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Estimated move date: Jan Feb March Apr May June July Aug Sep Oct Nov Dec 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 2007 2008 2009 2010 2011 2012 Moving From:     Moving To: Address: Address: City : City : State: State: Zip: Zip: Size of residence: House Apartment # of Bedrooms # of Rooms Flights of Stairs Major Appliances Square Feet Size of residence: House Apartment # of Bedrooms # of Rooms Flights of Stairs Square Feet         Will Temporary Storage be needed? Yes No Will destination residence be ready by time of move? Yes No Do you need mover to pack? Yes No Do you need packing supplies? Yes No Do you need load/unload assistance? Yes No Do you need onsite moving? Yes No Do you have any items that need to be crated? Yes No   Piano Moving   Piano Type Quantity Grand -------------------------------- Baby Grand (under 6 ft) Grand (6 ft) Grand (7 ft) Grand (9 ft) Upright ---------------------- Studio Upright Full Upright Console (42") Spinet (38") Player Piano Organ -------------------------- Smaller Organ Full Pedal Organ

Living Room/Family Room Quantity Arm Chair Sofa Love Seat Rocking Chair Lamp Rugs Stereo Coffee Table End Table Big Screen TV TV-under 40" Stand Futon E. Center Ottoman Family Room Grandfather Clock Pictures     Office Quantity Desk File Cabinet Fan Book Case Computer Exercise Equipment Trunk Chair Safe     Boxes Quantity Small Medium Large X-Large Wardrobe Picture       Dining Room Quantity China Cabinet Buffet Chair Table Hutch Glass Shelves Glass Table Top     Garage/Storage Quantity Grill Workbench Toolchest Lawnmower Snow Blower Shelving Units Bicycles Lawn Tool Picnic Table     Kitchen Quantity Refrigerator Freezer Dryer Washer Table Chairs Cabinet Vacuum Microwave A/C Glass Table Top Microwave Cart     Bedroom Quantity Double Bed Queen Bed King Bed Single Bed Bureau Chest Dresser Night Table Armoire Mirror     Comments