General Information First Name:  * required Last Name:  * required Home Phone:  * required Cell Phone: Requested Date: Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 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 28 29 30 31 Year 2007 2008 2009 2010 2011 2012 2013 Email Address:  * required Type of Home: House Apartment Condominium Sq Footage of Home: Less than 1500 1501 - 3000 3000 - 4500 Greater than 4500 What floor are you living on, if the home is a condominium or apartment? (ground is the first floor) How would you prefer to be contacted with your estimate? Phone Email Schedule Appointment Other Origin and Destination Information Origin Information: Address:   City:  * required State: AL AZ CA CO CT DE DC FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY   Zip Code:  * required Second Stop Address:   Second Stop State: NA AL AZ CA CO CT DE DC FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY # of Steps to Front Door:   Elevator: No Yes Destination Information: Address:   City:  * required State: AL AZ CA CO CT DE DC FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY   Zip Code:  * required Second Stop Address:   Second Stop State: NA AL AZ CA CO CT DE DC FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY # of Steps to Front Door:   Elevator: No Yes Living Room Item CF Quantity Item CF Quantity Item CF Quantity Bar, portable 15 Fireplace Equipment 5 Sofa, 2 cushions 35 Piano 70 None Grand Spinet Baby Grand Bookcase 20 Sofa 3 cushions: 50 Clock (Grandfather or Grandmother) 20 Arm Chair 10 Sofa Sectional, per section 30 Chair, Overstuffed 25 Desk 22 Hideabed 50 Television (table, console) 20 Entertainment Center 40 Tables, end, coffee 5 Dining Room: Item CF Quantity Item CF Quantity Item CF Quantity Table, dining 30 Chair, dining 5 Buffet 30 Cabinet, china 25 Cabinet, corner 20 Server 15 Bench 10 Carpet, rolled 10 Tea cart 10 Bed Rooms Item CF Quantity Item CF Quantity Item CF Quantity King Bed 70 Bureau, Dresser, Chest of Drawers 25 Triple Dresser 60 Queen Bed 60 Cedar Chest 15 Double Dresser 50 Double Bed 50 Chair, Boudoir 10 Night Stand 5 Twin Bed 40 Chair, Rocker 6 Vanity 20 Kitchen Item CF Quantity Item CF Quantity Item CF Quantity Refridgerator 60 Table 10 Hutch 18 Dish Washer 20 Chairs 5 2pc Hutch 25 Bench Seat 25 Microwave 10 Microwave Stand 10 Garage & Miscellanous Item CF Quantity Item CF Quantity Item CF Quantity Tablesaw 70 Lg Shop Tools 25 Bicycle 25 Lawnmower 50 Barbeque 15 Mower Attachments 18 Riding Mower 60 Washer 25 Dryer 25 Comments or Concerns Items not listed above that are large, articles of concern, or general comments please add them in the comments field below. (i.e. Automobiles, Motorcycles, ATVs, Hot Tubs etc.)