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CONTACT
REMOVAL FROM
Name
Street 1:
Street 2:
Town:
Country:
Postcode:
Email
Home Tel:
Work Tel:
Mobile Tel:
House,
Flat or
Bungalow?
H
F
B
No. Of Bedrooms
0
1
2
3
4
5
6
7
8
Which floors to collect from ?
Lower
Grd
Grd
1st
2nd
3rd
If above 3rd floor please give details:
Is there a Lift?
Yes
No
Parking?
V. Good
Good
Poor
Parking distance from front door?
metres
Are there any access issues ie tight staircase, parking problems
Any removal access required through windows?
REMOVAL TO
Street 1:
Street 2:
Town:
Country:
Postcode:
House,
Flat or
Bungalow?
H
F
B
No. Of Bedrooms
0
1
2
3
4
5
6
7
8
Which floors to deliver to?
Lowr Grd
Grd
1st
2nd
3rd
If above 3rd floor please give details:
Is there a Lift?
Yes
No
Parking?
V. Good
Good
Poor
Parking distance from front door?
metres
Are there any access issues ie tight staircase, parking problems
Any removal access required through windows?
Do you require packing service?
Please Choose
Yes
No
Removal month
month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
How were we recommended to you?
What is the total value of insurance cover required?
<<<<<<<<<< >>>>>>>>>>
Lounge, Dining Room
Bedrooms
3 Seater Sofa
0
1
2
3
4
5
6
7
8
Wardrobe 6' 6"
0
1
2
3
4
5
6
7
8
2 Seater Sofa
0
1
2
3
4
5
6
7
8
Wardrobe 4' 6"
0
1
2
3
4
5
6
7
8
Armchair
0
1
2
3
4
5
6
7
8
Wardrobe 3' 0"
0
1
2
3
4
5
6
7
8
Occasional Chair
0
1
2
3
4
5
6
7
8
Wardrobe 2' 6"
0
1
2
3
4
5
6
7
8
Wall Unit
0
1
2
3
4
5
6
7
8
Wardrobe (Flat Packed)
0
1
2
3
4
5
6
7
8
China Cabinet
0
1
2
3
4
5
6
7
8
Dressing Table
0
1
2
3
4
5
6
7
8
Welsh Dresser
0
1
2
3
4
5
6
7
8
Chest of Drawers, Large
0
1
2
3
4
5
6
7
8
Sideboard
0
1
2
3
4
5
6
7
8
Chest of Drawers, Medium
0
1
2
3
4
5
6
7
8
Dining Table
0
1
2
3
4
5
6
7
8
Tallboy
0
1
2
3
4
5
6
7
8
Gate-leg Table
0
1
2
3
4
5
6
7
8
Washstand and Slab
0
1
2
3
4
5
6
7
8
Occasional Table
0
1
2
3
4
5
6
7
8
Folding Bed
0
1
2
3
4
5
6
7
8
Dining Chair
0
1
2
3
4
5
6
7
8
Sofa Bed
0
1
2
3
4
5
6
7
8
Carver
0
1
2
3
4
5
6
7
8
Bedroom Chair
0
1
2
3
4
5
6
7
8
Roll-Top Desk
0
1
2
3
4
5
6
7
8
Lloyd Loom Chair
0
1
2
3
4
5
6
7
8
Desk
0
1
2
3
4
5
6
7
8
Kingsize Bed
0
1
2
3
4
5
6
7
8
Bookcase
0
1
2
3
4
5
6
7
8
Double Bed
0
1
2
3
4
5
6
7
8
Bookshelves
0
1
2
3
4
5
6
7
8
Single Bed
0
1
2
3
4
5
6
7
8
Overmantel
0
1
2
3
4
5
6
7
8
Bunk Beds
0
1
2
3
4
5
6
7
8
Grandfather Clock
0
1
2
3
4
5
6
7
8
Child's Folding Cot
0
1
2
3
4
5
6
7
8
Chandelier
0
1
2
3
4
5
6
7
8
Changing Unit
0
1
2
3
4
5
6
7
8
Standard Lamp
0
1
2
3
4
5
6
7
8
Bedside Table
0
1
2
3
4
5
6
7
8
Carpet, Fitted
0
1
2
3
4
5
6
7
8
Ottoman
0
1
2
3
4
5
6
7
8
Rug
0
1
2
3
4
5
6
7
8
Linen Basket
0
1
2
3
4
5
6
7
8
Piano, Upright
0
1
2
3
4
5
6
7
8
Screen
0
1
2
3
4
5
6
7
8
Piano Grand
0
1
2
3
4
5
6
7
8
Bedside Lamp
0
1
2
3
4
5
6
7
8
Piano Stool
0
1
2
3
4
5
6
7
8
Home Computer
0
1
2
3
4
5
6
7
8
Hi-Fi System
0
1
2
3
4
5
6
7
8
Computer Desk and Chair
0
1
2
3
4
5
6
7
8
T.V
0
1
2
3
4
5
6
7
8
Video Recorder/DVD Player
0
1
2
3
4
5
6
7
8
Nest Tables
0
1
2
3
4
5
6
7
8
T.V / Hi Fi Cabinet
0
1
2
3
4
5
6
7
8
Stool
0
1
2
3
4
5
6
7
8
Mirror
0
1
2
3
4
5
6
7
8
Coffee Table
0
1
2
3
4
5
6
7
8
Picture
0
1
2
3
4
5
6
7
8
<<<<<<<<<< >>>>>>>>>>
Kitchen, Outside Effects
Outside Effects, Boxes and Other Items
Cooker
0
1
2
3
4
5
6
7
8
Pram/Pushchair
0
1
2
3
4
5
6
7
8
Freezer, Upright
0
1
2
3
4
5
6
7
8
Extensions Ladder
0
1
2
3
4
5
6
7
8
Freezer, Chest
0
1
2
3
4
5
6
7
8
Work Bench
0
1
2
3
4
5
6
7
8
Fridge Freezer
0
1
2
3
4
5
6
7
8
Plant Pots
0
1
2
3
4
5
6
7
8
Refrigerator
0
1
2
3
4
5
6
7
8
Plants
0
1
2
3
4
5
6
7
8
Washing Machine
0
1
2
3
4
5
6
7
8
Golf Clubs
0
1
2
3
4
5
6
7
8
Washer and Dryer
0
1
2
3
4
5
6
7
8
Bicycle
0
1
2
3
4
5
6
7
8
Tumble Dryer
0
1
2
3
4
5
6
7
8
Vacuum Cleaner
0
1
2
3
4
5
6
7
8
Packing Materials & Requirements
Dishwasher
0
1
2
3
4
5
6
7
8
Please estimate the number of Packaging boxes you require.
Kitchen Cabinet
0
1
2
3
4
5
6
7
8
Kitchen Table
0
1
2
3
4
5
6
7
8
China & Glass (1 Box holds approximately 1 single Kitchen cupboard)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Kitchen Chair
0
1
2
3
4
5
6
7
8
Baby's High Chair
0
1
2
3
4
5
6
7
8
Books (1 Box holds approximately 3ft of shelf space)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Hostess Trolley
0
1
2
3
4
5
6
7
8
Store Cupboard
0
1
2
3
4
5
6
7
8
Miscellaneous (1 Box holds approximately 1 kitchen cupboard)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Hand Sewing Machine
0
1
2
3
4
5
6
7
8
Treadle Sewing Machine
0
1
2
3
4
5
6
7
8
Food & Drink (1 Box holds approximately 1 single kitchen cupboard)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Hall Table
0
1
2
3
4
5
6
7
8
Hall Stand
0
1
2
3
4
5
6
7
8
Linen (1 Box holds approximately 1 airing cupboard space)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Hall Chair
0
1
2
3
4
5
6
7
8
Clothes Horse
0
1
2
3
4
5
6
7
8
Clothing (1 Wardrobe carton holds approximately 2ft of hanging space)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Stair Carpet
0
1
2
3
4
5
6
7
8
Safe ( State Make & Weight )
0
1
2
3
4
5
6
7
8
Additional Items & Information
Please give details of any other special items that you would like to be moved. e.g. Motorbike, Jet Ski Climbing Frame, Green House, Loft Contents etc
Outside effects
Garden Roller
0
1
2
3
4
5
6
7
8
Wheelbarrow
0
1
2
3
4
5
6
7
8
Lawn Mower
0
1
2
3
4
5
6
7
8
Petrol Lawn Mower
0
1
2
3
4
5
6
7
8
Sun Lounger
0
1
2
3
4
5
6
7
8
Hose and Reel
0
1
2
3
4
5
6
7
8
Garden Tools
0
1
2
3
4
5
6
7
8
* It is your responsibility to dismantle and re-assemble flat pack furniture. However should you require assistance please give details.
Dustbin
0
1
2
3
4
5
6
7
8
Stepladder
0
1
2
3
4
5
6
7
8
Garden Table & Chairs
0
1
2
3
4
5
6
7
8
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