Please select one or both for this estimate.
Packing estimate?
Moving Estimate?
Desired Date of Move (or best guess, if date unknown) *
January
February
March
April
May
June
July
August
September
October
November
December
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
Date flexible within
1
2
3
4
5
First Name*
Last Name *
Contact Name (if other)
Name of Business or Apartment Complex
Home Phone (example 309-698-1693)
Work Phone
Mobile (Cell) Phone
E-mail Address
Complete Address of Origin of Move (Address you are moving
from)Street Address*
Apt/Suite
City*
Zip Code*
Complete Address of Destination of Move (Address you
are moving to)Street Address*
Apt/Suite
City*
Zip Code*
If mailing Address is Different
No
Yes
If intermediate pickup or drop off Address
Street Address
Apt/Suite
City
Zip Code
Description of Move
House Type?*
Ranch
2 Story
Split Level
Shared-condo
Options are: (Ranch, 2 Story, Split-Level,
Shared-Condo Style)
Number of floors of home or condo (including the basement)*
Select
1 Floor
2 Floors
3 Floors
4 Floors
5 Floors
Example: 2 Story with Basement = 3 Floors
If Apartment or business (What Floor is it on?)
Select
1st Floor
2nd Floor
3rd Floor
4th Floor
5th Floor
6th Floor
7th Floor
8 or more Floors
Elevator?
Exclusive
or Shared?
Walking distance to the truck (at origin)
Approximately 10 Feet
Approximately 25 Feet
Approximately 50 Feet
Approximately 75 Feet
Approximately 100 Feet
Approximately 200 Feet
Approximately 300 Feet
more
Number of staircase steps out (at origin)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
more than 20
Walking distance to the truck (at destination)
Approximately 10 Feet
Approximately 25 Feet
Approximately 50 Feet
Approximately 75 Feet
Approximately 100 Feet
Approximately 200 Feet
Approximately 300 Feet
more
Number of staircase steps in (at destination)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
more than 20
Driveway (at loading zone)?
None
1 Truck Wide
2 Truck Wide
Circular Drive
Options: (None, 1 Truck wide, 2 Truck Wide, circular
drive)
Number of Boxes we are moving (once you are packed)? (75
is the Average for a 3 bedroom home.)
Not Applicable
25 Boxes
35 Boxes
45 Boxes
65 Boxes
75 Boxes
100 Boxes
Will you need boxes from our office in advance? Yes/No
Yes
No
List of the furniture items we are moving (The more
complete, the more accurate we can be)
Master Bedroom
Bed Size (type of bed)?
Select
King
Queen
Full
Twin
Crib
Head board (type of Headboard or footboard?
None
Headboard only
Headboard and Footboard
4 post with bed Frame
1 Piece shelf headboard
shelf and water bed
3 piece cabinet headboard
mats only - no frame
Dresser? (low and long, or Tall and high?)
None
Double
Double with mirror
Triple
Triple with mirror
Chest, Armoire, Highboy?
None
Chest
Armoire
Highboy
Chest with mirror
Chest, Armoire, Highboy?
None
Chest
Armoire
Highboy
Chest with mirror
Night Stand(s)
None
1
2
List other (Chairs, TV Stand, Jewelry Chest, Lingerie chest,
treadmill, safe, etc.)
2nd Bedroom
Bed Size (type of bed)?
none
King
Queen
Full
Twin
Bunk Bed
Daybed with trundle
Daybed without trundle
Futon
Crib
Toddler bed
Head board (type of Headboard or footboard?
None
Headboard only
Headboard and Footboard
4 post with bed Frame
1 Piece shelf headboard
shelf and water bed
3 piece cabinet headboard
mats only - no frame
Dresser? (low and long, or Tall and high?)
None
Double
Double with mirror
Triple
Triple with mirror
Chest, Armoire, Highboy?
None
Chest
Armoire
Highboy
Chest with mirror
Chest, Armoire, Highboy?
None
Chest
Armoire
Highboy
Chest with mirror
Night Stand(s)
None
1
2
Desk?
None
Small Computer desk
Small desk with hutch
3 Piece desk
Roll top desk
Secretary Desk
File Cabinet?
None
2 Drawer
3 Drawer
4 Drawer
Lateral
List other (Chairs, Desk Chairs, TV Stand, treadmill,
bookshelf, portable drawer stand, etc.)
3rd Bedroom
Bed Size (type of bed)?
none
King
Queen
Full
Twin
Bunk Bed
Daybed with trundle
Daybed without trundle
Futon
Crib
Childs bed
Head board (type of Headboard or footboard?
None
Headboard only
Headboard and Footboard
4 post with bed Frame
1 Piece shelf headboard
shelf and water bed
3 piece cabinet headboard
mats only - no frame
Dresser? (low and long, or Tall and high?)
None
Double
Double with mirror
Triple
Triple with mirror
Chest, Armoire, Highboy?
None
Chest
Armoire
Highboy
Chest with mirror
Night Stand(s)
None
1
2
Desk?
None
Small Computer desk
Small desk with hutch
3 Piece desk
Roll top desk
Secretary Desk
File Cabinet?
None
2 Drawer
3 Drawer
4 Drawer
Lateral
List other (Chairs, Desk Chairs, TV Stand, treadmill,
bookshelf, portable drawer stand, etc.)
4th Bedroom
5th Bedroom
Living Room
Couch?
None
Regular
Hide-a-bed
Reclining
2 Piece sectional
3 Piece sectional
4 Piece sectional
Futon
Love Seat?
