Your Info

Title* :
 Mr  Mrs
Surname* :
First Name* :
Phone* :
Company :
Email* :

Removal Information

Planned Moving Date :

Place of Loading

Street Name* :
Street No. :
Zip Code* :
City :
Room :
Living Space (m2) :
Floor :
Building :
Persons :
Elevator in the house usable :
 Yes  No
Setting up prohibition zone ?
 Yes  No  Perhaps
Basement ?
 Yes  No
Attic ?
 Yes  No
Distance between the truck parking lot and front door approx. [M] :

Unloading point

Street Name* :
Street No. :
Zip Code*
City :
Room :
Living Space (m2) :
Floor :
Building :
Persons :
Elevator in the house usable :
 Yes  No
Setting up prohibition zone ?
 Yes  No  Perhaps
Basement ?
 Yes  No
Attic ?
 Yes  No
Distance between the truck parking lot and front door approx. [M] :

My Remarks

Kindly describe and help us to know about your planned relocation process :
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