Title Page
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Site Visit?
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Client Name(s):
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Date of Birth(s):
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Address
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Postcode
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National Insurance Number(s):
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Client Home phone/Mobile
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Client e-mail:
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Best Time to Contact
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Landlord
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Tenancy Status
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Property Type
- Ground Floor flat
- Flat
- Maisonette
- Terraced House
- End Terrace
- Semi Detached
- Detached
- Studio
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Rent/Month
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Any Rent Arrears?
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If yes How Much?
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Payment plan for arrears?
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Number of Occupants?
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Have you taken advice from a solicitor before?
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Clients ID and POA
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BRIEF DESCRIPTION OF THE DISREPAIR ISSUES, INCLUDING HOW THEY WERE REPORTED & THE LANDLORD'S RESPONSE
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FIRST REPORT
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LAST REPORT
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HOW MANY REPORTS IN THE MIDDLE?
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HAS THE LANDLORD EVER INSPECTED THE PROPERTY?
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If so, when and what action was taken:
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Exterior - DETAILS OF DISREPAIR & CAUSE eg: Structural Cracks, Chimney, DPC, Roof, Guttering, Brickwork, Soffit, Fascias
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Hallway/Stairs/Landing - DETAILS OF DISREPAIR & CAUSE eg Front Door, Stairs, Landing, Ceiling, Windows, Gable end Wall
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Kitchen - DETAILS OF DISREPAIR & CAUSE eg: Extractor Fan, Kitchen Cupboards, Boiler, DPC, Windows, Back Door, Electrics, Tiles
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Living Room - WITH DETAILS OF DISREPAIR & CAUSE eg: Chimney breast, Skirting Boards, DPC, Windows, Sockets, Radiators
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BEDROOM 1 - WITH DETAILS OF DISREPAIR & CAUSE eg: DPC, Roof, Guttering, Brickwork, Roof, Windows, Skirting Boards
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BEDROOM 2 - WITH DETAILS OF DISREPAIR & CAUSE eg: DPC, Guttering, Brickwork, Roof, Windows, Skirting Boards
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BEDROOM 3 - BEDROOM 1 - WITH DETAILS OF DISREPAIR & CAUSE eg: DPC, Roof, Guttering, Brickwork, Windows, Skirting Boards, Loft
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BEDROOM 4 - WITH DETAILS OF DISREPAIR & CAUSE eg: DPC, Roof, Guttering, Brickwork, Windows, Skirting Boards, Loft
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Bathroom - WITH DETAILS OF DISREPAIR & CAUSE eg Extractor Fan, Bath, Toilet, Tiles, Windows
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OTHER ROOM - WITH DETAILS OF DISREPAIR & CAUSE
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Type of tenancy Agreement:
