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1
Contact & Move Details
Contact Info
First Name:
*
Last Name:
*
Phone:
Other Phone:
Email:
*
Estimated Move Date
*
Moving From Details
Zip Code Moving From?
*
How many flights of stairs?
None
Elevator
1/2 Flight
1 Flight
1 1/2 Flts
2 Flights
3 Flights
How far will the movers
need to carry items to the truck?
Less than 100 ft.
Less than 200 ft.
Less than 300 ft.
Less than 400 ft.
Less than 500 ft.
New Location Details
Zip Code Moving To?
*
How many flights of stairs?
None
Elevator
1/2 Flight
1 Flight
1 1/2 Flts
2 Flights
3 Flights
How far will the movers
need to carry items from the truck?
Less than 100 ft.
Less than 200 ft.
Less than 300 ft.
Less than 400 ft.
Less than 500 ft.
2
Items To Be Moved
Living Room
Sofa or Loveseat
Sleeper/Hide-a-bed Sofa
Reclining Sofa
Sectional Sofa (# of Pieces)
Futon & Frame
Recliner/Armchair
Ottoman/Stool
End Table
Coffee/Sofa Table
Ent Center (# of peices)
DVD/Stereo Component
TV Under 30 Inch
TV-31-40 Inch
TV 41-56 Inch
TV-57-65 Inch
TV 66 - 72 Inch
Stereo/DVD Player
Small Bookcase
Med. Bookcase
Large Bookcase
Curio/Etagere
Grandfather Clock
Upright Piano
Picture or Lamps*
Table Tops
Glass Top Under 3 Feet
Glass Shelves*
Glass Top Under 4 Feet
Glass Top Under 6 Feet
Pictures Over 3ft
Bedrooms
King Bed
Queen Bed
Full/Twin Beds
Head/Foot Board
XL Head/Foot Board
Platform Bed
Sleigh Bed Frame
Bridge Bed
Bunk Bed
Day/Trundle Bed
Crib/Cradle
Nightstand
Dresser/Chest of Drawers
Armoire/Wardrobe
Vanity
Med/Large Mirror*
Small Mirror
Foot Locker/Trunk
Jewelry Chest
Sewing Machine
Feet of Hanging Clothes
Outdoor
Patio/Lawn Table
Patio/Lawn Chair
Bench/Chaise/Sm. Swing
BBQ Grill/Sm. Smoker
Dog Crate
Small Lawn Tools
Plant stand
BB Goal
Hose Real
Dining Room/Appliances
Dining Table
Dining Chairs/Bar Stools
Dinette/Breakfast Table
China Cabinet
Buffet/Server
Fridge/Freeze
Side By Side Fridge
Washer or Dryer
Microwave or Cart
Bakers Rack
Iron Board/Vacum
Garage
Utility Shelves
Garbage Cans
Treadmill
Total LBS. of Marble Tops
Folding Table
Riding Mower
Bicycles
Rolling Tool Chest
Large Smoker
Area Rug
Sm. Exercise Equipment
Lbs Weights
Plants Under 3 Gallons
Plants Under 5 Gallons
Work Bench
Toy Box/Large Toy
Mower/Edger/Blower
Ladder/Umbrella
Office
Executive Desk
Office/Roll Desk
Computer Desk Pcs
Desk Extension
Small Desk
Credenza
Office Chair
2-3 Drawer File
4-5 Drawer File
Storage Cab
Computer Pcs
Boxes
Small Box/Bags
Medium Boxes
Large Boxes/Plastic Totes
Not Listed
3
Other Services & Notes
How did you hear about us?
*
Notes