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Full Name:
Phone:
Address From:		Address To:
Zip:		Zip:
Extra Pickup At:		Extra Pickup At:
House Rooms:		House Rooms:
Service Entr:		Service Entr:
Apt:		Apt:
Flights:		Flights:
Long Carry:		Long Carry:
Elevator:		Elevator:
Front Stoop:		Front Stoop:
Type:		Type:
Piano Type:		Marble Size:
Hoisting:		Coffee Table:
Crane Job:		Chest of Drawers:
Living Room:		Other:
Bedroom (s):		Wall Unit:
Dining Room/Kitchen:		Vanity:
Sofa Bed:		Computer:
Bed Type:		T V:
Chairs:		Armoire:
Couch over 7:		Desk:
Love Seat:		Stereo:
Breakfront:		Mirror:
Overstuffed Chairs:		Secretary:
Night Tables:		Appliances:
Sideboard:		Basement Storage:
End Tables:		Hutch:
Dresser:		Washer:
Garage Shed:		Furniture:
Rugs:		Bookcases:
Boxes:		Dryer:
Plants:		Pictures:
PBO:		Refrigerator:
Bikes:		Other:
Lamps:		Paintings:
Wardrobes:
File Cabinets:
Special Remarks: