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FIRST NAME

LAST NAME

DATE OF MOVE

PHONE NUMBER

EMAIL

MOVING FROM

MOVING TO

MOVE SIZE

PICK UP ADDRESS

DROP OFF ADDRESS

APPROX. NUMBER OF BOXES / TOTES

BEDROOM ITEMS

KING BED

0

QUEEN BED

0

TWIN BED

0

VANITY

0

NIGHT TABLE

0

BIG DRESSER

0

SMALL DRESSER

0

MIRRORS

0

WARDROBE

0

KITCHEN ITEMS

KITCHEN TABLE

0

BREAKFAST TABLE

0

KITCHEN CHAIRS

0

KITCHEN CABINET

0

APPLIANCES

FRIDGE

0

DISHWASHER

0

WASHER

0

FREEZER

0

OVEN

0

DRYER

0

MICROWAVE

0

WINE FRIDGE

0

AIR CONDITIONER

0

DINING ROOM ITEMS

DINING TABLE

0

CHINA CABINET

0

DINING CHAIRS

0

LIVING ROOM ITEMS

SMALL COUCH

0

MEDIUM COUCH

0

LARGE COUCH

0

BENCHES

0

ARM CHAIR

0

ROCKING CHAIR

0

COFFEE TABLES

0

END TABLE

0

RUGS

0

BOOKSHELVES

0

DESK

0

OFFICE ITEMS

OFFICE DESK

0

OFFICE CHAIR

0

FILING CABINETS

0

NURSERY ITEMS

CRIB

0

HIGH CHAIR

0

PLAYPEN

0

GYM / FITNESS ITEMS

TREADMILL

0

EXERCISE BIKE

0

ELLIPTICAL

0

BENCH & WEIGHTS

0

OUTDOOR / PATIO ITEMS

PATIO TABLE

0

OUTDOOR CHAIRS

0

PICNIC TABLE

0

LAWNMOWER

0

OUTDOOR CHILD SLIDE

0

OUTDOOR CHILD GYM

0

BBQ

0

GARAGE ITEMS

WORKBENCH

0

METAL SHELVES

0

TIRES (SET OF 4)

0

TOOL CHEST - SMALL

0

TOOL CHEST - LARGE

0

BICYCLE

0

MISC. ITEMS

PIANO

0

PING PONG TABLE

0

AIR HOCKEY TABLE

0

POOL TABLE

0

ADDITIONAL NOTES

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