Name

Phone

Email Address

Moving Date (DD.MM.YY)

Post Code (Current Property)

Post Code (New Property)

Floor (Current Property) Floor (Current Property)BasementGround Floor12345+N/A

Floor (New Property) Floor (New Property)BasementGround Floor12345+N/A

Lift (Current Property) Lift (Current Property)YesNoNot Sure / Not WorkingN/A

Lift (New Property) Lift (New Property)YesNoNot Sure / Not WorkingN/A

Property Type House (Current) Property Type House (Current)1 Bedroom2 Bedroom3 Bedroom4 Bedroom5+ BedroomN/A

Property Type House (New) Property Type House (New)1 Bedroom2 Bedroom3 Bedroom4 Bedroom5+ BedroomN/A

Packing Service Packing ServiceYesNoPartial OnlyBreakables OnlyNot SureNeed Packing Material Only

Dismantle / Reassemble Furniture Dismantle / Reassemble FurnitureYesNoNot Sure

Removal Type Removal TypeFull RemovalPart RemovalLarge Items Only

Removal Type Removal TypeChain FreeIn ChainHouse to StorageCorporate Client

Additional Information

Number