Information
Tenancy Information
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Tenancy Reference
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Please use the following format, 12345678-1-5
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Address
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Tenancy Start Date
Visit Information
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Last Annual Visit Date
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Officer Completing
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Date & time of visit(s)
Visit
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Date & time of visit
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UGA?
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Escalated?
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Date of Escalation
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Escalated to?
Tenancy Information
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Please check the following information and update as necessary
Occupants
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Home Telephone
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New Number
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Please add occupant details here
Person
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Relationship
- Tenant 1
- Tenant 2
- Son
- Daughter
- Spouse
- Partner
- Other
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Please specify
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Full Name
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Updated Full Name
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Date of Birth
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Updated DOB
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Email Address
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Updated Email Address
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Mobile
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Updated Mobile
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Vulnerabilities or concerns to report
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Photo ID Seen?
Additional Information
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Rent account or arrears concerns
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Evidence of subletting
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Proof of address seen
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Next Gas Service is due
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ASB Issues?
Condition of Property
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External
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Kitchen
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Downstairs WC
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Lounge
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Dining Room
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Hall, Stairs and Landing
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Bathroom
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Bedrooms
Bedroom
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Bedroom
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Gardens
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Other
Room/Area
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Please Specify
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Condition
Action Log
Action Log
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Actions
Action
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Action
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Due Date
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Who's Responsible
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Appointment Made / Task ID
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Notes
Additional Notes
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Notes
Signatures
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Tenant
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Visiting Officer
