Appliance Order Form

"*" indicates required fields

All required fields must be completed, or this form will be rejected.

1. Property Manager Name*

2. Property Manager phone number*

3. Enter your email*

4. Tenant name*

5. Tenant phone number*

6. Property address for delivery*

7. Work order number*

8. Owner approved purchase*

Yes

9. Type of appliance needed*

10. Current Brand, Model, and Serial Number*

11. Dimensions of the appliance*

H X W X D (Must detail all and must be accurate)

12. Properties of the appliance*

(Gas, Electric, Etc.). Must Be accurate.

13. Choice of color*

14. Quantity*

15. Alternate brand

(if requested is unavailable)

16. Do you have a preferred vendor? If yes, provide your preferred vendor.

17. If you have a direct link to the appliance of choice, please provide it here

18. Cords needed*

3 Cords

4 Cords

19. Haul-Away services needed*

Yes

20. Installation services needed*

Yes

21. Appliance urgency or date needed by*

22. Attach a photo of the appliance model and serial number:

Max. file size: 256 MB.

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