Personal information

    Name (compulsory)

    E-mail (compulsory)

    Tel.

    Fax.

    Where are you moving from?

    Origin address

    Origin city

    Origin country

    Postal code

    Size of the appartment (m2)

    Approximate carrying distance

    Floor from ground level

    Elevator available?

    Moving to destination

    Destination address

    Destination city

    Destination country

    Postal number

    Size of appartment (m2)

    Approximate carrying distance

    Floor from grounf level

    Elevator available?

    Other information

    Removal date

    Insurance

    Additional information

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