www.ParcAt5.com
9140 Brookshire Avenue
Downey, CA 90240
Phone: (562) 862-6721 Fax: (562) 862-7065

May 19, 2012

Resident Service Request Form

Please fill out the service request form below and include as much detail as possible. This will ensure your request is handled appropriately. The leasing office will be in contact with you to schedule a maintenance appointment. If your request is an emergency that requires immediate attention, please contact our leasing office directly at (213) 364-1902.

Resident Name:
Address:
Contact Phone # (with area):
X Ext:
E-Mail:
Pets: Yes No
Pets' special instructions:
Permission is granted to enter my home:
Yes No
Location of Problem:

Service requested:
(please provide a detailed description of request)
Please type the characters that appear in the image.