Repair Form — Residential Resource

P.O. Box 5375

Kaneohe, HI

808-235-0950

Managing residential properties on Oahu since 1984

Name

First Name

Last Name

Email Address

Describe Repair Request

Appliance Make & Model

Emergency?

Yes

No

Unit Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####