A Change of Place Movers

Household Inventory List/Estimate Form


A Change of Place Movers

Please Fax to: (804)-642-1404

Customer Name:__________________________________________________
Phone Numbers         Home:_________________________________________
                                       Cell:_________________________________________
                                     Work:_________________________________________

Date requested for move:___________________________________________

Current address:__________________________________________________
                            __________________________________________________

Please state if apartment, condo,  townhouse, and number of stories, or
  what floor you are on:_____________________________________________

New address:_____________________________________________________
                       _____________________________________________________

Please state if apartment, condo,  townhouse, and number of stories, or
  what floor you will be on:___________________________________________

_________________________________________________________________
Items to be moved:

Master Bedroom:                                        Dining Room/Kitchen:
          Size of bed:_______________                       Table:_____________________
 HeadBoard/Footboard:__________              Number of Chairs:________________
          Dresser:__________________                China Cabinet:__________________
 Chest of Drawers:_______________                    Single/two piece:_____________
                      TV:________________                 List other:_____________________
List other:______________________                    _____________________________
     ____________________________                    _____________________________
     ____________________________                    _____________________________


2nd Bedroom:                                                   Living Room/Family Room:
         Size of bed:_______________                       Sofa:_______________________
 HeadBoard/Footboard:__________              Number of Chairs:________________
          Dresser:__________________                             Sleeper:________________
 Chest of Drawers:______________                 Loveseats (total #):______________
                      TV:_______________             Enterainment Center:______________
List other:______________________              End Tables/Tables (total #):________
     ____________________________               List other:_______________________
     ____________________________                   ______________________________
     ____________________________                   ______________________________


3rd Bedroom:                                                Est. of # of Customer Packed Boxes:
         Size of bed:______________                       Small:______________________
 HeadBoard/Footboard:_________                     Medium:_____________________
          Dresser:_________________                       Large:______________________
 Chest of Drawers:______________                Wardrobe:______________________
                      TV:_______________            Picture Boxes:_____________________
List other:_____________________              Mirror Boxes:_____________________
     ___________________________               List other:________________________
     ___________________________                   _______________________________
     ___________________________                   _______________________________

Outside Items/Garage:                                 Piano:_______________
        Furniture (list):____________                     Size:______________
           _______________________
           _______________________
        Grill:_____________________
    Lawn Mower:_______________   Push/Riding:_____________
    List Other:____________________________________________
         ___________________________________________________
        ___________________________________________________

Anything Else (Please List):
     ________________________________________________________________
     ________________________________________________________________
    _________________________________________________________________
    _________________________________________________________________

 
Please Fax to: (804)-642-1404
A Change of Place Movers