• First Name:*
• Last Name:*
• E-mail:*
• Phone:
• Mobile:
• Address (from):*
• Will you be doing the packing?
  Yes No
• Please Select (Type)
  House Bungalow Flat
• Lift Available?
  Yes No
• Parking
  Driveway Side Road Main Road More than 100yrds Flat Maisonette
• Address to (Town):*
• Estimated Moving Date:*
• Please Select (Type)
  House Bungalow Flat
• Lift Available?
  Yes No
• Parking
  Driveway Side Road Main Road More than 100yrds Flat Maisonette

• First Bedroom (Please fill in the numbers of items) 
• 4ft, 5ft, 6ft Wardrobe:
• Dressing Table:
• Chest of Draws:
• Single Bed:
• Double Bed:
• Ottoman:
• Chairs:
• Bedside Tables:
• Packing cases:
• Headboard:

• Second Bedroom (Please fill in the numbers of items) 
• 4ft, 5ft, 6ft Wardrobe:
• Dressing Table:
• Chest of Draws:
• Single Bed:
• Double Bed:
• Ottoman:
• Chairs:
• Bedside Tables:
• Packing cases:
• Headboard:

• Third Bedroom (Please fill in the numbers of items) 
• 4ft, 5ft, 6ft Wardrobe:
• Dressing Table:
• Chest of Draws:
• Single Bed:
• Double Bed:
• Ottoman:
• Chairs:
• Bedside Tables:
• Packing cases:
• Headboard:

• Fourth Bedroom (Please fill in the numbers of items) 
• 4ft, 5ft, 6ft Wardrobe:
• Dressing Table:
• Chest of Draws:
• Single Bed:
• Double Bed:
• Ottoman:
• Chairs:
• Bedside Tables:
• Packing cases:
• Headboard:

• Bathroom (Please fill in the numbers of items) 
• Laundry Basket
• Cabinet

• Lounge (Please fill in the numbers of items) 
• 3 piece suite small/large
• piano grand/upright
• China cabinet
• Extra easy chairs
• Books
• Bookcase
• Occasional Table
• Television
• Records/Tapes/Videos/DVDs
• Video/DVD player
• Music Centre
• Standard Lamp & Shade
• Pictures/Mirrors
• Packing Cases

• Dining Room (Please fill in the numbers of items) 
• Sideboard
• Dining Table
• Chairs
• Bureau
• Pictures and Mirrors
• Wines and Spirits
• Packing Cases

• Kitchen (Please fill in the numbers of items) 
• Table
• Cabinet
• Chairs
• Washing Machine
• Cooker
• Refrigerator
• Dishwasher
• Freezer
• Tumble Dryer
• Microwave Oven
• Packing Cases

• Hall/Landing (Please fill in the numbers of items) 
• Table
• Chair
• Grandfather Clock
• Packing Cases

• Sundries (Please fill in the numbers of items) 
• Carpets/Rugs
• Carpets Fitted/Squares
• Pram
• Sewing Machine
• Suitcases/Trunks
• Bicycles
• Electric/Gas fires
• Tricycles/Dolls Prams
• Toys
• Packing Cases

• Garage/Roof Space (Please fill in the numbers of items) 
• Tools
• Timber
• Bench
• Packing Cases

• Garden Equipment (Please fill in the numbers of items) 
• Mower
• Roller
• Wheelbarrow
• Section Shed/Greenhouse
• Garden Seats
• Deck Chairs
• Large Ornaments
• Tools
• Dustbins
• Potted Plants
• Ladders/Steps
• Extras

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