* -required field

    Apartment information
    Building: *
    Apartment number: *
    Apartment owner
    Forenames (given names)
    and surname (family name): *
    Owner's street address: *
    E-mail address: *
    Phone number: *
    Defect information
    Description of defect: *
    Schedule
    Starting date (day.month.year): *

    * -required field