  No

Inspection Details

• Inspection Details including Dates

• Outcome:

• Rooms Inspected:

• Yes

  No

Repair Details

• Repair Date

• Outcome:

• Rooms repaired

Constructive Notices:

• When was your last Gas check completed?

• When was your last EPC check completed?

• When was the last time full inspection was done of the property:

Reporting History Details

• When was the First time you reported the repair to your Landlord?

• When was the Last time you reported the repair to your Landlord?

• Year:

• Amount of Times Reported?

• Reporting Method

• Evidence Available?

  Yes

  No

• Year:

• Amount of Times Reported?

• Reporting Method

• Evidence Available?

  Yes

  No

• Year:

• Amount of Times Reported?

• Reporting Method

• Evidence Available

  Yes

  No

Personal Injury Details

• Yes

  No

• If Yes, Please give details:

Vetting Details

• Have you ever made an application to your landlord for a right to buy the property/intend to make an application to buy the property?

  Yes

  No

• If yes, please give details

• Have you ever made an application to move to a different property?

  Yes

  No

• If yes, please give details

• Have you ever caused any accidental damage to the property?

  Yes

  No

• If yes, please give details

• Have you ever denied your landlord access to your property to inspect or carry out repairs?

  Yes

  No

• If yes, please give details

• Has your landlord ever contacted you to make arrangements to inspect or carry out repairs?

  Yes

  No

• If yes, please give details

• Do you have any inspections or repairs booked in/scheduled?

  Yes

  No

• If yes, please give details

• Have you ever hired anybody or carried out work to the property yourself?

  Yes

  No

• If yes, please give details

• Has your gas ever been capped off?

  Yes

  No

• If yes, please give details

• What is the best time to contact you?