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Please print this form and fax it to our office.

P.O. Box 86699 North Vancouver BC V7L 4L2 Call 604-618-9675 prior to faxing

(   ) Request for Written Estimate     (    ) Inventory for Booked Order Only #___________________
Today's Date: _______________             Approximate Moving Date: _________________________
How did you FIRST hear about us:____________________________________________________
Your Name:______________________________ E-Mail Address:___________________________
Mailing Address:__________________________________________________________________
Home Phone (       )______________Work Phone (       )______________ FAX (       )______________

Moving From (Choose One):               City:_________________________
( ) House
( ) Townhouse
( ) Walk-Up Apartment/Condo    Floor_________
      #/feet from where we can park the truck to the unit's door_______________
( ) Elevator Apartment
      #/feet from where we can park the truck to the loading dock____________________
      #/feet from the elevator door to the unit's door______________________________
( ) Storage/Warehouse                 Floor_________
      If ground floor, #/feet from where we can park the truck to the unit's door__________
      If elevator unit, #/feet from where we can park the truck to the loading dock________
      #/feet from the elevator door to the unit's door______________________________

Moving To (Choose One):                 City:_________________________
( ) House
( ) Townhouse
( ) Walk-Up Apartment/Condo     Floor_________
      #/feet from where we can park the truck to the unit's door_______________________
( ) Elevator Apartment
      #/feet from where we can park the truck to the loading dock_____________________
      #/feet from the elevator door to the unit's door_______________________________
( ) Storage/Warehouse                  Floor_________
      If ground floor, #/feet from where we can park the truck to the unit's door___________
      If elevator unit, #/feet from where we can park the truck to the loading dock_________
      #/feet from the elevator door to the unit's door_______________________________

Household Goods Descriptive Inventory
Instructions: Please enter the number of each type of item within each room.
If an item is not listed, it can be entered on a blank line.

Living Room
____ Bookcase, Small	____ Fireplace Equipment	____ Table, Coffee
____ Bookcase, Large	____ Footstool	____ Table, End
____ Cabinet, Curio	____ Hall Tree	____ TV <19"
____ Chair, Straight	____ Lamp, Table	____ TV >19"
____ Chair, Arm	____ Lamp, Floor	____ TV, Big Screen
____ Chair, Rocker	____ Magazine Rack	____ Wicker Item, Small.
____ Chair, Occasional	____ Music Cabinet	____ Wicker Item, Large
____ Chair, Overstuffed	____ Rug, Small	____ Art Glass, Small
____ Chest, Small	____ Rug, Large	____ Art Glass, Large
____ Chest, Large	____ Sofa, Loveseat	____ Misc. Item, Small
____ Clock, Grandfather	____ Sofa, 3 Cushion	____ Misc. Item, Large
____ Day Bed	____ Sofa, 4 Cushion / Sleeper	____ Carton, Small
____ Desk, Small	____ Stereo / VCR Component	____ Carton, Large
____ Desk, Large	____ Table, Drop Leaf / Occasional	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Dining Room
____ Bench, Harvest	____ Art / Glass, Small	____ Rug, Small
____ Buffet, Base	____ Art / Glass, Large	____ Rug, Large
____ Cabinet, China Hutch, Top	____ Misc. Item, Small	____ Wicker Item, Small
____ Cabinet, China/One Piece	____ Misc. Item, Large	____Wicker Item, Large
____ Cabinet, Curio	____ Carton, Small	____ ______________________
____ Cabinet, Corner	____ Carton, Large	____ ______________________
____ Dining Table	____ Server	____ ______________________
____ Dining Chair	____ Tea Cart	____ ______________________

Master Bedroom
____ Bed, Single	____ Chest, Bachelor / Lingerie	____ Table, Coffee
____ Bed, Double / Full	____ Chest, Cedar	____ Table, End
____ Bed, Queen	____ Chest	____ TV < 19"
____ Bed, King	____ Desk, Small	____ TV > 19"
____ Bed, Waterbed	____ Desk, Large	____ TV, Big Screen
____ Bed, Bunk	____ Dresser, Vanity	____ Wicker Item, Small
____ Bed Frame Only	____ Dresser, Single	____ Wicker Item, Large
____ Bedwall, Queen	____ Dresser, Double	____ Art/Glass, Small
____ Bedwall, King	____ Dresser, Triple	____ Art/Glass, Large
____ Bookcase, Small	____ Night Stand	____ Misc. Item, Small
____ Bookcase, Large	____ Rug, Small	____ Misc. Item, Large
____ Chair, Small	____ Rug, Large	____ Carton, Small
____ Chair, Large	____ Wardrobe / Armoire, Small	____ Carton, Large
____ Chair, Rocker	____ Wardrobe / Armoire, Large	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Bedroom
____ Bed, Single	____ Chest, Bachelor/Lingerie	____ Table, Coffee
____ Bed, Double/Full	____ Chest, Cedar	____ Table, End
____ Bed, Queen	____ Chest	____ TV < 19"
____ Bed, King	____ Desk, Small	____ TV > 19"
____ Bed, Waterbed	____ Desk, Large	____ TV, Big Screen
____ Bed, Bunk	____ Dresser, Vanity	____ Wicker Item, Small
____ Bed Frame Only	____ Dresser, Single	____ Wicker Item, Large
____ Bedwall, Queen	____ Dresser, Double	____ Art/Glass, Small
____ Bedwall, King	____ Dresser, Triple	____ Art/Glass, Large
____ Bookcase, Small	____ Night Stand	____ Misc. Item, Small
____ Bookcase, Large	____ Rug, Small	____ Misc. Item, Large
____ Chair, Small	____ Rug, Large	____ Carton, Small
____ Chair, Large	____ Wardrobe/Armoire, Small	____ Carton, Large
____ Chair, Rocker	____ Wardrobe/Armoire, Large	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Bedroom
____ Bed, Single	____ Chest, Bachelor/Lingerie	____ Table, Coffee
____ Bed, Double/Full	____ Chest, Cedar	____ Table, End
____ Bed, Queen	____ Chest	____ TV < 19"
____ Bed, King	____ Desk, Small	____ TV > 19"
____ Bed, Waterbed	____ Desk, Large	____ TV, Big Screen
____ Bed, Bunk	____ Dresser, Vanity	____ Wicker Item, Small
____ Bed Frame Only	____ Dresser, Single	____ Wicker Item, Large
____ Bedwall, Queen	____ Dresser, Double	____ Art / Glass, Small
____ Bedwall, King	____ Dresser, Triple	____ Art / Glass, Large
____ Bookcase, Small	____ Night Stand	____ Misc. Item, Small
____ Bookcase, Large	____ Rug, Small	____ Misc. Item, Large
____ Chair, Small	____ Rug, Large	____ Carton, Small
____ Chair, Large	____ Wardrobe / Armoire, Small	____ Carton, Large
____ Chair, Rocker	____ Wardrobe / Armoire, Large	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Kitchen
____ Baker's Rack	____ Art / Glass, Small	____ Table
____ Chair	____ Art / Glass, Large	____ TV < 19"
____ Chair, High	____ Misc. Item, Small	____ TV > 19"
____ Ironing Board	____ Misc. Item, Large	____ Wicker Item, Small
____ Kitchen Cabinet	____ Carton, Small	____ Wicker Item, Large
____ Microwave Oven	____ Carton, Large	____ Stool
____ Serving Cart	____ Carton, Dish Pack	____ ______________________

Office/Den
____ Bookcase, Small	____ Desk, Small	____ Wicker Item, Small
____ Bookcase, Large	____ Desk, Large	____ Wicker Item, Large
____ Chair, Small	____ Electronic Component, Misc.	____ Misc. Item, Small
____ Chair, Large	____ File, 2 Drawer	____ Misc. Item, Large
____ Computer, Monitor	____ File, 4 Drawer	____ Art / Glass, Small
____ Computer, Printer/Processor	____ Table, Small	____ Art / Glass, Large
____ Copier, Table-Top	____ Table, Large	____ Carton, Small
____ Copier, Floor	____ Table, Typewriter	____ Carton, Large
____ Credenza	____ Wastepaper Basket	____ ____________________
____ ______________________	____ ______________________	_________________________

Nursery
____ Bassinette	____ Table, Child's	____ Table, Child's
____ Bed, Youth	____ Table	____ Table
____ Chair, Child's	____ Wicker Item, Small	____ Wicker Item, Small
____ Chair, High	____ Wicker Item, Large	____ Wicker Item, Large
____ Chair, Rocker	____ Art/Glass, Small	____ Art/Glass, Small
____ Chest, Small	____ Art/Glass, Large	____ Art/Glass, Large
____ Chest, Large	____ Misc. Item, Small	____ Misc. Item, Small
____ Chest, Toy	____ Misc. Item, Large	____ Misc. Item, Large
____ Crib, Baby	____ Carton, Small	____ Carton, Small
____ Dresser, Small	____ Carton, Large	____ Carton, Large
____ Dresser, Large	____ Carton, Wardrobe	____ Carton, Wardrobe
____ Playpen	____ Rug, Small	____ Rug, Large
____ ______________________	____ ______________________	____ ______________________

