Please complete part 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	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:	-
		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 1st 2nd 3rd or above	Collection/Delivery Floor:	Ground 1st 2nd 3rd 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

Part 2