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First Name:
Last Name:
Home Phone (ie: ###-###-####):
Work Phone (ie: ###-###-####):
Fax (ie: ###-###-####):
Email:
Moving From  
Street:
City:
Zip:
Moving To  
Street:
City:
Zip:
Date of Move:
Size of Home You're Moving From (square feet):
How Many Bedrooms?
Will you do your own packing?
Truck access to front door home:
How many flights of stairs at old home?
Any other long carry?
Additional Comments:
Truck access to front door home:
How many flights of stairs at old home?
Any other long carry?
Additional Comments:
Will you need storage?
How did you hear about Copper Palm Moving?
INVENTORY FORM

LIVING AREAS
Sofa Loveseat Hide-a-bed
Sec Sofa-#Pcs Recliner Sofa Chaise Lounge
Lg Chairs Ottoman/Stool Coffee/Sofa Table
End Tables Bookcase Ent. Center
Wall Unit-#Pcs TV up to 32'' TV over 32''
TV Stand Big Screen/Plasma Audio Comp Pcs
Table Lamps Floor Lamps Statue/Pedestal
Pictures Wall Mirror Hall Tree
Grand Clock    

BEDROOM AREAS
King/Queen Bed Full/Twin Bed Bunk Bed Set
Trundle Bed Nightstands Triple Dresser
Chest Drawers Armoire Dressor Mirror
Cedar/Trunk Crib/Changing Table Ft of Clothes

OFFICE STUDY
Exec/Roll Desk Office Desk Sec/Student Desk
Desk Return Desk Hutch Credenza
Exec Chair Desk Chair Floor Mat
Drawer File Cabinet Drawer Lat File Lg Copier
Sm Copier Lg Conf Table Sm Conf Table
PC Components Printer Stand Storage Cabinet
Partition    

APPLIANCES
2 Door Fridge Fridge/Freezer Wine Fridge
Washer/Dryer Micro/Cart Vaccuum/Iron
Water Cooler    

DINING/BREAKFAST AREA
Dining Table Breakfast Table Patio Table
Table Chairs Bar Stools Buffet/Server
Curio/Etagere Bakers Rack China Cabinet-#Pcs
Bench    

MISCELLANEOUS
Area Rugs Wall Mirrors Lg Marble Top
Sm Marble Top Lg Glass Top Sm Glass Top
Glass Shelves 1-Man Box 2-Man Box
Wardrobe    

PATIO/GARAGE
BBQ/Grill Lg Grill/Smoker Lg Plants
Med Plants Chiminea Exercise Equip
Bicycles Ladder Folding Table
Workbench Metal Shelf Tool Chest
Wheelbarrow Mower/Edger Riding Mower
Garden Tools Cab Sew Mach
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