Contact Information   Title:  Mr. Mrs. Miss     Name:      Telephone:      Cell Phone:      Fax:        Email:        Moving Information   Note: If you have multiple moving points, please specify in "Additional Information" box below.     Desired Moving Date:      Preferred Contact Time:   1  2  3  4  5  6  7  8  9 10 11 12 AM PM     Moving from Street:     City:  State:    Zip:     Moving to Street:     City:  State:    Zip:
		Living Room     Item Qty. Need Packed?  Value($)       Upright Piano       Electric Piano       Sofa Bed       1-Seat Couch       2-Seat Couch       3-Seat Couch       4-Seat Couch       Wall Unit       Wine Cabinet       Entertainment Center       TV Stand       Marble Table       Coffee Table       End Table       Arm Chair       Rocking Chair       Bar Table       Bar Chair                   Dining Room     Item Qty. Need Packed?  Value($)       Marble Dining Table       Glass Dining Table       Dining Table       Credenza       Kitchen Chest       Stove           Chair           Folding Chair           Refrigerator           Microwave                         Bed Room     Item Qty. Need Packed?  Value($)       Night Table       Working Table       Desk       Computer Desk       L-Shape Desk       Large File Cabinet           Small File Cabinet           Book Shelf           Bed  SizeKingQueenTwin       Under Dresser Bed        Baby Bed         Wooden Bunk Bed        Steel Bunk Bed        Head Board       Dresser       Armoire       Chest       Drawer       Mattress       Mirror                   Additional Information     Electronic Appliance     Item Qty. Need Packed?  Value($)       Air Conditioner       Copier       Computer       Printer       Vacuum Cleaner           Sewing Machine           Washing Machine           Dryer           Floor Lamp           Lamp           Electric Fan           Stereo Set           Large Speakers           TV  Size 65" 60" 52" 50" 46" 42" 37" 32" 26" 24" <20" LCD Plasma Tube           A / V System                       Others     Item Qty. Need Packed? Value($)       Safe Box           Lawn Mower                       Snow Blower           Large Tool Box           Shelf Storage Organizer           Exercise Machine           Motorcycle           Bicycle           Carpet           Misc. Box           Book Box           Clothes Box           Luggage