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Personal Info

*Full Name: *Home Phone:
*Email: *Cell Phone:

Preferred Response: Work Phone:
*Moving Date:(dd/mm/yy)

Moving From

Destination

*Address: *Address:
*City: *City:
*State: *State:
*Zip *Zip:

Living Room

Item Quantity Item Quantity Item Quantity
Bar, Portable

Desk, Small

Stereo

Bookcase Large

Desk, Secretary

Coffee Table

Bookcase Small

Foot Stool

End Table

Bookshelves, Large

Lamp, Floor or Pole

Flat Screen TV 21″-41″

Bookshelves, Small

Stereo Cabinet

Flat Screen TV 42″-47″

Chair, Arm

Piano, Baby Grand

Flat Screen TV 48″-55″

Chair, Lounge

Piano, Grand

Flat Screen TV 55″-60

Chair, Overstuffed

Piano, Upright

TV Projector

Chair, Rocker

Bench, Piano

Tub/Console TV

Chair, Straight

Carpet, Large- 8X10

TV stand

Recliner

Carpet, Small

Entertainment Center: Small

Clock, Grandfather

Loveseat

Entertainment Center: Reg.

Day Bed

Sofa, 3 Seat

Entertainment Center: Large

Chair, Office

Sofa, 4 Seat

Picture Frames

Sofa, Sectional

Ottoman

Sofa, Sleeper

Floor Lamp

Table Lamp

Dining Room

Item Quantity Item Quantity Item Quantity
Bench

Chair, Dining

Tea Cart

Buffet Base

Server

Rugs,Carpet Large 8X10

Corner Cabinet

Table Dining

Rugs, Carpet Small

China Cabinet 1 Piece

Wine Rack

Drop Leaf

China Cabinet 2 Piece

Glass Top for Dining Table

Hutch

Glass Top

Bed Room

Item Quantity Item Quantity Item Quantity
Bed, Canopy

Chest of Drawers: Small

Dresser, Single

Bed, Twin

Chest of Drawers: Med.

Dresser, Double

Bed, Queen

Chest of Drawers: Large

Dresser, Triple

Bed, King

Cedar Chest

Night Table

Bed, Bunk

Chair, Boudoir

Rugs, Large Roll or Pad

Bed, Trundle

Chair, Rocker

Rugs, Small Roll or Pad

Bed, Double

Chaise Lounge

Vanity Dresser

Futon

Desk, Small or Winthrop

Wardrobe, Small

Foot Board

Table Lamp

Wardrobe, Large

Head Board

Wardrobe Closet: Small

Mirror Large

Hamper

Wardrobe Closet: Med.

Mirror Small

Wardrobe Closet: Large

Armoire: Small

Book Shelves

Armoire: Medium

Armoire: Large

Safe, Small

Nursery

Item Quantity Item Quantity Item Quantity
Bed, Toddler

Chest, Toy

Play Pen

Chair, Child

Crib, Baby

Changing Table

Chair, High

Table, Child

Baby Swing

Chair Rocking

Toy Box

Stroller

Foot Stool

Diaper Pail

Kitchen:

Item Quantity Item Quantity Item Quantity
Chair, Kitchen

Kitchen Cabinet

Stool

Kitchen Table

Serving Cart

Butcher Board

Garbage Can

Water Cooler

Bakers Rack

Small Kitchen Table

Appliances

Item Quantity Item Quantity Item Quantity
Air Conditioner

Range / Stove

Microwave: Small

Dehumidifier

Refrigerator: Small

Microwave: Medium

Dishwasher

Refrigerator: Medium

Microwave: Large

Freezer: Small

Refrigerator: Large

Washing Machine

Freezer: Medium

Refrigerator: Extra Large

Combo Washer & Dryer

Freezer: Large

Refrigerator: Side by Side

Dryer

Refrigerator: Upright

Refrigerator: Dormitory

Porch, Outdoor Furniture and Equipment

Item Quantity Item Quantity Item Quantity
Barbecue or Port. Grill

Lawn Mower, Push

Picnic Table

Chairs, Lawn

Lawn Mower, Riding

Rocker, Swing

Chairs, Patio

Outdoor Drying Racks

Umbrella

Garden Hose and Tools

Outdoor Swings

Spreader

Ladder

Leaf Sweeper

Snow Blower

Wheelbarrow

Shed

Miscellaneous

Item Quantity Item Quantity Item Quantity
Trash Can

Fan

Sewing Machine

Card Table

Foot Lockers

Step Ladder

Cabinet, Filing

Golf Bag

Suitcase

Chairs, Folding

Metal Shelves

Table, Utility

Vacuum

Pool Table

Tool Chest

Tool Box, Large

Power Tools

Waste Paper Basket

Tool Box, Small

Ironing Board

Work Bench

Bicycle, Child

Bicycle, Adult

Boxes:

Item Quantity Item Quantity Item Quantity
Small

Plastic bins: Small

Wardrobe Box

Medium

Plastic bins: Medium

Picture Box

Large

Plastic bins: Large

TV Box

Office:

Chair Office

Printer Table

Fax / Printer Machine

Computer Desk

Desk, Double

File Cabinet 2 Drawers

Laptop

Desk Executive

File Cabinet Large

Computer System

Desk, Hutch

File Cabinet Small

Additional Items

Item1 L x W x H Quantity

Item2 L x W x H
Item3 L x W x H
Item4 L x W x H
Item5 L x W x H

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