APPLIANCE REQUEST
Property/Code
Ashbourne 166-
Berkshire 056-
Bethel Terrace 011-
Chateaugay 004-
Eagle Nook 041-
Greentree 044-
Kensington Terrace 017-
Kingsley 013-
Lynwood 001-
McFarland 165-
Morrison 067-
Pineview 059-
Sandy Creek 007-
Savoy 058-
Statesman 081-
Warwick 039-
Waverly 002-
Weber 060-
Willock 110-
Winchester 016-
Unit #
STREET ADDRESS
*
City, State Zip
*
Refrigerator
24" White=58 7/8" Height
28" White=64.75
28" Stainless Steel S=67 3/8"
30" Stainless Steel-66.13"
Other
Range
White
Stainless
Electric
Gas
20"
30"
Other
Dishwasher
White
Stainless
Other
Microwave
White
Stainless
30" Under Counter
Other
!!!!APARTMENT MUST BE CLEANED AND PAINTED TO SUBMIT THIS FORM!!!!
IS THE APARTMENT RENTED
YES
NO
EXPECTED MOVE IN DATE
-
Month
-
Day
Year
Date
Did you remove the old appliances
*
YES
NO
No Appliances to Remove
Do you want the appliance company to remove the old appliances
*
YES
NO
OTHER REQUESTS OR NOTES
Submit
Email
example@example.com
Email
example@example.com
Should be Empty: