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*Your Name:
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*E-Mail Address:
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Telephone (Home):
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Telephone (Work):
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*Approximate Moving Date:
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*Moving From:
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*Elevator Yes
No
*No. Flight Stairs
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*Moving To:
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*Elevator Yes
No
*No. Flight Stairs
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*Who Packs For You?
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Mover
You
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*Who Supplies Cartons?
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Mover
You
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*No. of Bedrooms:
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*Approximate No. Cartons:
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*Paintings Smaller than 2 X 3:
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*Paintings Larger than 2 X 3:
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*Glass Smaller than 2 X 3:
(furniture tops/shelves)
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*Glass Larger than 2 X 3:
(furniture tops/shelves)
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*Piano:
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*List Special Items or Antiques:
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How Did You Hear About Us
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Privacy
Notice
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