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Contact Information
Name:
E-Mail Address:
Home Phone:
Alt. Phone:

Moving From
Moving From:
Office/Apt. Floor:
Street Address:
City, State, Zip:
Elevator:

Moving To
Moving To:
Office/Apt. Floor:
Street Address:
City, State, Zip:
Elevator:
Preferred Date of Move:
Approx. Mileage:

Your Items

Please denote any items that will need special consideration, such as antiques, with an * next to the amount in the appropriate field. Items already marked with an * due to insurance purposes may incur extra charges.
"A"-adding machine: chest, tool lg.: leaf blower, gas:
air cond. 5-10 BTU's: chest, tool med.: "M"-magazine rack:
air cond. 10-15 BTU's: chest, tool sm.: microwave:
air cond. 15 BTU's & over: chest, toy: microwave stand:
armoire: clock, grandfather: milkcrates:
"B"-baby, bassinette: clock, wall: mirrors:
baby, carriage: coffee maker: musical instruments:
baby, changing table: computer: "O"-outdoor childs gym:
baby, chest: copier: outdoor childs slide:
baby, crib: cots: outdoor dry racks:
baby, desk: credenza: outdoor swing set:
baby, dresser: "D"-dehumidifier: outdoor umbrella:
bags: desk, childrens: "P"-paint rack:
bakers rack: desk, computer wood: piano, baby grand:
bar: desk, computer metal: piano, grand:
bar stools: desk, corner: piano, spinet:
barbeque grill, charcoal: desk, executive: piano, upright:
barbeque grill, gas: desk, roll top: pictures:
basket: desk, secretary: plastic totes:
basket, wicker: dishwasher: playpen:
bed, bunk: dog house: pool table:
bed, canopy: dresser, double: pool table, slate:
bed, day: dresser, double w/mirror: "R"-rakes:
bed, double: dresser, double w/2 mirrors: range, 20" wide:
bed, frames: dresser, single: range, 30" wide:
bed, king: dresser, single w/mirror: range, 35" wide:
bed, motorized: dresser, single w/2 mirrors: range, double:
bed, queen: dresser, triple: refrigerator, 5 cu. ft.:
bed, rollaway: dresser, triple w/mirror: refrigerator, 10 cu. ft.:
bed, single: dresser, triple w/2 mirrors: refrigerator, over 10 cu. ft.:
bed, waterbed: dryer: rowing machine:
bed, youth: d.v.d. player: rug, large:
bench, cedar: "E"-entertainment center, ex. lg.: rug, small:
bench, harvest: entertainment center, lg.: "S"-safe:
bench, picnic: entertainment center, med.: sand box:
bench, work: entertainment center, sm.: seed spreader:
bicycles: "F"-fans, box: server, lg.:
bookcase, lg.: fans, ceiling: server, med.:
bookcase, med.: fans, floor: server, sm.:
bookcase, sm.: fireplace equipment: sewing machine:
boxes, lg.: foot locker: shelves:
boxes, med.: footboard, double: sleds:
boxes, sm.: footboard, full: sofa, bed:
boxes, wardrobe: footboard, king: sofa, love seat:
buffet: footboard, queen: sofa, love seat sleeper:
"C"-cabinet, china 1 pc.: footboard, single: sofa, rattan:
cabinet, china 2 pc.: foot stool: sofa, reclining:
cabinet, corner: freezer, 10 cu. ft. or less: sofa, sectional:
cabinet, curio lg.: freezer, 11 to 15 cu. ft.: sofa, three cushion:
cabinet, curio med.: freezer, 16 cu. ft. or over: sofa, wicker:
cabinet, curio sm.: futon, metal lg.: stair master:
cabinet, filing 2 dr.: futon, metal med.: statues:
cabinet, filing 4 dr.: futon, metal sm.: stereo, component(s):
cabinet, filing 5 dr.: futon, wood lg.: stereo, console:
cabinet, glass lg.: futon, wood med.: stereo speakers:
cabinet, glass med.: futon, wood sm.: suitcases:
cabinet, glass sm.: "G"-garden hose: "T"-table, card lg.:
cabinet, kitchen lg.: golf equipment: table, card sm.:
cabinet, kitchen med.: "H"-hall trees: table, childs:
cabinet, kitchen sm.: hamper: table, coffee:
cabinet, metal lg.: hat rack: table, coffee w/ glass:
cabinet, metal med.: headboard, double: table, dinette:
cabinet, metal sm.: headboard, double w/ mirror: table, dinette w/ glass:
cabinet, utility lg.: headboard, full: table, dining:
cabinet, utility sm.: headboard, full w/ mirror: table, dining w/ glass:
cabinet, wood lg.: headboard, king: table, dropleaf:
cabinet, wood med.: headboard, king w/ mirror: table, end:
cabinet, wood sm.: headboard, queen: table, end w/ glass:
cable box: headboard, queen w/ mirror: table, kitchen:
carpet cleaner: headboard, single: table, kitchen w/ glass:
cash register: headboard, single w/ mirror: table, night:
c.d. player: heater, electric: table, night w/ glass:
chairs, aluminum: heater, gas: table, picnic:
chairs, arm: heater, kerosene: table, ping pong:
chairs, beach: high chair: table, utility:
chairs, childrens: hobby horse: tea cart:
chairs, computer: humidifier: telephone stand:
chairs, dinette: hutch, 1 pc.: television, 17"-22":
chairs, dining: hutch, 2 pc.: television, 24"-27":
chairs, folding: "I"-ironing boards: television, 30"-32":
chairs, iron: "L"-ladder, step: television, over 32":
chairs, kitchen: ladder, 6': television, portable:
chairs, lounge: ladder, 8': television stand:
chairs, office: ladder, 12': tools, hand:
chairs, ottoman: ladder, 18': tools, power:
chairs, overstuffed: ladder, 24': trashcans:
chairs, plastic: ladder, 36': trash compactor:
chairs, rocking: ladder, 48': treadmill:
chairs, wheel: lamps, floor ceramic: tricycle:
chairs, wicker: lamps, floor pole: trunk:
chairs, wingback: lamps, spider: "U"-umbrella stand:
chest, bedroom lg.: lamps, table ceramic: "V"-vacuum cleaners:
chest, bedroom med.: lamps, table flourescent: v.c.r.:
chest, bedroom sm.: lamps, table glass: "W"-wagon, childs:
chest, cedar lg.: lamps, table wood: washer/dryer combo:
chest, cedar sm.: lawn equipment: washing machine:
chest, hope: lawn mower, hand: weights (in lbs.):
chest, steamer lg.: lawn mower, electric:
chest, steamer sm.: lawn mower, gas:
chest, storage: leaf blower, electric:

Please type any items not listed above in the space provided:


Referred By:

We will respond to your submittal within 24 hours.

Dan Ewall
215-431-2002
dan@carefulmovingservices.com
www.carefulmovingservices.com