Name: E-mail address: Res. Phone: Bus. Phone: Fax: Best time to contact you: Moving From: Address: City: State: Zip: Moving To: Address: City: State: Zip: Approximate Move Date: total number of rooms (w/furniture) Check each room that has furniture: kitchen living room dining room den play room basement office patio shed garage attic Number of bedrooms Number of major appliances Number of flights of stairs