Residential Quote Request Form
General Information
Full Name
Email Address
Home Phone
Work Phone
Origination Address
Origination City
Origination State
Destination City
Destination State
Square Feet of Living Area
Living Room
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Bar, Portable Foot Stool Sofa, 3 Cushion
Bench, Frsd/Piano FirePlace Equip. Sofa, Hide, 4 Cush
Bookcase Lamp, Floor or Pole Sofa Sect. Per Sec
Bookshelves, Sect. Magazine Rack Stereo
Chair, Arm Music Cabinet Stereo Component
Chair, Occasional Piano Baby Gr/Upr Stud, Couch or Hideabed
Chair, Straight Piano, Parlor Grand Tables, Dropl/Occas
Chair, Rocker Piano, Spinet/Console Tables, Coffee
Chair, Overstuffed Radio, Table Telephone Stand
Clock, Grandfather Rec. Player, Port. TV BigScreen
Day Bed Rugs Lg Roll/Pad TV, Combination
Desk, Small or Winthrop Rugs Small Roll/Pad TV, Table Model
Desk, Secretary Sofa, Loveseat TV, Console
Dining Room
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Bench, Harvest Dining Table Tea Cart
Buffet (Base) Dining Chair Rugs, Large or Pad
Cabinet, China Server Rugs, Small or Pad
Cabinet, Corner
Bedroom (Bed Incl Sp/Matt)
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Bed, Double Chair, Boudoir Night Table
Bed, King Size Chair, Str/Rocker Rug, Large or Pad
Bed, Rollaway Chaise Lounge Rug, Small or Pad
Bed, Single/Hollywood Chest, Cedar Vanity Dresser
Bed, bunk(Set of 2) Desk, SM/Winthrop Wardrobe, Small
Bookshelves, Sect. Dresser or Vanity Bench Wardrobe, Large
Bureau, Dresser Dresser Double      
Nursery
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Bathinette Chest Playpen
Bed, Youth Chest, Toy Rug, Large or Pad
Chair, Child's Crib, Baby Rug, Small or Pad
Chair, High Table, Child's
Appliances
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Air Cond Wind Freezer, 11 to 15 Refrigerator, 7 to 10 cu ft
Dehumidifier Freezer, 16 or Over Refrigerator, 11 cu ft/over
Dishwasher Ironer or Mangle Vacuum Cleaner
Dryer, Electric or Gas Range, Electric or Gas Washing Machine
Freezer 10 or Less Refrigerator, 6 or less cu ft      
Kitchen
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Bkft Suite, Chairs Kitchen Cabinet Stool
Breakfast Table Microwave Oven Table
Chair, High Roaster Utility Cabinet
Ironing Board Serving Cart Vegetable Bin
Porch and Outdoor
article # of pieces lbs article # of pieces lbs article # of pieces lbs
BBQ or Port. Grill Lawn Mower, Hand Roller, Lawn
Bath, Bird Lawn Mower, Power Rug, Large
Chairs, Lawn Lawn Mower, Riding (HP) Rug, Small
Chairs, Porch Leaf Sweeper Sandbox
Clothes Line Outdoor Child Slide Spreader
Clothes Dryer Rack Outdoor Child Gym Rocken, Swing
Garden Hose and Tools Outdoor Dry. Racks Table
Glider or Settee Outdoor Swings Umbrella
Ladder, 8' Metal Picnic Table Wheelbarrow
Ladder, Extension Picnic Bench
Miscellaneous
article # of pieces lbs article # of pieces lbs article # of pieces lbs
Ash or Trash Can Fan Sled
Basket(Clothes) Fernery or Plant Stands Step Ladder
Bicycle Foot Lockers Suitcase
Bird Cage & Stand Garbage Cans Table, Utility
Card Table Golf Bag Tackle Box
Cabinet,Filling Heater, Gas or Electric Tool Box
Carriage, Baby Metal Shelves Tricycle
Chairs, Folding Ping Pong Table Wagon, Child's
Clothes Hamper Pool Table Waste Paper Basket
Cot, Folding Power Tools Work Bench
Desk, Office Sewing Machine      
Other Items
article # of pieces lbs per 1 piece article # of pieces lbs per 1 piece