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Name *

Mobile Number *

Move-out Address *

Move-in Address *

Move Date

Items that need to be moved (Select what applies) *

BOXES
TABLES/DESKS
COUCH/SOFA
CABINET/DRESSER
CHAIRS
TELEVISION SET
BED/MATTRESS
BAGS AND SUITCASES
KITCHEN EQUIPMENT
DELICATE EQUIPMENT
VENDING MACHINE
HOSPITAL EQUIPMENT
MUSICAL INSTRUMENT
WASHING MACHINE
FREEZER
PLANTS
OTHER

Additional Information (optional)

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