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Name
Address
Postal address
Home telephone
Work Telephone
Cellular phone
Fax
E-mail

Where are you moving from?

City
Country
Zip code (postcode)
Number of rooms
Size of your home ft²
Number of stairs
Elevator? Yes    No
Type House   Flat

Where are you moving to?

City
Country
Zip code (postcode)
Number of rooms
Size of your home ft²
Number of stairs
Elevator? Yes   No
Type House   Flat

Livingroom Total
QTY
Armchair
Baby Grand Piano
Bookcase
Bureau
Carpet & Rug
Coffe Tables
Cupboard Large
Cupboard Small
Curtain
Grand father clock
Grand Piano
Lamps Floor or Pole
Lamp Table
Lazy Boy
Magazine Rack
Occasional Chair
Pictures
Sofa 2 Seater
Sofa 3 Seater
Sofa 4 Seater
Sofa Bed
Sofa Sectional (per section)
Stereo / HiFI Large
Stereo / HiFi Mid
Television
Television table
Upright Piano
Wall Unit Large
Wall Unit Small
Video
Bedroom Total
QTY
Bed, King Size
Bed, Double Size
Bed, Singe
Bed, Bunk
Dresser, Chest of Drawers
Cedar Chest
Ironing Board
Side Table
Wardrobe Boxes
(30 hangers)
Mirror

Kitchen Total
QTY
Breakfast Chair
Breakfast Table
Chair, High
Kitchen Cabinet
Serving Cart
Utility Cabinet
Refrigerator Small
Refrigerator Mid
Refrigerator Large
Freezer Small
Freezer Mid
Freezer Large
Washing Machine
Dryer
Stove
Dishwasher
Microwave
Vacuum Cleaner
Office Total
QTY
Bench
Bookcase, Small
Bookcase, Mid
Bookcase, Large
Cabinet
Cabinet, metal small
Chair, arm
Glass top
Partitions
Rack
Rug
Safe
Shelf, metal small
Shelving, industrial
Chair, Stackable
Chair, Upholstered
Chair, Folding
Coat rack
Computer desk
Copier stand
Credenza
Desk, executive
Desk, secretary
Desk, return
File 2 drawer
File 3 drawer
File 4 drawer
File 5 drawer
Showcase
Sofa, small
Sofa, large
Office Total
QTY
Stool
Table
Table coffee
Table, conferece
Table, drawing
Table, end
Table, folding
Trunk

Porch Total
QTY
Barbecue or Portable Grill
Chair, Lawn
Chair, Porch
Ladder, Extension
Lawn Mower
Outdoor Swings
Picnic Table

Dining Room Total
QTY
Buffet
Dining Table Small
Dining Table Mid
Dining Table Large
Dining Chair
China Cabinet
Corner Cabinet

Misc Total
QTY
Removal boxes

Total: cubic feet: ft³ cubic meters:
When are you moving?

Date

Service-level
1st Class   Door-to-port Freight-box Storage

Additional information

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email   fax   telephone post

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