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Electrical
Electrical

First Name:
Last Name:
 
Please contact me with the results via:
 
Contact Email/Fax:
 
The amount you would like to pay Regional REO Services for this service when the task is 100% complete:
 
Property Address:
Property City:
Property State:
Property Zipcode:
 
 
Deadline for Service: (MM-DD-YYYY)
 
I would like the following completed / additional information:
Special Instructions & Circumstances:
 
Breaker or Wiring, Repair/Replace:
Fixture Repair/Replace:
Outlets, Switches:
Globes, Switch Plates:
Ceiling Fan:
Other: