Contact Information

      NAME
      COMPANY
      PHONE
      FAX
      E-MAIL
      DATE

     Origin

      CITY
      STATE
      COUNTRY
      POSTAL CODE

     Destination

      CITY
      STATE
      COUNTRY
      POSTAL CODE

     Billing Method

      Select Billing Method . . . Individual Corporate

     Service Required

      Select Service Required . . . Door to Door Door to Port Warehouse to Door Warehouse to Port Port to Door Port to Port

     Estimated HHG Weight      

     Note: Average Household Goods Weight is
     Approximately 1,200 Pounds Per Room

      Select HHG Weight . . . 1,000 to 1,999 lbs. 2,000 to 2,999 lbs. 3,000 to 4,999 lbs. 5,000 to 6,999 lbs. 7,000 to 8,999 lbs. 9,000 to 11,999 lbs. 12,000 to 14,999 lbs. 15,000 to 18,000 lbs.

     Storage Requirements

      SIT Rate/Per Month   Warehouse HDLG. Rate

     Temporary Storage Between lbs. and lbs.

     Unaccompanied Air Bagage

      none 250 lbs. 450 lbs. 600 lbs. 800 lbs. 900 lbs. 1000 lbs.

     Automobile

     Year Make Model