M O V E R S  •  S T O R E R S  •  S H I P P E R S

Name of customer




Correspondence and contact details if different than customer




Collection date

(enter approximate date if not known)

Collection address




(please include basement and attic rooms accessed by staircase)

Is access to the address suitable for a large 18m vehicle?



Do you need us to check this for you?

(metres from the back of the removal van to your front door or access door)

(please enter the number of outside steps if you have any)

( gravel or unmade path / steep slope / slippery surface etc.)

Second collection address?

Delivery address





(please include basement and attic rooms accessed by staircase)

Is the access to the address suitable for a large 18m vehicle?

Do you need us to check this for you?

(metres from the back of the removal van to your front door or access door)

(please enter the number of outside steps if you have any)

(please describe any other obstacles)

Second delivery address?

Packing & Storage

Do you need container storage?

Do you need self storage?

Do you want us to pack fragile items?

(china, glass, ornaments, small pictures, mirrors, lamps, other small fragile items)

Do you want us to pack non-fragile items?

(books, pots & pans, food stuffs, clothing, toys, other small non-fragile items)

Do you want us to pack non-fragile items in the garage and/or shed?

Do you want us to bubble pack paintings, pictures and mirrors?

Do you want us to crate paintings/pictures and mirrors?

Do you have any individual paintings/pictures and mirrors with a value above £1,000 for specialist wrapping/crating?

Do you have any individual items (furniture/sculpture) with a value above £1,000 for specialist wrapping/crating?

Mattress bags required



Are there any items to move that require more than 2 men?

Are there any items to move that require dismantling and re-assembling?

Do you require items to be brought down from an attic/loft?

We can bring items down from the loft/attic as long as there is a loft ladder (not a step/portable ladder) and that the attic/loft is boarded.

True total value of the consignment for insurance purposes

Additional notes and proceed