Survey Summary
Customer Information
Shipper Name:
selma duran
Email:
Survey Date:
Origin Address:
Destination Address:
Items Inventory
Description
Qnt.
Volume (CFT)
Weight (LBs)
Comment
Room
Sea
Sofa/ Couch, 3 Cushion
1
60
390
---------
Sofa/ Couch, 2 Cushion
1
42
273
---------
Chair, Arm
1
21
136.5
---------
Chair, Dining
6
84
546
---------
Table, Dining
1
42
273
---------
Breakfast Table
1
12
78
---------
Breakfast Suite Chairs
1
6
39
---------
Bookcase
1
24
156
---------
Buffet Cabinet
1
36
234
---------
Table Utility
1
2
13
---------
High Chair
3
36
234
---------
Coffee Table
3
60
390
---------
Bed, Double Size
4
280
1820
---------
Wardrobe, Large
3
189
1228.5
---------
Chest of Drawers
3
105
682.5
---------
Night Table
6
36
234
---------
Chandelier
1
5
32.5
---------
Cartons, Flat Wardrobe
1
9
57
---------
Ironing Board
1
3
19.5
---------
Bicycle, Kids
2
20
130
---------
Painting
2
4
26
---------
Board
2
10
65
---------
Cartons, Large
1
5
32.5
---------
Cartons, Large
30
150
975
---------
Suitcase
8
48
312
---------
Mattress
3
75
487.5
---------
Cartons, Large
2
10
65
---------
Total
1374
8929.5
Owner Signature
____________________
Cartons
Box Name
Quantity
Wrapping
0
Book/Small Box
0
Book/Small Box
33
Medium Box
1
Medium Box
0
Large Box
0
Large Box
0
Flat Box
0
Flat Box
0
Stand Up Box
0
Stand Up Box
0