www.RegentApts.com
6835 Laurel Canyon Boulevard
North Hollywood, CA 91605
Phone: (818) 982-8181 Fax: (818) 503-9843

May 19, 2012
*** WELCOME HOME *** OPEN HOUSE ***

North Hollywood California Rentals

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.

Resident Name:
Address:
Contact Phone # (with area):
X Ext:
E-Mail:
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.