Moving From:

*Name:
Address:
*City, *State, Zip:
Work Phone:
*Home Phone:
*E-Mail Address:
# of Flights of Stairs
Elevator
Yes
Preferred Response:
How Did You Find Us?:
Approximate Moving Date:
Moving To:

Name:
Address:
*City, *State, Zip:
Work Phone:
Home Phone:
E-Mail Address:
# of Flights of Stairs
Elevator
Yes
Preferred Response:
      *Required Fields
Living/Family Room
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Bar, Portable
15  
Fireplace Equipment
5
Sofa, 2 Cushions
35
Bench, Fireside or Piano
5
Foot Stool
2
Sofa, 3 Cushions
50
Bookcase
20
Lamp, Floor or Pole
3
Sofa, 4 Cushions
60
Bookshelves, sectional
5
Magazine Rack
2
Sofa, Sectional, per sect.
30
Chair, Arm
10
Music Cabinet
10
Stereo
20
Chair, Occasional
15
Piano, Baby Gr. or Upr.
70
Stud, Couch and Hideabed
50
Chair, Overstuffed
25
Piano, Parlor Grand
80
Tables, Dropl'f Occas.
12
Chair, Rocker
12
Piano, Spinet
60
Tables, Coffee, End or Nest
5
Chair, Straight
5
Radio, Table
2
Telephone Stand and Chair
5
Clock, Grandfather
20
Record Player Port.
2
Television Combination
25
Day Bed
30
Rugs, Large Roll or Pad
10
Television or Radio Console
15
Desk, Small or Winthrop
22
Rugs, Small Roll or Pad
3
Television Table Model
10
Desk, Secretary
35
Dining Room
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Bench, Harvest
10
Chair, Dining
5
Tea Cart
10
Buffet
30
Server
15
Rugs, Large Roll or Pad
10
Cabinet, Corner
20
Table Dining
30
Rugs, Small Roll or Pad
3
Cabinet, China
25
Bedrooms
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Bed, Incl. Spring and Mattr.
Please select below
Bureau, Dresser, Chest of Drawers
25
Dresser, Double (Mr.  & Mrs.)
50
Bed, Double
60
Cedar Chest
15
Night Table
5
Bed, King Size
70
Chair, Boudoir
10
Rugs, Large Roll or Pad
10
Bed, Single or Hollywood
40
Chair, Straight or Rocker
5
Rugs, Small Roll or Pad
3
Bed, Rollaway
20
Chaise Lounge
25
Vanity Dresser
20
Bed, Bunk (set of 2)
70
Desk, Small or Winthrop
22
Wardrobe, Small
20
Bookshelves
5
Dresser of Vanity Bench
3
Wardrobe, Large
40
Nursery
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Bassinet
5
Chest
12
Pen, Play
10
Bed, Youth
30
Chest, Toy
5
Rugs, Large Roll or Pad
10
Chair, Childs
3
Crib, Baby
10
Rugs, Small Roll or Pad
3
Chair, High
5
Table, Child

5

Kitchen
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Breakfast, Suite Chairs
5
Kitchen Cabinet
30
Table
5
Breakfast Table
10
Roaster
5
Utility Cabinet
10
Chair, High
5
Serving cart
15
Vegetable Bin
3
Ironing Board
2
Stool
3
Appliances
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Air Conditioner
30
Ironer or Mangle
12
Dehumidifier
10
Range, Electric or Gas
30
Dishwasher
20
Refrigerator, 

Please select below

Dryer, Electric or Gas
25
6 Cubic Feet or less
30
Freezer, Cu. Capacity 
Please select below
7 to 10 Cubic Feet
45
10 Cubic Feet or less
30
11 Cubic Feet or More
60
11 to 15 Cubic Feet
45
Vacuum Cleaner
5
16 Cubic Feet and Up
60
Washing Machine
25
Porch, Outdoor Furniture and Equipment
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Barbecue or Port. Grill
10
Lawn Mower, Power
15
Rocker, Swing
15
Bath, Bird
5
Lawn Mower, Riding
35
Roller, Lawn
15
Chairs, Lawn
5
Leaf Sweeper
5
Rug, Large
7
Chairs, Porch
10
Outdoor Childs Slide
10
Rug, Small
3
Clothes, Line
5
Outdoor Childs Gym
20
Sand Box
10
Clothes, Dryer Rack
5
Outdoor Drying Racks
5
Settee
20
Garden Hose and Tools
10
Outdoor Swings
30
Spreader
1
Glider or Settee
20
Picnic Table
20
Table
10
Ladder, Extension
10
Picnic Bench
5
Umbrella
5
Lawn Mower, Hand
5
Porch Chair
10
Wheel Barrow
8
Miscellaneous
Item
CF

Qty

Item
CF

Qty

Item
CF

Qty

Ash or Trash Can
7
Fan
5
Sewing Machine
10
Basket (Clothes)
5
Fernery or Plant Stands
10
Sled
2
Bicycle
10
Foot Lockers
5
Step Ladder
5
Bird Cage and Stand
5
Garbage Cans
7
Suitcase
5
Card Table
1
Golf Bag
2
Table, Utility
5
Cabinet, Filing
20
Heater, Gas or Electric
5
Tackle Box
1
Carriage, Baby
20
Incinerator
10
Tool Chest
10
Chairs, Folding
1
Metal Shelves
5
Tricycle
5
Clothes, Hamper
5
Ping Pong Table
20
Wagon, Child's
5
Cot, Folding
10
Pool Table
40
Waste Paper Basket
2
Desk, Office
30
Power Tools
20
Work Bench
20
Boxes
Small 1.5
Large
6
Picture
5
Medium 3
Wardrobe
15
Dishpak
10
Comments


Step 1.
= Total Cubic Feet
= Total Weight
Step 2.
 
Step 3.
 

 


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