Please complete parts 1 and 2
PART 1 of 2
PERSONAL / REMOVAL DETAILS
Name:
Home Tel:
Email:
Work/Mobile:
Removal Date:
January
February
March
April
May
June
July
August
September
October
November
December
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
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Value of Insurance Cover required:
PROPERTY DETAILS
Removals From
Removals To
House No/Name:
House No/Name:
Street:
Street:
Town:
Town:
Country:
Country:
Postcode:
-
Postcode:
-
Is full packing service required?
Yes
No
If not known, estimated miles:
1 - 60 miles
60 - 100 miles
100 - 150 miles
150 - 200 miles
200 - 250 miles
250+ miles
House Type:
House
Purpose Built Flat
Maisonette
House Type:
House
Purpose Built Flat
Maisonette
Bedrooms:
1
2
3
4
5 or more
Bedrooms:
1
2
3
4
5 or more
Receptions:
1
2
3 or more
Receptions:
1
2
3 or more
Collection/Delivery Floor:
Ground
1
st
2
nd
3
rd
or above
Collection/Delivery Floor:
Ground
1
st
2
nd
3
rd
or above
Is there a lift:
Yes
No
Is there a lift:
Yes
No
Parking:
Outside Property
Yellow Line(s)
Red Route
Car Park
Parking:
Outside Property
Yellow Line(s)
Red Route
Car Park
Parking distance from door?:
Parking distance from door?:
Removal Access through windows:
Yes
No
Removal Access through windows:
Yes
No
