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Request to Relocate
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Contact Information
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Last
Email
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Primary Phone
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Alternative Phone
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Relocation Request Cutoff Time
:
Hours
Minutes
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Calculated Cutoff Time
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Internal Only Current Date
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Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Dallas-area relocations Mon-Fri only - no weekends. Relocation requests require 7 day advance notice.)1
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Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Dallas-area relocations Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.) 2
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Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Dallas-area relocations Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.) 3
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Dallas-area relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)4
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Dallas-area relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)5
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Houston-area relocations Mon-Fri only - no weekends. Relocation requests require 7 day advance notice.)a
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Houston-area relocations Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.)b
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Houston-area relocations Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.)c
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Houston-area relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)d
Hidden
Requested Date to Relocate Machine(s)
*
MM slash DD slash YYYY
(Houston-area relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)e
NOTE: Relocations are not done same day; pickup will be first and then delivery will be the following day.
Address Information
Current Address (where the appliance is currently located)
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Indiana
Iowa
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Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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North Carolina
North Dakota
Northern Mariana Islands
Ohio
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Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
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Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip/ Postal Code
Current Property Name
*
Gate Code
*Enter 0000 if there is no gate code.
New Address (where you'd like the appliance to be moved to)
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip/ Postal Code
New Property Name
*
Relocation Details
Written Permission to Enter
*
I will leave Written Permission to Enter with the Apartment Leasing Office
I will be present at the time of the move
Pet Containment
*
All pets (if any) will be contained
Special Instructions
I would like a 1-hour call ahead
Is your unit located above floor/ground level?
*
Yes
No
Does your unit have access to an elevator?
*
Yes
No
Additional Comments regarding parking or gate entry?
Please read and the Conditions below and check to indicate your agreement.
Service Charge
*
I understand there will be a Service Charge of $35.00 to relocate the equipment
Dry-Run Fee
*
I understand I will be charged a 'dry-run' fee of $35.00 if the driver is unable to gain access
Signature
*
Comments
This field is for validation purposes and should be left unchanged.
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