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Residence Information
Current City
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Current State
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Current Zip
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Relocation City
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Relocation State
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Relocation Zip
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When Are You Planning To Move?
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Current Residence
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House
Apartment
Condo
Office
Other
Future Residence
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House
Apartment
Condo
Office
Other
Contact Information
First Name
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Last Name
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Email
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Phone Number
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Living Room
Arm Chair
Baby Grand Piano
Book Case
Bureau
Carpel & Rug
Clock Grand Father
Coffee Tables
Cupboard Small
Cupboard Large
Curtain
End Table
Folding Chair
Grand Piano
Lamps Floor or Pole
Lazy Boy (Chair)
Magazine Rack
Occasional Chair
Pictures
Love Seat
Sofa (3 Seater)
Sofa Bed
Sofa Sectional (per section)
Stereo / Hi-Fi : Mid
Stereo / Hi-Fi: Large
Television up to 20'
Television 21'-29'
Television 30'-39'
Television 40'-49'
Television 50' or larger
Television Table
Upright Piano
Video
Wall Unit Small
Wall Unit Large
Bedroom
Bed: Bunk (Set of 2)
Bed: Double
Bed: Single
Bed: King
Bed: Queen
Bed: Roll-Away
Bookshelves Section
Cedar Chest
Dresser: Chest of Drawers
Ironing Board & Iron
Side Tables
Wardrobe Boxes (30 hangers)
Wall Mirror
Kitchen
Box: Dish-Pack
Box: Large
Box: Medium
Box: Small
Breakfast Suite: Chairs
Breakfast Table
Chair: High
Kitchen Cabinet
Microwave Oven
Serving Cart
Stool
Table
Utility Cabinet
Dining Room
Buffet: Total
China Cabinet
Corner Cabitnet
Dining Chair
Dining Table: Large or Glass
Dining Table: Mid
Dining Table: Small
Appliances
Air Conditioner: Large
Air Conditioner: Small
Dehumidifier
Dishwasher
Washing Machine
Dryer
Freezer: 10 or less
Freezer: 11 or 15
Freezer: 16 or over
Microwave
Range: 20' wide
Range: 30' wide
Range: 36' wide
Refrigerator (CuCp): 6 cu. ft. or less
Refrigerator (CuCp): 7 to 10 cu. ft.
Toaster Oven
Trash Compactor
Vacuum Cleaner
Miscellaneous
Baby Carriage
Barbecue or Portable Grill
Bicycle
Chair: Lawn
Chair: Porch
Child's Wagon
Computer
Fan
Filing Cabinet: Cardboard
Filing Cabinet: 2 doors
Filing Cabinet: 4 doors
Heater
Ladder Extension
Lawn Mower
Office Desk
Outdoor Swings
Picnic Table
Ping Pong Table
Plastic Shelves
Pool Table
Power Tool
Metal Shelves
Tire
Tool Tower
Trash Can
Tricycle
Utility Table
Video Game Console
Piano Info
Vertical
Spinet
Studio
Upright
Spinet Organ
Console
Grand
5' to 6'3"
6'5" to 7'6"
9' - 12' Concert
Player
Yes
No
Speakers
Yes
No
Quantity: Vertical
Quantity: Grand
Environmental Factors
Are there stairs?
Yes
No
How many steps/flights?
Additional items to move, not listed above. Please be specific.
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