Anglo Pacific

SURVEY/QUOTE REQUEST

Please fill in the form below. All fields marked with * are mandatory

Title

Surname *

Forename(s) *

Address *

Telephone home *

Telephone work

Fax home

Fax work

Mobile

Email *

REMOVAL TO:

Country *

Town/city/region *

GOODS FOR REMOVAL:

Full household		Part household		Selected items
Airfreight		Pets

Motor vehicle
(please indicate make/model)

STORAGE REQUIREMENTS:
If applicable please indicate the number of weeks storage required

At origin

At destination

Proposed collection date (if known)

Where did you hear about Anglo Pacific *

Please select Anglo Pacific branch:

Please submit now to arrange a free home survey. Alternatively complete the self assessment form below for a free quotation or list any items with their dimensions in the description table at the end of the form.

SELF ASSESSMENT FORM

RECEPTION ROOMS

Article	Units	Article	Units

Armchair		Bookcase

Books per doz		Butlers tray

Cabinet hi-fi		Cabinet corner

Cabinet china		Cabinet display

Cabinet filing		Carpet fitted

Chair dining		Chair carver

Chair swivel		Chair rocking

Chair recliner		Chair wing

Chair occasional		China place setting

Cutlery canteen		Desk roll top

Desk bureau		Grand father clock

Glasses per doz		Hostess trolley

Magazine rack		Mirror/picture

Pouffee		Piano upright

Piano grand		Piano stool

Rug		Settee 3 str

Settee 2 str		Sideboard

Side lamp/shade		Std lamp/shade

Stereo		Stereo speaker lg

Stereo speaker sm		Table coffee

Table dining		Table gateleg

Table nest of		Table side

Table refectory		TV cabinet

TV stand		TV colour

TV portable		Type writer

Video		Wall unit

Welsh dresser		Wp/printer

HALL/BATHROOMS

Article	Units	Article	Units

Bathroom cabinet		Cloaks cupboad

Hall stand		Hall chair

Hall table		Linen basket

Linen cupboard		Mirror/picture

OUTDOORS/MISCELLANEOUS

Article	Units	Article	Units

Barbeque		Bicycle adult

Bicycle child		Buggy folding

Cabin trunk		Chair folding

Deckchair		Dustbin

Exercise bike		Garden bench

Garden chair		Garden pot sm

Garden pot lg		Garden roller

Garden statue sm		Garden statue lg

Garden table		Garden tool

Golf clubs/buggy		Hose & reel

Ladder extending		Lawn mower

Sewing machine		Step ladder

Suitcase		Sun lounger

Swing/slide		Table folding

Tool box small		Wheel barrow

Work mate

Total volume FT³

KITCHEN/UTILITY

Article	Units	Article	Units

Base unit contents		Chair

Clothes horse		Cooker

Cookery books		Dishwasher

Drawer contents		Electrical appliance

Fridge		Fridge freezer

Freezer U/R Sm		Freezer U/R Lg

Freezer chest		High chair

Ironing board		Microwave

Stool		Table large

Table small		Tumble dryer

Vacuum cleaner		Wall unit contents

Washing machine		Wine rack

Wine per doz

BEDROOMS

Article	Units	Article	Units

Bed bunk		Bed double

Bed king/queen		Bed single

Bedding dbl bed		Bed sng bed

Bedside cabinet		Dressing table

Chest of drawers lg		Chest of drawers sm

Cheval mirror		Child table/chair

Cloths drawer		Clothes 3ft rail

Cot folding		Mirror/picture

Ottoman		Rug

Side chair		Side lamp/shade

Stool		Tall boy

Wardrobe double		Wardrobe single

Wicker chair

Please submit now for a free quotation or list any additional items with their dimensions below.

	Dimensions in inches
Description	Length	Breadth	Height	Quantity

ANY SPECIAL REQUIREMENTS

SELF ASSESSMENT FORM

RECEPTION ROOMS

HALL/BATHROOMS

OUTDOORS/MISCELLANEOUS

KITCHEN/UTILITY

BEDROOMS