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Repair Request Form

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Updated October 19, 2026

A repair request form is used by a landlord or property manager to provide tenants with a means to submit a formal request for any necessary repairs. Using a request form keeps communication between the landlord and tenant open and creates a record of submitted requests and completed repairs.

Key Features

  • Describes needed repair. Summary of what is broken and the needed repairs.
  • Grants permission to enter. Tenant must provide consent for landlord to enter premises when they are not there.
  • Creates written record. Can provide legal protection for landlord, or legal basis for tenant claim.
  • Provides tenant/landlord contact. Includes best contact method for both parties.

3 Categories for Tenant Requested Repairs

Tenant rights regarding the habitability of a home are governed by individual state/city laws. Under most local laws, landlords are obligated to provide repairs for their tenants within a specified timeframe. The types of issues can typically be classified under three categories, which have different repair deadlines for the landlord.[1]

1. Non-hazardous Conditions

This is the least urgent type of repair, with a common landlord deadline of around 60 days.

Examples include:

  • Peeling paint or plaster on walls
  • Missing apartment number on door
  • Refrigerator leaking water

2. Hazardous Conditions

These issues require more timely action from the landlord, typically within 30 days.

Examples include:

  • Bedbug, roach, or mice infestation
  • Mold or water leak on ceiling or wall
  • Defective lock or knob on entrance door

3. Immediately Hazardous Conditions

These issues require immediate action from the landlord, typically within 24 hours.

Examples include:

  • Broken sink or toilet
  • No hot water or heat during winter season
  • No guards in windows (if there are minors)
  • No lock on entrance door

What Happens If Landlord Doesn’t Provide Repairs?

If the landlord does not fix the issues within the specified timeframe under statute, they can be fined for each day past the deadline. For example, in New York, the Department of Housing Preservation (HPD) can fine the landlord anywhere from $10 to $150 per violation per day, depending on the category of the violation.[2]

If the landlord is still refusing to make repairs after the tenant has taken all the measures to notify them, the tenant may consider the following steps:[3]

  1. Report the violations to 311
  2. Withhold rent or deduct repair costs from rent
  3. Break the lease by sending a lease termination letter
  4. Take legal action

Sample

Download: PDF, MS Word, ODT

Video

Sources

  1. LawHelp NY: HPD List of Repairs
  2. LawHelp NY: Getting Your Landlord to Make Repairs
  3. Law NY: When a Landlord Won’t Make Repairs