WESTERN RELOCATIONS, INC. - Your Full Service Relocation Specialists.

Cal-T-189570

ICC #MC621

FREE Moving Estimate

Please Note: Quotes are only good for 30 days because final costs may vary depending on situation
and changing fuel costs. This estimate can only be taken as a general indication of
moving cost, it is always best to speak directly with a Western Relocation Moving
Consultant for exact final cost.

Origin Location: *Required Fields

Destination Location:

Moving Date:
*First Name:
*Last Name:
*Address:
Apt#:
*City:
*State:
*Zip Code:
*Home Ph. #:
Work Ph. #:
Email:

First Name:
Last Name:
Address:
Apt#:
City:
State:
Zip Code:
Home Ph. #:
Phone #:
Email:

Please, Input Item Quantity in Boxes below or leave blank if none.

Appliances: (Small, Medium, Large)
Air Conditioner Dish Washer Dryer (Electric or Gas) Heater (Electric or Gas) Range (Electric or Gas)	Refrigerator, 11 cubic ft. or more Refrigerator, 7 to 10 cubic ft. Refrigerator, 6 cubic ft. or less Vacuum Cleaner Washing Machine
Living Area: (Beds, Chairs, etc.)
Buffet Bed, Bunk (set of 2) Bed, Day Bed, Full Bed, King Bed, Queen Bed, Rollaway Bed, Twin Bed, Youth Cabinet, Corner Cabinet, China Cabinet, File Cabinet, Kitchen Cabinet, Utility Chair, Occasional Chair, Rocker Chair, Arm Chair, Child's Chair, Dining Chair, High Chair, Kitchen Chair, Lawn Chair, Overstuffed Chair, Porch Chair, Straight	Desk - Describe size and style below Dresser - Describe size below Chest, Armoire Mirror Painting Piano - Describe size and style below Recliner Rug - Describe size below Sofa, 2 Cushions Sofa, 3 Cushions Sofa, 4 Cushions Sofa, Love Seat Sofa, Sect. per Sect. Sofa, Sleeper Vanity Table, Child's Table, Coffee Table, Dining Table, End Table, Kitchen Table, Night Table, Picnic Table, Small Bookshelves Bookcase
Office & Hi-Tech Equipment: (Computers, TV's, etc.)
Computer Exercise Equipment Lamps or Lighting Stereo System and Speakers VCR or DVD Player	Entertainment Unit Television, 19" - 21" Television, 25" - 27" Television, 29" - 32" Television, 32" and UP
Boxes: (Types and Content)
Box, Medium Box, Book Box, China Box, Large	Box, Letter Box, Linen Box, Wardrobe
Other: (Other Equipments, Bicycle, etc.)
Outdoor Swing Child's Outdoor Gym	Bicycle Lawn Mower

Please, List any additional items and any items needing Special Attention below: