Survey Summary
Customer Information
Shipper Name:
HEGELE/STOLL
Survey Date:
Origin Address:
Destination Address:
Items Inventory
Description
Qnt.
Volume (CFT)
Weight (LBs)
Comment
Room
Sea
Table, Dining
1
42
273
---------
Chair, Dining
6
84
546
---------
Sofa/ Couch, Sectional, Per Section
2
72
468
---------
Coffe table
1
12
78
---------
TV Cabinet
1
32
208
---------
Washing Machine
1
25
162.5
Not seen
---------
Rugs, Small Roll or Pad
1
4
26
---------
Armoire
1
48
312
---------
Cabinet
1
36
234
---------
Plastic Box
10
30
195
Approx qty
---------
Bicycle
3
51
331.5
---------
Computer table
3
42
273
Saw only 1
---------
Kitchenware
5
17.5
115
Not seen
---------
Total
495.5
3221.5
Owner Signature
____________________
Cartons
Box Name
Quantity
Book/Small Box
0
Medium Box
5
Large Box
0
Flat Box
0
Stand Up Box
0