Name:
*
Tel:
*
Fax:
e-mail:
*
Origin address:
*
Destination address:
*
Date of Removal:
date:
* (DD/MM/YYYY)
time:
am
pm
*
1
2
3
4
5
6
7
8
9
10
11
12 on>
hour *
Other information: (for example,
whether have lift service in origin & destination address or long
distance from loading area or to go through the platform etc, please
describe as detail as you can)
Porterage article: Quantity: Porterage article: Quantity:
Altar Table
0
1
2
3
4
5
6
7
8
9
10
11
12
Oven
0
1
2
3
4
5
6
7
8
9
10
11
12
Aquarium
0
1
2
3
4
5
6
7
8
9
10
11
12
Piano (upright)
0
1
2
3
4
5
6
7
8
9
10
11
12
Arm Chair
0
1
2
3
4
5
6
7
8
9
10
11
12
Picture
0
1
2
3
4
5
6
7
8
9
10
11
12
Baby Cot
0
1
2
3
4
5
6
7
8
9
10
11
12
Plant
0
1
2
3
4
5
6
7
8
9
10
11
12
Barbecue
0
1
2
3
4
5
6
7
8
9
10
11
12
Plastic Container with 3 drawer
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (bunk bed)
0
1
2
3
4
5
6
7
8
9
10
11
12
Plastic Container/ Box
0
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Bed (combination bed)
0
1
2
3
4
5
6
7
8
9
10
11
12
Printer
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (double size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Rack / Shelf
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (hydraulic, double size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Rack / Shelf(large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (king size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Safe
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (loft bed)
0
1
2
3
4
5
6
7
8
9
10
11
12
Screen
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (queen size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Shoes Cabinet
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (twin bed)
0
1
2
3
4
5
6
7
8
9
10
11
12
Shoes Cabinet (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Bed (single size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Side Table
0
1
2
3
4
5
6
7
8
9
10
11
12
Bike
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (5' length, made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Book Shelf
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (5' length , with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Book Shelf (with glass door)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (5' length, with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Carton Box
0
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Sideboard (below 5’, made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Chest of Drawer
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (below 5’, with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Coffee Table (glass top & standard size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (below 5’, with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Coffee Table (glass top & large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard ( 6-7’, made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Coffee Table (wooden & large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (6-7’, with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Coffee Table (wooden & standard size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sideboard (6-7’, with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Computer
0
1
2
3
4
5
6
7
8
9
10
11
12
Sofa (1 Seater)
0
1
2
3
4
5
6
7
8
9
10
11
12
Computer desk
0
1
2
3
4
5
6
7
8
9
10
11
12
Sofa (2 Seater)
0
1
2
3
4
5
6
7
8
9
10
11
12
Computer desk (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Sofa (3 Seater)
0
1
2
3
4
5
6
7
8
9
10
11
12
Copier
0
1
2
3
4
5
6
7
8
9
10
11
12
Sofa Bed
0
1
2
3
4
5
6
7
8
9
10
11
12
Corner Table (glass Top)
0
1
2
3
4
5
6
7
8
9
10
11
12
Speaker (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Corner Table (wooden)
0
1
2
3
4
5
6
7
8
9
10
11
12
Stereo
0
1
2
3
4
5
6
7
8
9
10
11
12
Dehumidifier
0
1
2
3
4
5
6
7
8
9
10
11
12
Stone Carving
0
1
2
3
4
5
6
7
8
9
10
11
12
Desk
0
1
2
3
4
5
6
7
8
9
10
11
12
Stove
0
1
2
3
4
5
6
7
8
9
10
11
12
Desk (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Stripe Bag/ Nylon Bag
0
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
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Dinning Chair
0
1
2
3
4
5
6
7
8
9
10
11
12
Suitcase
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 4 Person (with glass Top)
0
1
2
3
4
5
6
7
8
9
10
11
12
Suitcase (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 4 Person (with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (14"-17”)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 4 Person (Wooden)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (18" to 21")
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 6 Person (with glass Top)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (22"-27")
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 6 Person (with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (28"-30")
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 6 Person (Wooden)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (31"-37")
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 8 Person (with glass Top)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV (40"-47")
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 8 Person (with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (5' length, made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 8 Person (Wooden)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (5' length, with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 12 Person (with glass Top)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (5' length, with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 12 Person (with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (below 5', made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dinning Table for 12 Person (Wooden)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (below 5', with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Display Cabinet
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (below 5', with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Display Cabinet (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (6-7', made of wood)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dressing Table
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (6-7' , with glass)
0
1
2
3
4
5
6
7
8
9
10
11
12
Dryer
0
1
2
3
4
5
6
7
8
9
10
11
12
TV Stand (6-7', with marble)
0
1
2
3
4
5
6
7
8
9
10
11
12
Electric Fan
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (3.5' Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Exercise equipment
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (4' Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
File Cabinet
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (4.5'Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Floor Lamp
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (5' Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Floor Lamp (large size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (5.5' Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Folding Chair
0
1
2
3
4
5
6
7
8
9
10
11
12
Wall-Unit (6' Length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Folding Table
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (2.5' length or below)
0
1
2
3
4
5
6
7
8
9
10
11
12
Fridge (2-Door)
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (3' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Fridge (3-Door)
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (3.5' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Fridge (King Size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (4' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Heater
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (4.5' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Mahjong Table
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (5' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Massage Chair
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (5.5' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Mattress (double Size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Wardrobe (6' length)
0
1
2
3
4
5
6
7
8
9
10
11
12
Mattress (king Size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Washing Machine (metal Body)
0
1
2
3
4
5
6
7
8
9
10
11
12
Mattress (single size)
0
1
2
3
4
5
6
7
8
9
10
11
12
Washing Machine (plastic body)
0
1
2
3
4
5
6
7
8
9
10
11
12
Microwave
0
1
2
3
4
5
6
7
8
9
10
11
12
Water Dispenser
0
1
2
3
4
5
6
7
8
9
10
11
12
Mirror
0
1
2
3
4
5
6
7
8
9
10
11
12
Wine Cabinet
0
1
2
3
4
5
6
7
8
9
10
11
12
Office Chair
0
1
2
3
4
5
6
7
8
9
10
11
12
Others: (any furniture / item doesn't show
in above form)
