About you
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| Surname: |
Telephone:
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| e-mail: |
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Current Address:
Line1
Line2
Line3
Line4
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New Address:
Line1
Line2
Line3
Line4
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| House Bungalow Flat |
House Bungalow Flat |
| If property is a flat, please indicate the floor no. : |
If property is a flat, please indicate floor no. : |
| Distance from the van to the front door: |
Distance from the van to the front door: |
| (feet) |
(feet) |
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Do you wish us to pack your glassware, china, books, etc.? Yes No
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| Estimated date of your move: |
| Will you require storage?: YES NO |
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Account type: PERSONAL COMPANY OTHER
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and all major cards.
