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PLEASE BE AS DETAILED AS POSSIBLE WHEN FILLING OUT FORM
PLEASE ENTER IN DATE YOUR SERVICES ARE NEEDED
ENTER CONTACT PHONE NUMBER AS WELL AS ALTERNATE
PLEASE ENTER YOUR E-MAIL
FIRST & LAST NAME OF CUSTOMER/BUSINESS
ADDRESS & ZIP CODE OF PICK UP LOCATION
ADDRESS & ZIP CODE OF DROP OFF LOCATION
EST. SIZE OF STRUCTURE IN SQUARE FEET TO BE MOVED/TRANSPORTED
0-500 Sq Ft.
500-1000 Sq Ft.
1000-1500 Sq Ft.
1500-2000 Sq Ft.
2000-2500 Sq Ft.
2500-ABOVE WILL BE CONFIRMED
NUMBER OF ROOMS TO BE MOVED/TRANSPORTED
ONE
TWO
THREE
FOUR
FIVE
SIX
SEVEN
EIGHT
NINE
TEN
MORE THAN TEN
TYPE & NUMBER OF ROOM TO BE MOVED/TRANSPORTED
KITCHEN
LIVING ROOM
FAMILY ROOM/DEN
LAUNDRY ROOM
DINNING ROOM
OFFICE
PATIO/SHED ROOM
GARAGE/CAR PORT
BATH ROOM 1
BATH ROOM 2
MORE THEN 3 BATH ROOMS
MASTER BED ROOM
BED ROOM 1
BED ROOM 2
BED ROOM 3
BED ROOM 4
BED ROOM 5
MORE THAN 5 BED ROOMS
WALK-IN-CLOSET
CLOSET
OTHER TYPE OF ROOMS
OTHER TYPE OF ROOMS DESCRIPTION
KITCHEN: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE EST. NUMBER OF BOXES
LIVING ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE EST. NUMBER OF BOXES
FAMILY ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE EST. NUMBER OF BOXES
LAUNDRY ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
DINNING ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
OFFICE: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
PATIO/SHED ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
GARAGE/CAR PORT: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
LIST # OF BATH ROOM ITEMS & BOXES
MASTER BED ROOM: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
BED ROOM #1: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
BED ROOM #2: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
BED ROOM #3: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
BED ROOM #4: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
BED ROOM #5: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
WALK-IN-CLOSET: PLEASE LIST NUMBER AND SIZE AND EST. WARDROBE BOXES NEEDED
CLOSETS & NUMBER OF: LIST A BRIEF DESCRIPTION OF ITEMS INCLUDE & EST. NUMBER OF BOXES
LEVEL OF PACKING NEEDED
NONE AT ALL (WILL PACK YOUR SELF)
LITTLE BIT
MILD TO MODERATE
MOST TO ALL
LEVEL OF ASSEMBLY/DISASSEMBLE
NONE AT ALL
SOME OR A LITTLE
MILD TO MODERATE
MOST OR A LOT
LEVEL OF STRUCTURE MOVING FROM
LEVEL OF STRUCTURE MOVING TOO
TYPE OF STRUCTURE MOVING FROM
HOME/HOUSE
APARTMENT
CONDO/TOWN HOME
STORAGE/MOBILE POD
DUPLEX/QUDPLEX
HIGH RISE BUILDING
OFFICE PLEX
OTHER
IF YOU SELECTED OTHER TYPE OF STRUCTURE MOVING FROM PLEASE LIST A DESCRIPTION
TYPE OF STRUCTURE MOVING TOO
HOME/HOUSE
APARTMENT
CONDO/TOWN HOME
STORAGE/MOBILE POD
HIGH RISE BUILDING
DUPLEX/QUDPLEX
OFFICE PLEX
OTHER
IF YOU SELECTED OTHER TYPE OF STRUCTURE MOVING TO PLEASE LIST BRIEF DESCRIPTION
Vehicle hauling services needed
No
Yes
possible
If vehicle services are needed list type of vehicle make and model
Preferred method of payment: Note you can select more than one method if needed
CASH: biggest discount offered
CHECK
CREDIT
DEBIT

                                       STATE TO STATE MOVING SERVICES

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