Self Survey by X4apL3

VIEWS: 9 PAGES: 4

									Premier Packing                                              Self-Survey Form
Services Limited


Please complete all of our questions in order for us to assist you.


     Personal effects belonging to


     Person/Company paying for move


     Required PACKING date(s)


     Required DELIVERY date(s)

     Collection address(es) House/Flat – Please state Floor
                    st nd rd
     No if Flat ie 1 2 3



     Delivery address(es) House/Flat – Please state Floor
                    st nd rd
     No if Flat ie 1 2 3



     Please advise any parking restrictions at both origin
     and destination address (e.g. resident’s permits, zig
     zag lines, red route, etc.)



     Origin


     Destination


     Home telephone


     Work telephone


     Mobile telephone


     Email

     Any dimensions are given in:
     CM / INCHES (Please specify)



                                                                                              1
                                  297 North Anderson Drive, Aberdeen AB16 7GT
                     Telephone: +44 1224 697682 Fax: 08701410353 Email: info@prempack.co.uk
Premier Packing                                             Self-Survey Form
Services Limited

    Any items which could be difficult to move (e.g. due to
    size, weight or nature of residence)




    Please advise of any items of a particularly delicate
    nature which may require special attention (e.g.
    unusual ornaments, musical instruments without hard
    cases, etc.)


    Other relevant information




   Service Required:

   Sea Door to Door                             Door to Port      Storage Required     Yes  No
   Air Door to Door                             Door to Airport         Store Until (insert date below)

   Euro Road Door to Door                                                   

   Shipment:

        Packed by Owner (PBO)
        Box No                Weight                                  Dimensions




                                297 North Anderson Drive, Aberdeen AB16 7GT                                   2
                   Telephone: +44 1224 697682 Fax: 08701410353 Email: info@prempack.co.uk
Premier Packing                                    Self-Survey Form
Services Limited

Please list below the contents to be sent.

         ROOM / ITEM                         QUANTITY      COMMENT
         LOUNGE                                            *Advise size
         Stereo system*                      1             121212
         Stereo speakers / stands*
         Picture*
         Mirror*
         Ornament
         Books
         Fragile items
         CD’s / tapes
         TV / VCR
         Video tapes
         Rugs
         HALL                                              *Advise size
         Picture*
         Coats
         Shoes
         Mirror*
         Rugs
         KITCHEN                                           *Advise size
         Utensils
         Pots and pans
         Linen
         Foodstuff / tins / spices
         Microwave oven
         Cook Books
         Crockery
         Glassware
         Tupperware
         Bakeware
         Coffee pot
         Iron / Board
         Kettle / Toaster
         Blender
         DINING ROOM                                       *Advise size
         Pictures / Mirrors*
         Dinner service
         Ornaments
         Candles
         Wine glasses
         GARDEN                                            *Advise size/ Give type e.g. adult/child
         Garden tools
         Bicycle*
         Plant pots
         Barbecue*
         Garden toys
         Climbing frames*
         Benches

                                297 North Anderson Drive, Aberdeen AB16 7GT                           3
                   Telephone: +44 1224 697682 Fax: 08701410353 Email: info@prempack.co.uk
Premier Packing                                       Self-Survey Form
Services Limited

          ROOM / ITEM                             QUANTITY      COMMENT
          Umbrella
          Tables / Chairs
          BASEMENT/LOFT/ATTIC
          (please remove these items before our
          men arrive)
          Christmas decorations
          Empty Boxes (ie stereo/tv)
          BATHROOM
          Scales
          Toiletries
          Towels
          Bath toys
          BEDROOM
          Pillows
          Bed linen
          Books
          Clock/alarm
          Photos/frames
          Ornaments
          Clothes
          Shoes
          Leisure wear
          Sports Equipment
          Accessories (bags/hats)
          CAR
          Child Seat
          Tool kit
          First Aid Kit
          ANCILLARY ITEMS                                       Please advise approximate sizes where
                                                                possible




Payment Method: (Non payment of consignment may lead to storage charges being incurred)
Cheque                      Cash                       Bank Transfer          
Signed:                                                      Name:
Date:
                                 297 North Anderson Drive, Aberdeen AB16 7GT                            4
                    Telephone: +44 1224 697682 Fax: 08701410353 Email: info@prempack.co.uk

								
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