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CLIENT DETAILS
Name		Date of move
Telephone (H)		Telephone (W)
Telephone (Cell)		Telephone (Fax)
E-mail address
Person responsible for payment:		Company responsible for payment:

WHY AA VAN LINES
Yellow pages	Google	Referral	Used our services before
Other (Please specify)

HOME DETAILS
Moving from:		Moving to:

Easy Access	Yes No	Easy Access	Yes No
How far to carry		How far to carry

OTHER SERVICES
Storage required for a period of
Assist with packing
Supply packaging material
Transit / All risk Insurance required to the value of R
Assist with transport of pets
Assist with transport of vehicle
Assist with dismantling of the following furniture items
All furniture items can fit through doors / security doors (i.e. fridges, etc.)

* All Fields above are compulsory, please specify "none" where non-existing information is requested *

Description	Qty	Description	Qty	Description	Qty	Description	Qty
Lounge
1 Seater		2 Seater		3 Seater		4 Seater
CD Stand		Chair		DSTV Dish		DSTV, DVD, VCR
Hi-Fi		Hi-Fi Speakers (Large)		Hi-Fi Speakers (Small)		Hi-Fi Stand
Lamp (Large)		Lamp (Small)		Organ		Ottoman
Piano: Grand		Piano: Upright		Show Case		Television (TV)
TV: Big Screen		TV: Plasma		Table: Coffee		Table: Side
Television Unit (M)		Wall Unit (1pc)		Wall Unit (2pc)		Wall Unit (3pc)
Dining Room
Cabinet (Large)		Cabinet (Medium)		D/Room Chair		D/Table (10 Seater)
D/Table (8 Seater)		D/Table (6 Seater)		D/Table (4 Seater)		Hostess
Server		Sideboard		Tea Trolley		Welsh Dresser
Entrance Hall
Chair		Clock: Grand		Ent Hall Table		Half Moon Table
Hat Stand		Telephone Table		Washstand
Bedrooms
Bed (Single)		Bed (Double)		Bed (Queen)		Bed (Sleeper Couch)
Chaise Lounge		Chest of Drawers		Cheval Mirror		Clothes Basket
Cot / Compactum		Dress Table (Large)		Dress Table (Medium)		Dumb Valet
Exercise Bicycle		Futon (Double)		Futon (Single)		Gym: All-in-One
Headboard		Health Walker		Kist		Pedestals
Television		Treadmill		Wardrobe (2 Door)		Wardrobe (3 Door)
Kitchen / Appliance
Bar Fridge		Cabinet (S)		Chair		Clothes Airer
Dishwasher		Fans		Freezer		Fridge
Heaters		Ironing Board		Knitting Machine		Microwave Oven
Polisher		Sewing Machine		Stove (Large)		Table
Tumble Dryer		V-Cleaner		Veggie Rack		Washing Machine
Study / Office
Cabinet (2 Draw)		Carpets		Computers		Credenza
Desk (L)		Desk (M)		Desk (S)		Drawing Board
Office Chair		Pillars
Servants Quarters
1 Seater		2 Seater		Bed (Double)		Bed (Single)
Chair		Dress Table		Television		Table
Wardrobe
Garage / Garden
Bicycle		Bin		Bird Cage		Birdbath
Braai - Gas		Braai - Webber		Chair (Stack)		Concrete Bench
Cooler Box		Fishing Rods		Garden Bench		Garden Ornaments
Garden Statues		Garden Table - Wood		Garden Tools		Golf Bag / Cart
Hose Pipe		Kennel (L)		Kennel (M)		Ladder
Lathe / Saw Bench		Lawn Mower		Lounger		Steel Shelves
Suitcase		Table (Plastic)		Toolbox		Trunks
Umbrella		Welder / Compressor		Wheelbarrow		Workbench
Miscellaneous
Bean Bag		Canoe		Children Chair		Children Table
Fish Tank		Jungle Gym		Motor Bike (cc)		Prams
Safes		Sandpit		Snooker Table (1/2)		Snooker Table (1/4)
Snooker Table (FS)		Wendy House		Bar Unit		Bar Stool
Other



Carpets		G/TOPS		Mirrors		Ornaments
Paintings		Pictures

Pot Plant Stands		Pot Plants (L)		Pot Plants (M)		Pot Plants (S)

Crockery Cartons		Linen Cartons		Wardrobe Cartons		General Cartons

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