CURRENT LOCATION
Can we park our moving truck within how many feet of your door to load? 120 240 360 More than 360
What floor? 1st Split-Level Tri-Level 2nd 3rd 4th 5th 6th 7th 8th 9th 10th
Any Stairs? None 1 Set 2 Sets 3 Sets Elevator
NEW LOCATION
Can we park our moving truck within how many feet of your door to load? 120 240 360 More than 360
What floor? 1st Split-Level Tri-Level 2nd 3rd 4th 5th 6th 7th 8th 9th 10th
Any Stairs? None 1 Set 2 Sets 3 Sets Elevator
ADDITIONAL INFORMATION
Any Additional Stops in Between? No Yes
Second Stop Address
Second Stop City
Stop StateArizona California Nevada
Zip Code
Major Cross Streets
What floor? 1st Split-Level Tri-Level 2nd 3rd 4th 5th 6th 7th 8th 9th 10th
Additional Comments Not Covered Above : Complex Names - Storage - Unit or Apt Numbers)
Enter Quantity of items to be moved. Leave blank if not moving those items.
Armoire (Select # of Pieces) 1 2 3
Air Conditioner / Window
Air Compressor (Size?) Up to 30 Gallons Up to 60 Gallons Up to 100 Gallons
Bakers Rack
Bar Portable
Bar Stools
B-Ball Hoop / Portable / Empty
Bassinet
Bed, Day/Trundle
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bed, Bunk
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bed, Captain's
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bed, Dbl./Single
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bed, Electric
Bed, King/Queen
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bed, Post/Canopy
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Bench, Park
Bench, Piano
Bench, Vanity
Bicycle
Bird Bath
Bird Cage
Box, under 50 lbs.
Box, over 50 lbs.
Box, Wardrobe
Book Case
Buffet (Select # of Pieces ) 1 2 3
Cabinet, Corner
Cat Tree
Cedar Chest
Chair, Armed
Chair, Chaise Lounge
Chair, High Chair
Chair, Computer/Office
Chair, Kitchen
Chair, Dining
Chair, Lawn/Patio
Chair, Overstuffed
Chair, Recliner
Chair, Rocker
Chest of Drawers
Chimney / Patio
Changing Table
China Cabinet (Select # of Pieces) 1 2 3
Clothes, Hanging per/foot.
(Free Wardrobe Rental With Flat Rate Moves)
Coffee Table (Glass Top?) no yes
Cooler
Cooler, Full
Computer, CPU/Key/Mon *Unhooked Only
Copy Machine, Large
Copy Machine, Small
Credenza
Crib - Baby
(Disassemble/Re-Assemble) Disassemble Re-Assemble Both
Curio Cabinet
Desk
Select # of Pieces 1 2 3 4 5
Disassemble/Re-Assemble Disassemble Re-Assemble Both
Desk, Executive
DSelect # of Pieces 1 2 3 4 5
DDisassemble/Re-Assemble Disassemble Re-Assemble Both
Desk, Roll Top
Dishwasher
Dog House
Drafting Table
Dresser w/Mirror? Disassemble Re-Assemble Both
Dryer
End Table Glass Top? no yes
Entertainment Center
Select # of Pieces 1 2 3
Etagere
Exercise Equipment
Not Home Gym
Fan
Fax Machine
File Cabinet, Legal
Number of Drawers 1 2 3 4 5
Is it Fire Rated? no yes
File Cabinet, Letter
Number of Drawers 1 2 3 4 5
Is it Fire Rated? no yes
File Cabinet, Lateral
Number of Drawers 1 2 3 4 5
Is it Fire Rated? no yes
Fish Tank, Per/Gal
Number of Gallons?
*Contents Must Be Emptied
Fish Tank, Stand
Footboard/Headboard
Foot Stool
Freezer, Small
Freezer, Large
Fountain, Garden
Futon
Garbage Can
Garden Hose
Garden Tools
Glass Shelves
Glass Top, Large
Glass Top, Small
Golf Cart, Drivable
Golf Bag
Grandfather Clock
Grill, Gas
Gun Rack
Gun Safe Weight? 0-50 lbs. 51-100 lbs. 101-300 lbs. 301-500 lbs. 501 - 650 lbs.
Hat Rack
Hide-a-Bed
Home Gym (Disassembled)
Hutch Select # of Pieces 1 2 3
Ironing Board
Jewelry Cabinet
Ladder, Under 8'
Ladder, Over 8'
Lamp
Lamp, Floor
Lawn Mower
Please Select Type Electric Gasoline Push Riding
Bed, Bunk
Disassemble/Re-Assemble Disassemble Re-Assemble Both
Lingerie Chest
Marble/Granite Top Weight? 0-50 lbs. 51-100 lbs. 101-200 lbs. 201-500 lbs. 501-800 lbs. Over 800 lbs.
Mattress,
King WITH NO FRAME. List here if not listed as complete bed.
Mattress, Queen
WITH NO FRAME. List here if not listed as complete bed.
Mattress, Full / Twin
WITH NO FRAME. List here if not listed as complete bed.
Mattress, Single
WITH NO FRAME. List here if not listed as complete bed.
Microwave Cart
Microwave
Mirror
Disassemble/Re-Assemble Disassemble Re-Assemble Both
Motorcycle, Street
Motorcycle, Dirt
Motor Vehicle, ATV
Night Stand
Organ, Small
Ottoman
Piano electric piano Spinet piano Upright piano Baby Grand antique Piano
Pictures
Ping Pong Table - Portable
Plants, Large
Plants, Small
Plant Stand
Playpen
Printer Stand
Quilt Rack
Refrigerator
Refrigerator, Side-by-Side
Room Divider
Rug, Over 4'
Rug, Under 4'
Safe - Weight? 0-50 lbs. 51-100 lbs. 101-300 lbs. More
Serving Cart
Sewing Machine
Shop Machines, under 200 lbs.
Shop Machines, over 200 lbs.
Skis (pair)
Sofa, Love Seat
Sofa Type Regular HideaBead Recliner
Sofa, Full Size
Sofa Type Regular HideaBead Recliner
Sofa, Sectional Sofa Type Regular HideaBead Recliner How many Sections? 1 2 3 4 5 6 7 8 9 10
Speakers
Stereo Components
Unhooked, Each Piece
Stereo Cabinet/Stand
Storage Cabinet, Small
Storage Cabinet, Large
Storage Shelves
Stove/Oven
Stroller
Table, Conference
Table, Card
Table, Small Kitchen
Table, Large Dining
Table, Drop Leaf
Table, Folding
Table, Patio
Table, Picnic
Table Saw, Contractor
Table Saw, Cabinet
Table, Sofa Glass Top? No Yes
Tool Box, On Wheels
Select # of Pieces 1 2 3 4 5
Tool Box, Hand Carry
Toy Box
Tree, in-a-pot (under 50 pounds)
Trunk, Storage
Typewriter
TV Trays, Set of 6
TV size 19-32 33-43 44-55 56-65 66 or larger
TV Stand
VCR/DVD
Vacuum
Vacuum, Shop
Vanity
Vanity, w/mirror
Vase
Washing Machine
Water Cooler
Water Jugs, Full
Weight Bench
Weights, Free Weight? 0-50 lbs. 101-200lbs. 201-300lbs. 301-500lbs. Over 500 lbs.
Wheelbarrow
Wine Rack
Work Bench
Please enter items not listed above here.
Enter information such as special handling requirements for Antiques or over size furniture, wardrobes, packing material or shrink wrap. Please be specific about any unusual pieces or moving conditions.