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        Your Name: *
Your E-mail Address: *
                     Address: *
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                 Telephone: * Ext:

Best time to contact you: *    

Estimate move date:           
The Red stat means Require  

Moving From:

 Moving To:
Address: Address:
City:       City:       
State:      State:      
Size of apartment:       Size of apartment:       
Elevator Yes   No Elevator  Yes      No
If walk up, write#of floors  If walk up, write#of floors  

  No. of people living in the apartment  
       Do you have artwork or antiques:     Yes    No

       Will you need:          Packing     Unpacking     Storage

    Enter your comments in the space provided below:

Comments:
Living Room:      
Bookcase Sofa, loveseat
Cabinet Sofa, large
Chair, straight Stereo
Chair, arm Tables, coffee
Chair, rocker Tables, end
Chair, overstuffed TV
Entertainment center VCR
Entertainment center, large Piano
Lamps Rugs
Pictures

Chest, cedar





Dining Room:      
Buffet Chair
Hutch (top) Server
Cabinet, corner Pictures
Rug small Rug large
Dining table





Bedrooms:      
Bed, single Dresser, single
Bed, double Dresser, double
Bed, queen Dresser, triple
Bed, king Night table
Bed, bunk Pictures
Bookshelves Lamps
Chair TV
Rug Large Rug
Chest, armoire





Nursery:      
Bed, youth Chest, toy
Crib, baby Table, child's




Appliances:      
Aircond/window.sm Refrigerator (11 cu. ft. or over)
Aircond/window.lg Vacuum cleaner
Dishwasher Washing machine
Freezer 10 cf or or less Dryer
Freezer 10-15 Freezer 16 or over
Refrigerator (6 cu. ft. or less Refrigerator (6 cu. ft. or less)
Refrigerator (7-10 cu. ft.)





Kitchen:      
Chairs Serving cart
Breakfast table Ironing board
Microwave oven





Porch & Outdoor:      
BBQ grill, small Chairs, metal
BBQ grill, large Table
Chairs, aluminum Chairs, metal




Misc:      
Bicycle Wagon, child's
Desk, office Golf bag
Filing cab. 2 door Filing cab. 4 door
Suitcase Suitcase




Boxes:      
Book Box (Small) Linen Box (Medium)
China Box (Large) Wardrobe Box
Picture / Mirror Box

Thank you for your comments!

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