Request to Relocate Name* First Last Email* Enter Email Confirm Email Primary Phone*Alternative PhoneDate to Relocate Machine(s)* MM slash DD slash YYYY (Relocations scheduled Monday - Friday only)Current Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip/ Postal Code (Where the machine(s) are currently located.)Current Property Name* New Address* Street Address Address Line 2 City County / State / Region ZIP / Postal Code New Property Name* 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 $30.00 to relocate the equipment* Dry-Run Fee* I understand I will be charged a 'dry-run' fee of $25.00 if the driver is unable to gain access* Signature*PhoneThis field is for validation purposes and should be left unchanged.