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Request to Relocate

Request to Relocate
Metro Market*
- Dallas
- Houston
Contact Information*
First Last
Email*
Enter Email Confirm Email
Primary Phone*
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

MM slash DD slash YYYY
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
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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 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 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 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*
Email
This field is for validation purposes and should be left unchanged.

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1920 Diplomat Drive
Farmers Branch, TX 75234

Houston:

10803 Vinecrest Drive
Suite 190
Houston, TX 77086

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