1, 2, 3, OR MORE ITEMS MOVED OR PICKED UP DELIVERED SAME DAY. NEGOTIATED FLAT RATE OR HOURLY RATE ALSO $90.00 MINIMUM IF ONLY ONE ITEM

Full Name  **MUST LIST PHONE NUMBERS
**Home Phone **Mobile Phone Work Phone
**E-mail 
Moving From  
Address City State
Moving To  
Address City State
Moving Date 
Zip Code Moving From 
Flights of stairs?
Zip Code Moving To 
Flights of stairs?
Do You Need Packing Services
Leave the number boxes blank for items you do not have
Living Room
Article
#
Article
#
Article
#
Sofa
Loveseat
Hid-a-bed or
Reclining Sofa
Sofa Sectional (No. of Pieces)
Arm Chair
Recliner
Rocker
Ottoman
Coffee Table
End Table
Sofa Table
Futon
TV Stand(s)
Entertainment Center
Wall Unit Pieces
Old Big Screen TV
Big TV Flat
TV, Portable
Dining Table
Dining Table
Dining Chairs
Bar Stools
China Cabinet
Curio Cabinet
Buffet
Kitchen
Microwave
Microwave Stand
Refrigerator
Freezer
Washer
Dryer
Bedroom
King Size Bed
Queen Size Bed
Full Size Bed
Twin Size Bed
Headboard / Footboard
Bridge Bed
Armoire
Bunk Bed
Day Bed
Baby Crib
Dresser
Chest of Drawers
Vanity
Night Stand or Lamp Table
Mirrors
Clothes, per Foot
Trunk
Cedar Chest
Office
Bookcase
Desk L or U Shape
Desk, Office
Hutch
Credenza
File Cabinet, Large
File Cabinet, Small
Tables
Chair, Small
Boxes or Other Misc. Items
Boxes Sealed (One-Man)
Boxes Sealed (two-man)
Glass Top
Mirrors
Picture, Large
Picture, Small
VCR
Chair Small
Fans
Lamps
Vacuum Cleaner
Ironing Board
Piano, Upright
Bench
Grandfather Clock
Plants
Sewing Machine
Aquarium
Stand
Suit Cases
Bike/ex. Bike
Exercise Machine
Treadmill
Weight Bench
Weights, Per Pound
Patio Table
Patio Chairs
BBQ Grill Large
BBQ Grill Small
Lawn Mower
Please list additional items or other information:

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