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Moving From: *Name: Address: City, State, Zip: Work Phone: *Home Phone: *E-Mail Address: # of Flights of Stairs Elevator Yes No  Preferred Response: N/A Phone Fax E-Mail Mail How Did You Find Us?: N/A Browsing Through Search Engine Advertisement Other Approximate Moving Date:

Moving To: Name: Address: City, State, Zip: Work Phone: Home Phone: E-Mail Address: # of Flights of Stairs Elevator Yes N Preferred Response: N/A Phone Fax E-Mail Mail How Did You Find Us?: N/A Browsing Through Search Engine Advertisement Other

      *Required Fields

Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Bar, Portable	15			Fireplace Equipment	5			Sofa, 2 Cushions	35
Bench, Fireside or Piano	5			Foot Stool	2			Sofa, 3 Cushions	50
Bookcase	20			Lamp, Floor or Pole	3			Sofa, 4 Cushions	60
Bookshelves, sectional	5			Magazine Rack	2			Sofa, Sectional, per sect.	30
Chair, Arm	10			Music Cabinet	10			Stereo	20
Chair, Occasional	15			Piano, Baby Gr. or Upr.	70			Stud, Couch and Hideabed	50
Chair, Overstuffed	25			Piano, Parlor Grand	80			Tables, Dropl'f Occas.	12
Chair, Rocker	12			Piano, Spinet	60			Tables, Coffee, End or Nest	5
Chair, Straight	5			Radio, Table	2			Telephone Stand and Chair	5
Clock, Grandfather	20			Record Player Port.	2			Television Combination	25
Day Bed	30			Rugs, Large Roll or Pad	10			Television or Radio Console	15
Desk, Small or Winthrop	22			Rugs, Small Roll or Pad	3			Television Table Model	10
Desk, Secretary	35
Dining Room
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Bench, Harvest	10			Chair, Dining	5			Tea Cart	10
Buffet	30			Server	15			Rugs, Large Roll or Pad	10
Cabinet, Corner	20			Table Dining	30			Rugs, Small Roll or Pad	3
Cabinet, China	25
Bedroom
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Bed, Incl. Spring and Mattr.	Please select below			Bureau, Dresser, Chest of Drawers	25			Dresser, Double (Mr.  & Mrs.)	50
Bed, Double	60			Cedar Chest	15			Night Table	5
Bed, King Size	70			Chair, Boudoir	10			Rugs, Large Roll or Pad	10
Bed, Single or Hollywood	40			Chair, Straight or Rocker	5			Rugs, Small Roll or Pad	3
Bed, Rollaway	20			Chaise Lounge	25			Vanity Dresser	20
Bed, Bunk (set of 2)	70			Desk, Small or Winthrop	22			Wardrobe, Small	20
Bookshelves	5			Dresser of Vanity Bench	3			Wardrobe, Large	40
Nursery
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Bassinette	5			Chest	12			Pen, Play	10
Bed, Youth	30			Chest, Toy	5			Rugs, Large Roll or Pad	10
Chair, Childs	3			Crib, Baby	10			Rugs, Small Roll or Pad	3
Chair, High	5			Table, Child	5
Kitchen
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Breakfast, Suite Chairs	5			Kitchen Cabinet	30			Table	5
Breakfast Table	10			Roaster	5			Utility Cabinet	10
Chair, High	5			Serving cart	15			Vegetable Bin	3
Ironing Board	2			Stool	3
Appliances
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Air Conditioner	30			Ironer or Mangle	12
Dehumidifier	10			Range, Electric or Gas	30
Dishwasher	20			Refrigerator,	Please select below
Dryer, Electric or Gas	25			6 Cubic Feet or less	30
Freezer, Cu. Capacity	Please select below			7 to 10 Cubic Feet	45
10 Cubic Feet or less	30			11 Cubic Feet or More	60
11 to 15 Cubic Feet	45			Vacuum Cleaner	5
16 Cubic Feet and Up	60			Washing Machine	25
Porch, Outdoor Furniture and Equipment
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Barbecue or Port. Grill	10			Lawn Mower, Power	15			Rocker, Swing	15
Bath, Bird	5			Lawn Mower, Riding	35			Roller, Lawn	15
Chairs, Lawn	5			Leaf Sweeper	5			Rug, Large	7
Chairs, Porch	10			Outdoor Childs Slide	10			Rug, Small	3
Clothes, Line	5			Outdoor Childs Gym	20			Sand Box	10
Clothes, Dryer Rack	5			Outdoor Drying Racks	5			Settee	20
Garden Hose and Tools	10			Outdoor Swings	30			Spreader	1
Glider or Settee	20			Picnic Table	20			Table	10
Ladder, Extension	10			Picnic Bench	5			Umbrella	5
Lawn Mower, Hand	5			Porch Chair	10			Wheel Barrow	8
Miscellaneous
Item	CF	Quantity		Item	CF	Quantity		Item	CF	Quantity
Ash or Trash Can	7			Fan	5			Sewing Machine	10
Basket (Clothes)	5			Fernery or Plant Stands	10			Sled	2
Bicycle	10			Foot Lockers	5			Step Ladder	5
Bird Cage and Stand	5			Garbage Cans	7			Suitcase	5
Card Table	1			Golf Bag	2			Table, Utility	5
Cabinet, Filing	20			Heater, Gas or Electric	5			Tackle Box	1
Carriage, Baby	20			Incinerator	10			Tool Chest	10
Chairs, Folding	1			Metal Shelves	5			Tricycle	5
Clothes, Hamper	5			Ping Pong Table	20			Wagon, Child's	5
Cot, Folding	10			Pool Table	40			Waste Paper Basket	2
Desk, Office	30			Power Tools	20			Work Bench	20
Boxes
Small				Large				Picture
Medium				Wardrobe

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