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Maintenance Request

Please fill out the following form: (*required fields)
*Name:
Address:
City:    State:      Zip:
*Phone, Day
Phone, Evening
*E-Mail

Emergency:

 Yes      No
Reason for contact:
  

Detailed description
of the problem:
How long has the
problem been occurring:
Please enter: MYCODE

 
 
 

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221 E. High Street  ●  Pottstown, PA 19464  ●  484.624.3338  ●  info@affinitypm.net  ●  ©2007 Affinity Property Management & Realty, LLC
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