None
Regular
Reclining
Already Listed with couch/ sectional
Single Lazy Chair?
None
straight back
reclining
motorized
swivel
rocker
Single Lazy Chair?
None
straight back
reclining
motorized
swivel
rocker
Coffee Table?
None
single piece
includes glass or marble
Number of end tables?
none
1
2
3
4
Entertainment Center?
none
TV stand
small entertainment center
large entertainment center
3 piece entertainment center
TV?
None
20 inch TV
30 inch TV
35 inch TV
console TV
Large Screen Projection TV
Large thin screen TV
List other (desk, chair, treadmill, book shelf, curio
cabinet, sewing table, etc.)
Dining Room
Dining Table?
none
4 chairs
6 chairs
8 chairs
4 seater glass
6 seater glass
Number of Leaves?
none
1
2
3
4
China Cabinet?
none
1 piece
2 piece
List other (buffet, server table, tea cart, curio, etc.)
Kitchen
Dining Table?
none
4 chairs
6 chairs
8 chairs
4 seater glass
6 seater glass
Reftigerator?
none
freezer on top
side-by-side
fridge door removal needed
Size of kitchen?
3-5 cabinets
6-8 cabinets
9-12 cabinets
9-15 cabinets with island
List other (microwave, microwave stand, baker's rack, bar
stools, stove, dishwasher, etc.
Family Room or Sun Room
Couch?
none
regular
hide-a-bed
reclining
3 piece sectional
4 piece sectional
futon
wicker
Love Seat?
None
Regular
Reclining
Already Listed with couch/ sectional
wicker
Single Lazy Chair?
None
straight back
reclining
motorized
swivel
rocker
Single Lazy Chair?
None
straight back
reclining
motorized
swivel
rocker
Coffee Table?
None
single piece
includes glass or marble
Number of end tables?
none
1
2
3
4
Entertainment Center?
none
TV stand
small entertainment center
large entertainment center
3 piece entertainment center
TV?
None
20 inch TV
30 inch TV
35 inch TV
console TV
Large Screen Projection TV
Large thin screen TV
List other (desk, chair, treadmill, book shelf, curio
cabinet, sewing table, etc.)
Extra Room (including Attic Storage)
List other (Den furniture, sewing room, hobby room, work
shop, room over garage, etc.)
Basement and/or Laundry Room
Walk out?
no
yes
Washer?
none
top loading washer
front loading washer
stackable
Dryer?
none
gas
electric
Freezer?
None
upright
small chest
large chest
chest needing lid removal
Exercise Equipment?
none
treadmill folding
treadmill rigid
ski thing
1 piece strength
2 piece strength
3 piece
Exercise Equipment?
none
treadmill folding
treadmill rigid
ski thing
1 piece strength
2 piece strength
3 piece
Pool Table?
None
one Piece top
3 piece regular slate
3 piece heavy slate
Other Game Table?
none
air hockey
foosball
pinball
ping-pong
other
Other Game Table?
none
air hockey
foosball
pinball
ping-pong
other
Click any of the following that apply.
Gun Safe?
Gun Cabinet?
3rd Living Room?
Work Shop?
Building Box Storage Room?
Furniture storage?
Toy Room?
Bar Room?
Extra
Bedrooms?
Storage Room?
Christmas/Holiday Items?
List any other items below that are not shown here.
Garage
Are the walls lined with permanent storage shelves?
Removable/Out? Yes
No
Ladder?
None
1 Ladder
2 Ladders
Lawn Mower?
none
push
rider
push and rider
Snow Blower, etc?
none
snow blower
other snow machine
Number of Cabinets?
None
1
2
3
4
5
Work Bench?
none
4 feet
6 feet
8 feet
5 feet
Large Tool Box?
none
1 piece
2 piece
Freezer/Fridge?
None
Chest Freezer
Up right
Refrigerator
Number of Bicycles?
None
1
2
3
4
5
Number of large kid toys?
None
1
2
3
4
5
Number of Stored 2 man furniture pieces?
None
1
2
3
4
5
6
7
8
9
10
Number of Stored 1 man furniture pieces?
None
1
2
3
4
5
6
7
8
9
10
List other (Number of small yard tools, misc. items, etc.)
Out Door Furniture (Front and back)
Grill?
None
small
medium
large
Outdoor table?
None
Umbrella Table for 4
Umbrella table for 6
Table for 4
Table for 6
Picnic table
Outdoor other Furniture?
None
Lounge chair
2 Lounge chairs
3 lounge chairs
3 piece set
4 piece set
Swing Set?
None
small
large
Swing Chair/slider chair?
None
front porch
back porch
Basketball Hoop?
None
Water Base (empty base required)
sand base (emptly base required)
(Empty Base Required)
Number of Large flower pots?
None
1
2
3
4
5
6
7
List other outdoor items. (Water fountain, tool-shed items,
storage boxes, water hoses, benches, large kid toys,
playground sets, etc.
List all other items not found on this form.
Boxes needed (for packing)
Small Boxes (18" by 12.5" by 12.5")
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Medium Boxes (18" by 18" by 16")
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Large Boxes (24" by 18" by 18")
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Packing Tape?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Packing Paper?(10 lbs. of clean sheet paper)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Wardrobes (2 feet wide, 4 feet tall)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Picture boxes (large - 4 feet)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Picture boxes (medium - 3 feet)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Dish Pack Boxes?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Rope
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
50 Foot plastic runners. (protect your floors)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Delivered?
Yes
No