Your Details

Business Name
Contact Name
Email Address
Home Phone
Work Phone
Mobile Phone

Pickup Location Details

Address
City / Suburb

State				Postcode

Country

Access Details

Driveway		Good Steep Drive Narrow Driveway Narrow Street		Level of Residence		Ground Level 1 Level 2 Level 3 Level 4 Level 5 Level 10 Level 15 Level 20 Level 50
Entry Point to Vehicle		metres		Does building have lift?		No Yes

Delivery Location Details

Delivery Location Status		Address known, and listed below: Address unknown, will be advised when confirmed. Address unknown, items to be placed into storage.

Address
City / Suburb

State				Postcode

Country

Access Details

Driveway		Good Steep Drive Narrow Driveway Narrow Street		Level of Residence		Ground Level 1 Level 2 Level 3 Level 4 Level 5 Level 10 Level 15 Level 20 Level 50
Entry Point to Vehicle		metres		Does building have lift?		No Yes

Date of Move

We wish to move:		Please Select We know the date Immediately Within the next month Within the next 3 months Not sure, but we will be moving

Actual Date (if known)

Packing Requirements

Would you like us to assist you with Packing?		Yes No

If not, can we assist in providing packing cartons?		Yes No

Bedroom 1

		Double/Queen Bed				Single Bed
		Dble Wardrobe				Single Wardrobe
		Dressing Table				Chest Drawers
		Tall Boy				Bedsides
		Chairs				Stools
		TV				Portarobes
		Standard Cartons				Book Cartons
		Picture Cartons

Bedroom 2

		Double/Queen Bed				Single Bed
		Dble Wardrobe				Single Wardrobe
		Dressing Table				Chest Drawers
		Tall Boy				Bedsides
		Chairs				Stools
		TV				Portarobes
		Standard Cartons				Book Cartons
		Picture Cartons

Bedroom 3/4

		Double/Queen Bed				Single Bed
		Dble Wardrobe				Single Wardrobe
		Dressing Table				Chest Drawers
		Tall Boy				Bedsides
		Chairs				Stools
		TV				Portarobes
		Standard Cartons				Book Cartons
		Picture Cartons

Study

		Desk				Fax
		Chair				Filing Cab. 2-draw
		Filing Cab. 3-draw				Filing Cab. 4-draw
		Drawing Board				Cupboard Single
		Cupboard Dble				Bookcase
		Computer				Printer
		Standard Cartons				Book Cartons
		Picture Cartons

Hall/Entry

		Hall Table				Hall Stand
		Ph. Stand				Pedestal
		Grandfather Clock				Standard Cartons
		Book Cartons				Picture Cartons

Dining Room

		Table				Chairs
		Mobile Tray				Buffet
		Side Board				Crystal Cabinet
		Book Case				Air Conditioner
		Standard Cartons				Book Cartons
		Picture Cartons

Family Room

		2 Seater				Arm Chair
		Divan				Biliard Table
		Lamp				Pouffe
		Coffee Table				Bar
		Bar Fridge				Bar Stool
		Book case				TV
		TV Stand				Video
		Stereo				Speakers
		Standard Cartons				Book Cartons
		Picture Cartons

Lounge

		2 Seater				3 Seater
		Arm Chair				Divan
		Biliard Table				Lamp
		Buffet				Coffee Table
		Bar				Bar Fridge
		Bar Stool				Bookcase
		TV				TV Stand
		Video				Stereo
		Speakers				CD Stand
		Piano Grand				Piano - upright
		Pianola				China Cabinet
		Magazine Tidy				Heater
		Standard Cartons				Book Cartons
		Picture Cartons

Kitchen

		Table				Chairs
		Refridgerator				Kitchen Dresser
		Pantry Cupboard				Rubbish Bin
		Microwave				Freezer
		High Chair				Standard Cartons
		Book Cartons				Picture Cartons

Laundry

		Washing Machine				Tumble Dryer
		Cupboard Sngle				Cupboard Dble
		Linen Basket				Laundry Basket
		Clothes Airer				Ironing Board
		Standard Cartons				Book Cartons
		Picture Cartons

Sundries

		Sewing Machine				Sewing Cabinet
		Golf Bag				Golf Buggy
		Vacuum Cleaner				Floor Polisher
		Kitchen Steps				Trunk
		Basket				Suitcase
		Bench Press				Weights
		Excercise Bike				Step Machine
		Trampoline				Pram
		Stroller				Change Table
		Cot				Canoe
		Surf Board				Dolls Pram
		Dolls House				Standard Cartons
		Book Cartons				Picture Cartons

Outside

		Rubbish Bin				Wheely Bin
		Wheel Barrow				Mower & Catcher
		Whipper Snipper				Garden Tools
		Garden Seat				Plastic Stack Chairs
		Other Chairs				Plastic Table
		Other Tables				Bicycle
		Dog Kennel				Garden Shed (dism)
		Welder				Camping Gear
		Trolley BBQ				Sml BBQ
		Door Mat				Garden Hose
		Pots Plants - 10cm pots				Pots Plants - 20cm pots
		Pots Plants - 30cm pots				Very Large Pot plants
		Standard Cartons				Book Cartons
		Picture Cartons

Additional Details