Itemized Customer Survey/Inventory

Customer
CYNTHIA JOHNSTON Rockaway Senior Apts, Unit 2C, Rockaway Southampton Phone: 747-6130

Total Estimated Weight:XXToTalWeightYY

Total Estimated Cubic Feet:XXToTalVolumeYY

Total # of Items: XXToTalCountYY

Items Inventory

XXBermudaItemsYY

Carrier Packing & Crating Summary

Carrier Pack

XXBermudaBoxesYY

Item Description

Room

Packing

XXBermudaTotalBoxesYY

Item Description

Cartons #

Pack-CP #

PBO #

Signing below acknoledges receipt an estimate of your move based on the Table of Measurments. Only the items listed are included in the cost. Any items added or additional services may result in additional cost.

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Customer Signature

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Date