Landlord or agent details

Landlord or agent details

Landlord or agent name

Address Line 1

Address Line 2

Address Line 3

Town

County

PostCode

The Postcode is not formatted correctly

Phone No Phone number can only contain numbers, space, (), - and +

E-Mail The email address is not a valid format

If you do not know the landlord or agent details, please provide any information that may help us to establish who they are
Up to 2000 characters allowed 0 / 2000 characters Please enter a maximum of 2000 characters

Gas appliance(s) details

*What gas appliances at the property are owned by the landlord?

Required

Gas fire Gas wall heater Gas boiler Gas cooker or hob Other appliance None

You must choose an option

*What gas appliances at the property are owned by the tenant?

Required

Gas fire Gas wall heater Gas boiler Gas cooker or hob Other appliance None

You must choose an option

Record of the gas safety check

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