Survey Summary
Customer Information
Shipper Name:
Rose Lenore
Email:Email:attorneyrose@gmail.com
Survey Date:
Origin Address:
Destination Address:
Items Inventory
Description
Qnt.
Volume (CFT)
Weight (LBs)
Comment
Room
Sea
Bed, Double Size
2
50
350
Residence
Chest of Drawers
1
25
175
Residence
Cartons, Large
1
4.5
31.5
Bed Support Pillow
Residence
Dry Sink
1
20
130
Residence
Picture
5
15
105
Residence
Mirror
1
3
21
Residence
Table, Dining
1
42
294
Residence
Plastic Container
1
3
19.5
Residence
Trash Can
1
3
21
Residence
Rugs, Large Roll or Pad
1
12
84
Residence
Coffee Table
1
10
70
Residence
Cartons, Small
1
1.5
10.5
Residence
Cartons, Medium
1
3
21
Residence
Rocking Chair
1
18
126
Residence
Artwork
1
3
21
Residence
Lamp, Table
1
3
21
Residence
Painting
2
6
42
Residence
Flat Screen TV Greater than 44"
1
3
21
Residence
Sound Bar
1
3
19.5
Residence
Carton, Dishpack
3
21
147
Residence
Electronics
1
3
19.5
Residence
Carton, Dishpack
1
7
49
Paper-mâché elephant
Residence
Cooler Small
1
3
21
Residence
Lamp, Hanging
1
10
65
Residence
Christmas Decor
1
3
21
Residence
Wall Art
1
3
19.5
Dragonfly
Residence
Mirror
1
3
21
Residence
File Box
2
10
70
Residence
Tote, Medium
3
15
105
Residence
Chair, Folding
1
3
21
Residence
Printer
1
3
21
Residence
Computer
1
3
21
Residence
Total
315
2184
Owner Signature
____________________
Cartons
Box Name
Quantity
1.5 carton
1
3.0 carton
5
4.5 carton
1
6.0 carton
0
Dish packs
1
Mirror cartons
12
TV cartons
1
StandUp Wardrobe
0
Lamp Carton
1
Mattress (single)
0
Mattress (Double)
2
Mattress (Queen)
0
Mattress (King)
0
Flat Wardrobe
0