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Email *
Home Phone *
Work Phone
Estimated Move Date

Moving From

Address
City
Province/Postal Code
Size of residence:
# of bedrooms
# of rooms
Flights of Stairs
# of major Appliances
Will Temporary Storage be needed?
 Yes No

Living Room - # of items

Arm Chair
Sofa
Love Seat
Rocking Chair
Lamp
Piano
Rugs
Stereo
Coffee Table
End Table
TV
Stand
Futon
Entertainment Center
Ottoman

Office - # of items

Desk
File Cabinet
Fan
Book Case

Boxes - # of items

Small
Medium
Large
Wardrobe
Picture

Notes

Moving To

Address
City
Province/Postal Code
Size of residence:
# of bedrooms
# of rooms
Flights of Stairs
# of major Appliances
Will destination residence be ready by time of move?
 Yes No

Dining Room - # of items

China Cabinet
Buffet
Chair
Table
Tea Cart
Hutch

Kitchen - # of items

Refrigerator
Stove
Freezer
Dryer
Washer
Table
Chairs
Cabinet
Vacuum
Microwave
A/C
Grill
Picnic Table

Bedrooms - # of items

Double Bed
Queen Bed
King Bed
Single Bed
Bureau
Chest
Dresser
Night Table
Armoire
Mirror

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