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Your Information

Name

Home Phone

Address
City State  

Zip

Work Phone

E-Mail
Address

Cell Phone

City State 

Zip

Approx. Move Date   Fax Number
Distance in feet from where the truck can park to your front door
Current Home/Apt  New Home/Apt 
Flight of stairs to current front door (Over 8 Steps)
Current Home/Apt  Elevator Available?
Flights of stairs to new front door (Over 8 Steps)
New Home/Apt  Elevator Available?
How would you like to be contacted with your price? 
How did you hear about us?
Special Notes:

 

 

To help us provide an accurate quote, please fill out the online inventory form below. Use numbers only.

 

Note: The actual location of the item in your home does not affect your price.

Living Rm

Family Rm

Qty Bedroom

Office

Qty Kitchen

Dining Rm

Qty Basement

Attic

Qty Garage

Outside

Qty
Arm Chair Armoire Bakers Rack Bar-Portable Air Conditioner
Bookcase-Large Bassinet Bench Card Table Set Bar BQ/Grill
Bookcase-Small Bed-Single Buffet Clothes Dryer Bike
CD/Video Rack Bed-Double Chair Clothes Washer Garbage Can
Coffee/End Table Bed-Queen China Cabinet Cooler Glider
Electronics Bed-King Compactor Cot Hose
Enter. Center Bed-Bunk/Trundle Corner Cabinet Dehumidifier Ladder
Fire Place Equip Bed-Water, Assem Curio Cabinet Fan Lawn Cart
Foot Stool Bed-Water, Diss Dishwasher Foot Locker Lawn Chair
Grandfather Clock Bookcase-Lg Hutch Freezer Lawn Mower
Hall Chest Bookcase-Sm Ironing Board Gun Cabinet Lumber
Lamp Cedar Chest Microwave Humidifier Metal Shelves
Piano-Baby Grand Changing Table Microwave Cart Metal Shelves Outdoor Sculp
Piano-Spinet Clothes Tree Refrigerator Ping Pong Tbl Outdoor Tools
Piano-Upright Comp. Pieces Rug Pool Tbl Patio Chair
Picture Credenza Serving Cart Power Tools Patio Tbl
Plant-Lg Crib Stool Sports Equip Picnic Bench
Plant-Small Desk Chair Stove/Range Storage Cabinet Picnic Tbl
Recliner/Rocker Desk-Computer Table Suitcase Planter-Lg
Sofa-2 Cushion Desk-Lg Vacuum Cleaner Tbl-Folding Planter-Sm
Sofa-3 Cushion Desk-Sm Waste Basket Tool Chest Port. BB Hoop
Sofa-Hide-a-Bed Dresser/High Boy Water Cooler Toy Chest Riding Mower
Sofa w/ Recliner Exercise Equip Toys-Lg Sand Box
Speakers File Cabinet-Lg Trunk
Stereo Cabinet File Cabinet-Sm Work Bench Snow Blower
TV 19" or less Futon Hoisting Service Storage Cabinet
TV 20"- 40" Hamper Swing Set
TV 40" Plus Hanging Clothes/2 ft Total Boxes-Small Umbrella
TV Stand Mirror Total Boxes-Large Tires
TV Snack Trays Night Table

Use These Boxes For Any Unlisted Items

Wheel Barrow
Wall Unit Pieces Sewing Machine Other 
Vanity Other 
Wardrobe Other 
Other 
Other 
Other