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Moving
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First Name
*
Last Name
*
Phone Number
*
Email Address
Alt. Phone Number
ESTIMATED MOVE DATE
*
+
Packing?
Self
Partial
Full Packing Required
Type of Residence?
Studio Apt.
1 Bedroom Apt.
2 Bedroom Apt.
3 Bedroom Apt.
1 Bedroom House
2 Bedroom House
3 Bedroom House
4 Bedroom House
5 Bedroom House
Other
Moving From
Street Address
Address Line 2
City
STATE?
🛈
Zip/Cntry Code
Elevator
Stairs
Neither
Elevator?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
15 Plus
What
Floor?
Parking Within 75 Feet?
🛈
Yes
No
Moving To
Street Address
City
State?
*
🛈
Zip/Cntry Code
Elevator
Stairs
Neither
Elevator?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
What
Floor?
Parking Within 75 Feet?
🛈
Yes
No
Enter Items to be moved below:
Number of Boxes To Be Moved
(Enter Quantity)
Boxes
🛈
Living Room Furniture
(Enter Quantity)
Sofa
Ottoman
Ottoman
Love Seat
Sectional
Recliner
Armchair
Ent. Center
🛈
Lamps
Credenza
Rugs
End Table
CoffeeTable
Book Case
TV Stand
TV < 19"
TV 19 - 29"
TV 30 - 36"
Big Screen
Bed Room Furniture
(Enter Quantity)
King Bed
Bunk Bed
Full/Twin Beds
Head/Foot Boards
Dresser
Night Tbl.
Chest/Trunk
Wardrobe
Armoire
Mirror
Crib
Dining Room Furniture
(Enter Quantity)
Table
Chair
Hutch
China Cabinet
Buffet
Bar
Kitchen Furniture
(Enter Quantity)
Table
Chair
Cabinet
Island
Appliances
(Enter Quantity)
Refrigerators
🛈
6 Cu.Ft or Less
7 to 10 Cu.Ft.
11 Cu.Ft or Bigger
Washer
Dryer
Freezer?
10 Cu.Ft or Less
10 to 16 Cu.Ft
16 Cu.Ft. or larger
Stove
Dishwasher
Air Conditioner
Microwave
Electronics
(Enter Quantity)
Stereo
Speakers
Computers
Printer/Fax
Shredder
Outdoor
(Enter Quantity)
Patio Table
Patio Chairs
Barbecue
Bikes
Exercise Equipment
(Enter Quantity)
Treadmill
Weight Set
LARGE ITEMS
(Enter Quantity)
Piano/Organ
🛈
Boat (canoe/kayak, etc.)
🛈
Car/Truck
🛈
Motorcycle/ATV
🛈
HIGH VALUE ITEMS
(Enter Quantity)
ART
🛈
Value
🛈
Antiques
Antique Description
🛈
0/200 characters
Other High Value Items
🛈
0/200 characters
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