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Customer Information
Name*
First Last
Phone*
Email*
Preferred Date of Collection*
Date Format: MM slash DD slash YYYY
Preferred Date of Delivery*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Upstairs Hallway
Sofa (Size)
NR
Dismantle
Cabinet (Size)
NR
Dismantle
Table (Size)
NR
Dismantle
Boxes (Size)
NR
Dismantle
Pictures (Size)
NR
Dismantle
Other (Size)
NR
Dismantle

Attic
Boxes (Size)
NR
Dismantle
Luggage's (Size)
NR
Dismantle
Other (Size)
NR
Dismantle

Garage
Bikes (Size)
NR
Dismantle
Tools (Size)
NR
Dismantle
Boxes (Size)
NR
Dismantle
Other (Size)
NR
Dismantle

Shed
Garden Tools (Size)
NR
Dismantle
Lawn-Mover (Size)
NR
Dismantle
Bikes (Size)
NR
Dismantle
Boxes (Size)
NR
Dismantle
Other (Size)
NR
Dismantle

Living Room/ Lounge
3 Seater Sofa (NR) Dismantle 2 Seater Sofa (NR) Dismantle Large Sofa (NR) Dismantle
Corner Sofa (NR) Dismantle Armchair (NR) Dismantle Footstool (NR) Dismantle
Coffee Table (NR) Dismantle Nest of Tables (NR) Dismantle TV Stand (NR) Dismantle
TV (NR) Dismantle Bookshelf (NR) Dismantle Pictures (NR) Dismantle
Mirrors (NR) Dismantle Rug (NR) Dismantle Boxes (NR) Dismantle

Dining Room
Dinning Table (NR) Dismantle Chairs (NR) Dismantle Sideboard (NR) Dismantle
Mirrors (NR) Dismantle Boxes (NR) Dismantle Other (NR) Dismantle
Hallway
Shoerack/Cabinet (NR) Dismantle Coatstand (NR) Dismantle Pictures (NR) Dismantle

Kitchen
Fridge Freezer (NR) Dismantle American Fridge (NR) Dismantle Washing Machine (NR) Dismantle
Tumble Dryer(NR) Dismantle Dishwasher (NR) Dismantle Microwave (NR) Dismantle
Boxes (NR) Dismantle Other (NR) Dismantle

Conservatory
3 Seater Sofa (NR) Dismantle 2 Seater Sofa (NR) Dismantle Armchair (NR) Dismantle
Cabinet (NR) Dismantle Coffee Table (NR) Dismantle Conservatory Furniture (NR) Dismantle
Boxes (NR) Dismantle Other (NR) Dismantle

Garden
Garden Furniture (NR) Dismantle Plants & Pots (NR) Dismantle Statues (NR) Dismantle
Slide (NR) Dismantle Swing (NR) Dismantle Playhouse (NR) Dismantle Other

Additional Notes
Special Requirements*