RED LETTERS INDICATES A REQUIRED FIELD   Full Name Email Address Day Time Telephone Evening Telephone MOVING FROM CITY STATE ZIP MOVING TO CITY STATE How Did You Hear Of Us Month Day Year     Type Of Move – Please Check One – Insert Below     House Apt. Co-Op Condo     SPECIAL NOTE:     As per Homeland Security Directive – All electronic equipment including but not limited to TV’s, DVD players, CD players, Computer Systems, Microwaves and etc. must be packed in cartons and completely sealed and marked. Check points are in place and movijng trucks will be subject to inspections.     HOUSEHOLD GOODS INVENTORY     Please indicate the number of items in each box that are going to be relocated. Under comments, let us know what items (if any) you are going to pack or if you want our team of movers to pack. If a particular item is not listed on this inventory you can add such item in the comments section.     LIVING / FAMILY ROOM     ITEM Qty ITEM Qty ITEM Qty Wall Unit Bookcase – Lg. Bookcase – Sm.   Chair – Arm Chair – Reg. Chair – folding   Chair – Rocker Chair – Desk Chair – Overstuff   Chair – Wing Back Desk – Office Desk – Computer   Desk – Student Desk – Hutch Ottoman   Lamp – Table Lamp – Standing Lamp – Desk   Rug – Sm. Rug -  Med. Rug – Lg.   Loveseat Sofa Sofa – 3 Cushion   Sofa – sectional Futon End Table   Glass/Marble Tops Coffee Table Pictures – Hanging   Mirror Grandfather Clock Attire     ELECTRONICS / ENTERTAINMENT SYSTEMS     ITEM Qty ITEM Qty ITEM Qty Entertainment Ctr. Stereo Rack TV – 13”-19” – 20”-21”   TV – 25”-27” TV – 32” TV – Flat Screen 32” +   TV – Projection TV – Above 50” TV – Stand   Computer – Tower Computer-Screen Printer   Fax / Scanner Surround Sound Stereo System   Large Speakers Spinet Piano Upright Piano   Bay Grand Piano Key Board Guitar   Amplifier Horns Karaoke System   DVD/VCR Speakers (Floor) Speakers (Med)   Speakers (DJ)           BEDROOMS     ITEM Qty ITEM Qty ITEM Qty Armoire – Sm. Armoire - Reg. High Riser   Bunk Bed Set Single Size Bed Full Size Bed   Queen Size Bed King Size Bed Captains Bed   Full Size Platform Queen Platform Calif. King Bed   Toddler Bed Head/Foot Boards Light Bridge Set   Cedar Chest Vanity Dresser – Single   Dresser – Double Dresser – Triple Chest of Drawers   Dresser Hutch Mirror Night Table   Table Lamp Standing Lamp Jewelry Chest   Wardrobe Closet           APPLIANCES     ITEM Qty ITEM Qty ITEM Qty Air – Cond. Ceiling Fan Standing Fan   Dehumidifier Portable Heater Micro Wave   Refrigerator Refrigerator – Sm. Micro Wave Stand   Freezer – Sm. Freezer – Average Washer   Dryer Dish Washer Stackable W/D   Vacuum Shop Vac Rug Shampoo   Stove     NURSERY     ITEM Qty ITEM Qty ITEM Qty Chair High Chair Changing Table   Play Pen Swing Chest of Drawers   Closet Crib – Regular Crib – Child Craft Type   Toy Chest StuffIies – Large Hamper   Rocking Chair Doll House     BOXES – ESTIMATED AMOUNT     ITEM Qty ITEM Qty   Small Size Boxes – Packed by Owner Medium Size Boxes – P.B.O.     Large Size Boxes – P.B.O. Small Plastic Bins     Medium Size Plastic Bins Large Plastic Bins     Over Size Boxes Flat Boxes     PBO: TO BE PACKED BY OWNER OR ALREADY PACKED     DINING ROOM / KITCHEN     ITEM Qty ITEM Qty ITEM Qty Buffet China Cab. 1-pc China Cab. 2-pc   Buffet Hutch Serving Cart Chandelier   Mirror Hanging Pictures Paintings   Dining Table Table Leaf Dining Table – Glass   Dining Chairs Kitchen Table Butcher Block   Stools Bakers Rack Veggie Rack   Pantry Storage Cabinet         MISC. ITEMS     ITEM Qty ITEM Qty ITEM Qty Bicycle Treadmill Plastic Storage Bins   Fish Tank Fish Tank Stand Garbage Can   Lawn Mower – Gas Snow Plow BBQ – Small   BBQ – Med Queen Platform Patio Table   Patio Table – Glass Patio Chairs Ex-Equip.   Hamper Sewing Mach. Port. Sewing Machine – Table   Suitcase File Cab. 2-drawer File Cab. Large   Tool Box – Sm. Tool Box – Med Tool Box – Shop Type   Trunk/Foot Locker Skies Golf – Clubs/Bag   Bar Universal Weights           Comments * :