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Person Details
First Name*
Last Name
E-mail*
Contact Number*
Moving Destintion
Moving From *
Address
City
State
House
---Select one---
Flat
Private House
Other
Apt. Size
---Select one---
One Bed Room
Two Bed Room
Three Bed Room
Pent House
Bigger
Floor
Moving to *
Address
City
State
House
---Select one---
Flat
Private House
Other
Apt. Size
---Select one---
One Bed Room
Two Bed Room
Three Bed Room
Pent House
Bigger
Floor
Estimate Moving
Date
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
27
28
29
30
31
Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
Year
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Enter the no. of articles (If zero leave t he box blank)
Bed Rooms
---Select one---
One
Two
Childrens Room
Double Bed
Music System
Side Table
T.V
Single Bed
Almirah
T.V Trolly
Photo Frames
Dressing Table
Mattress
Chairs
Chest of Drawrs
DRAWING ROOM
Sofa Set
Select
5 Seater
7 Seater
10 Seater
Bigger
Center Table
Piano
Dining Table
Select
4 Seater
6 Seater
Bigger
Antique
Carpets
Crockery Almirah
Photo Frames
Diwan
KITCHEN
Fridge
Select
165 Lt
280 Lt
Bigger
Utensils
Wet Grinder
Mixer/Grinder
Cooking Range
Gas Stove
Utensil Stand
Coffee Maker
Crockery
Water Purifier
Micro Wave
Dish Washer
MISCELLANEOUS
Washing Mach.
Select
Semi Automatic
Full Automatic
Air Conditioner
Books
Jhoola
Toys
Computer Table
Writing Table
Temple
Computer
Flower Pots
Clothes
Steel Drums
Cabinet
Stablizer
Gyser
Coolers
Cycle
Sethi
Wall Unit
Vaccume Cleaner
Shoe Rack
Approx. Value (In rupees)*
Rs.
.00
Any Other Items not mentioned above