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First Name:* 
Last Name:* 
Home Phone:*
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Moving From
Address
City*
State*
ZIP*
Date
Private House
Elevator
Walk Up # of flights
Apt. Size

 

 Moving To
Address
City*
Country*
ZIP*
   
Private House
Elevator
Walk Up # of flights
Apt. Size


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LIVING ROOM
Portable Bar Benches
Bookcase
Bookshelves Curio Cabinet Arm Chair
Rocker Chair Chest Grandfather Clock
Day bed Desk Fireplace Equip.
Footstool Hall tree rack Floor lamp
Magazine rack Music Cabinet Baby Grand Piano
Spinet Piano Radio Table Record Player
Rugs Wicker/Rattan Sofa Sofa (sectional)
Loveseat Sofa, 3 cushion Sofa, 4 cushion
Stereo Stereo console Coffee tables
End table Telephone stand TV, portable
TV table TV console TV combination
TV stand Trunk Entertainment Center
Wall Unit        
DINING ROOM
Hutch Cabinet, corner Dining table
Dining chairs Server Tea cart
Buffet China Cabinet    
BEDROOM
Single bed Double bed Queen bed
King bed Bunk bed Waterbed
Single futon Double futon Armoire
Dresser, vanity Dresser, single Dresser, double
Dresser, triple Night table Wardrobe, small
Wardrobe, large Mirrors    
NURSERY
Chair, childs Chair, high Chest, toy
Crib Table, childs Playpen
Bed, youth        
APPLIANCES
Air cond. (Window, small) Air condit (Window, large) Dehumidifier
Dishwasher Freezer Refrigerator
Dryer Vacuum cleaner Washing machine
KITCHEN
Ironing board Kitchen cabinet Microwave oven
Serving cart Stool Kitchen table
Utility cabinet Breakfast chairs Breakfast table
PORCH & OUTDOOR
Outdoor Chairs Garden Hose & tools Ladder
Lawnmower, hand Lawnmower, power Outdoor child slide
Outdoor child gym Outdoor dry racks Outdoor swing
Picnic table Picnic bench Sand box
Umbrella Wheelbarrow BBQ grill (large)
MISCELLANEOUS
Barbells Basket (clothes) Bicycle
Tricycle Bowling ball/bag Card table
Folding chairs Clothes hamper Folding cot
Office desk Fan Filing cab., cardboard
Filing cab., 2 door Filing cab., 4 door Footlockers
Game table Golf bag Heater, gas/elec
Metal shelves Ping pong table Pool table
Power tools Power tool stand Sewing machine
Sewing machine stand Sled Suitcase
Utility table Tackle Box Tire
Tire with rim Toolchest, small Toolchest, medium
Toolchest large Trash can Childs wagon
Wastepaper basket Workbench Approx. number of boxes
Computer Printer Computer stand

 

Vehicle?
no yes
Year
Make
Model

 

Would you like to inquire about insurance?

no yes

If so, what is the estimated value of your items

 

How many packed/unpacked boxes do you estimate you might have?

Carton: 1.5 cu. ft. 1.5
Carton: 3 cu. ft. 3
Carton: 4.5 cu. ft. 4.5
Carton: 6 cu. ft. 6
Carton: 10 cu. ft. 10

Items of extraordinary value:


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