Family Room
____ Bookcase, Small	____ Fireplace Equipment	____ Table, Coffee
____ Bookcase, Large	____ Footstool	____ Table, End
____ Cabinet, Curio	____ Hall Tree	____ TV, <19"
____ Chair, Straight	____ Lamp, Table	____ TV, >19"
____ Chair, Arm	____ Lamp, Floor	____ TV, Big Screen
____ Chair, Rocker	____ Magazine Rack	____ Wicker Item, Small.
____ Chair, Occasional	____ Music Cabinet	____ Wicker Item, Large
____ Chair, Overstuffed	____ Rug, Small	____ Art Glass, Small
____ Chest, Small	____ Rug, Large	____ Art Glass, Large
____ Chest, Large	____ Sofa, Loveseat	____ Misc. Item, Small
____ Clock, Grandfather	____ Sofa, 3 Cushion	____ Misc. Item, Large
____ Day Bed	____ Sofa, 4Cushion/Sleeper	____ Carton, Small
____ Desk, Small	____ Stereo/VCR Component	____ Carton, Large
____ Desk, Large	____ Table, Drop Leaf / Occasional	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Basement
____ Bookcase, Small	____ Fireplace Equipment	____ Table, Coffee
____ Bookcase, Large	____ Footstool	____ Table, End
____ Cabinet, Curio	____ Hall Tree	____ TV <19"
____ Chair, Straight	____ Lamp, Table	____ TV >19"
____ Chair, Arm	____ Lamp, Floor	____ TV, Big Screen
____ Chair, Rocker	____ Magazine Rack	____ Wicker Item, Small.
____ Chair, Occasional	____ Music Cabinet	____ Wicker Item, Large
____ Chair, Overstuffed	____ Rug, Small	____ Art Glass, Small
____ Chest, Small	____ Rug, Large	____ Art Glass, Large
____ Chest, Large	____ Sofa, Loveseat	____ Misc. Item, Small
____ Clock, Grandfather	____ Sofa, 3 Cushion	____ Misc. Item, Large
____ Day Bed	____ Sofa, 4Cushion/Sleeper	____ Carton, Small
____ Desk, Small	____ Stereo/VCR Component	____ Carton, Large
____ Desk, Large	____ Table, Drop Leaf / Occasional	____ Carton, Wardrobe
____ ______________________	____ ______________________	____ ______________________

Misc. Inside Items
____ Barbells	____ Fern / Plant Stand	____ Ping Pong Table
____ Basket, Clothes	____ Foot Locker	____ Pool Table
____ Bicycle/Tricycle	____ Game Table	____ Pool Table, Slate
____ Bowling Ball/Bag	____ Heater, Gas/Electric	____ Table, Utility
____ Card Table	____ Sewing Machine, Portable	____ Tablesaw
____ Chair	____ Sewing Machine, Console	____ Tool Chest, Small
____ Chair, Folding	____ Sewing Machine, Cabinet	____ Tool Chest, Medium
____ Clothes Hamper	____ Suitcase	____ Tool Chest, Large
____ Cot, Folding	____ Wastepaper Basket	____ ______________________
____ Fan	____ Workbench, Small	____ ______________________

Misc. Outside Items
____ BBQ Grill, Small	____ Outside Child Slide	____ Tackle Box
____ BBQ Grill, Large	____ Outside Child, Gym	____ Tire
____ Chair, Aluminum	____ Outside Child, Swings	____ Trash Can
____ Chair, Metal	____ Outdoor Drying Racks	____ Wagon, Child's
____ Chair, Wood	____ Picnic Table	____ Workbench
____ Garden Hose/Tools	____ Picnic Bench	____ Wicker Item, Small
____ Glider/Settee	____ Roller, Lawn	____ Wicker Item, Large
____ Ladder 6'	____ Rug, Small	____ Art/Glass, Small
____ Ladder 8'	____ Rug, Large	____ Art/Glass, Large
____ Ladder/Extension	____ Sand Box	____ Misc. Item, Small
____ Lawnmower, Push	____ Sled	____ Misc. Item, Large
____ Lawnmower, Power	____ Spreader	____ Carton, Small
____ Lawnmower, Rider	____ Table, Small	____ Carton, Large
____ Leaf Sweeper	____ Table, Large	____ Ornamental Statue

Bulky Articles/Appliances
Appliances	Pianos/Organs	Miscellaneous
____ Air Conditioner, Small	____ Spinet Piano < 38"	____ ______________________
____ Air Conditioner, Large	____ Console Piano 38" to 46"	____ ______________________
____ Dehumidifier	____ Studio Upright Piano 46" to 54"	____ ______________________
____ Dishwasher	____ Upright Piano > 54"	____ ______________________
____ Freezer, Chest	____ Upright Grand Piano	____ ______________________
____ Freezer, Upright	____ Upright Player Piano	____ ______________________
____ Range	____ Upright Player Grand Piano	____ ______________________
____ Refrigerator, Upright	____ Baby Grand Piano < 6'	____ ______________________
____ Refrigerator, Side By Side	____ Grand Piano > 7'	____ ______________________
____ Trash Compactor	____ Spinet Organ	____ ______________________
____ Washing Machine	____ Console Organ	____ ______________________
____ Dryer	____ Grand Organ	____ ______________________

Remarks / Other Locations:________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Total Number of Rooms:	_________
Total Number of Pieces:	_________
Total Number of Cartons:	_________