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Contact Information:

* Required fields
First name:	*
Last name:	*
E-Mail Address:	*
Day Time Phone:	* extension:
Evening Phone:	or
Cell Phone:

Best time to contact you:
Estimated move date:	*
Delivery date. After:
	(If storage required or destination not ready to receive goods on move date.)
How did you find our website?

Moving From:

Moving To:

Shipper's Name:
Address:
City :	*
State:	*
Zip Code:

Size of home: *
Elevator: Yes No
If walk up, enter # of Floors:

Consignee’s Name:
Address:
City :	*
State:	*
Zip Code:

Elevator: Yes No
If walk up, enter # of Floors:

Click here to submit short form.

Enter the quantity of each item in the section next to the item name.

Living Room Items

Chair (Recliner):
Chair (Straight):
Chair (Rocker):
Chair (Overstuffed):
Chair (Arm/Swivel):
Ottoman:
Chair (Occasional):
Footstool:
Bookshelves:
Sofa (Sectional): Sections:
Sofa (Love Seat):
Sofa (Hide-a-Bed - Queen):
Sofa (Hide-a-Bed)
Sofa (3 Cushion):
Sofa (4 Cushion)
Sofa (Rattan/Wicker):
Bar Stool:

Cabinet (Small):
Cabinet (Large)
Cabinet (Curio) :
Cabinet (Music) :
Entertainment Center:
Stereo Console:
Stereo Components:
Speakers:
VCR:
TV (Portable):
TV (Big Screen):
TV Stand:
TV (Console):
TV (Combination):
Coffee Table
Lamp Table:
Portable Bar:

Piano (Upright):
Organ:
Piano Bench:
Grandfather Clock:
Coat Rack:
Fireplace Equipment:
Magazine Rack
Rug or Pad (Small):
Rug or Pad (Large):
Floor Lamp:
Pole Lamp:
Table Lamp:
Benches:
Occasional Table:
End Table:
Desk:

Bedroom Items

Bed Frame:
Bed Headboard:
Bed (Single):
Bed (Queen):
Bed (Bunk):
Day Bed:
Chest of Drawers:
Chest (Armoire):
Dresser (Single):
Dresser (Triple):
Desk:

Night Table:
Bed Footboard:
Bed (Roll-a-way):
Bed (Double):
Bed (King):
Bed (Water):
Bookshelves/Sections:
Cedar Chest:
Dresser (Vanity):
Dresser (Double):
Futon:

Dining Room Items

Buffet (Base):
Cabinet (China):
Chair (Dining):
Dining Table:
Tea Cart:

Buffet (Top):
Cabinet (Corner):
Hutch:
Table Leaf:
Bench:

Children's Room Items

Baby Carriage:
Bed (Youth):
Chair (Child's):
Changing Table:
Chest:
Playpen:

Bassinet:
Car Seat:
Table (Child's):
Toy Chest:
Crib:
Stroller:

Kitchen Items

Baker's Rack:
Breakfast Table:
High Chair:
Freezer:
Kitchen Cabinet:
Microwave Oven:
Range (36"):
Refrigerator (6 ft3 or less):

Serving Cart:
Breakfast Chair:
Butcher Block:
Dishwasher:
Pie Saver:
Range (30"):
Trash Compactor:
Kitchen Table:
Stool:

Utility Room Items

Clothes Hamper:
Clothes Dryer Rack:
Dryer (Gas):
Ironing Board:
Utility Cabinet:

Basket:
Dryer (Electric):
Washing Machine:
Vacuum Cleaner:
Bookshelves:

Home Office Items

Bookcase:
Computer Desk:
Copier:
Office Desk:
Filing Cabinet:(2-3 drawer):
Lateral File (2 Drawer):

Computer:
Computer Printer:
Credenza:
Office Chair:
Filing Cabinet:(4 - 5 Drawer)
Lateral File (4 Drawer):
Table:

Outdoor Items

Chair (Plastic):
Chair (Wood):
Chaise Lounge:
Glider/Settee:
Garden Hose:
Leaf Sweeper:
Table (Outdoor):

Chair (Aluminum):
Chair (Metal):
Chair (Porch):
Outdoor Swings:
Bench:
Shelves
Picnic Table:
Canopy:

Sport Equipment Items

Bicycle:
Bowling Bag/Ball:
Golf Bag:
Home Gym:
Pool Table (Composite):
Rowing Machine:
Skis:
Weight Bench:
Tackle Box:
Basketball Goal:

Bicycle (Exercise):
Exercise Equipment:
Health Rider:
Ping Pong Table:
Pool Table (Slate-disassembled only):
Stair Climber:
Sled:
Weights:
Gun Cabinet:
Ice Chest:

Miscellaneous Items

Bird Cage:
Card Table:
Cooler:
De-Humidifier:
Fan:
Ladder (Step):
Power Tools:
Radio:
Sewing Machine (Portable):
Shelves (Metal):
Stand:
Table Saw:
Toolbox:
Trash Can:
Wagon:
Work Bench:

Cabinet Metal:
Folding Chair:
Cot Folding:
Dolly:
Footlocker:
Hammock:
Power Tool Stand:
Saw Horse:
Sewing Machine (Cabinet):
Shelves (Wooden):
Suitcase:
TV Tray Set (4):
Tool Chest:
Trunk:
Waste Basket:

Cartons

Dish Pack:
Book Box:
4.5 Cubic Foot:
6.5 Cubic Foot:
Wardrobe Carton:

1.5 Cubic Foot:
3 Cubic Foot:
6 Cubic Foot:
Lamp Shade Carton:
Mirror/Picture Carton:

Comments/Any other information

Email: a1movers@sbcglobal.net

	TXDOT # 000576655B
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