Request to Relocate Name* First Last Email* Enter Email Confirm Email Primary Phone*Alternative PhoneHiddenRelocation Request Cutoff Time : Hours Minutes HiddenCalculated Cutoff TimeHiddenInternal Only Current Date MM slash DD slash YYYY Requested Date to Relocate Machine(s)* MM slash DD slash YYYY ((Mon-Fri only - no weekends. Next-business-day relocation available if order received by 12pm.)Requested Date to Relocate Machine(s)* MM slash DD slash YYYY (Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.) Requested Date to Relocate Machine(s)* MM slash DD slash YYYY (Mon-Fri only - no weekends. Relocation orders placed after 12pm Central Time eligible for second-business-day delivery.) Requested Date to Relocate Machine(s)* MM slash DD slash YYYY (Relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)Requested Date to Relocate Machine(s)* MM slash DD slash YYYY (Relocations Mon-Fri only - no weekends. Relocation orders placed on weekends eligible for second-business-day delivery.)NOTE: Relocations are not done same day; pickup will be first and then delivery will be the following day.Current Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest 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* Reset signature Signature locked. Reset to sign again NameThis field is for validation purposes and should be left unchanged.