NAME (* NEED) SSN NUMBER (* NEED) COMMAND BASE (* NEED) EMAIL ADDRESS YOUR REQUEST P/U DATE ADDRESS (*NEED) HOME OR CEL. PHONE NUMBER (* NEED) HSE TYPE SINGLE HSE 2 STORY CONDOMINIUM TOWN HSE APARTMENT KITCHEN DINING TABLE WITH 4 CHAIRS DINING TABLE WITH 6 CHAIRS DINING TABLE WITH 8 CHAIRS CHINA CABINET MICROWAVE CHINA, POTS&PANS(EST # BOX NEEDED?) OTHERS LIVING ROOM COUCH SOFA LOVESEAT WALL UNIT CURIO CABINET GRAND/F CLOCK(Please specify dimension) PAINTING/MIRROR(How many?) COMPUTER DESK STEREO SPEAKER PC PRINTER VCR CD/DVD(How many?) BOOKS(How many?) LLADRO/CAPODIMONTE(How many?) RUG 8 X 10 RUG 10 X 12 RUG 12 X 12 OTHERS BED ROOM KING SIZE BED QUEEN SIZE BED BUNK BED FUTON CHEST DRAWER MATTRESS NIGHT STAND HUTCH FOOT LOCKER DRESSER CLOTHES(EST # BOX NEEDED?) TOY(EST # BOX NEEDED?) OTHERS TV PLAZMA 14-25" TV 26-31" TV 32-49" TV OVER 50" TV(Please specify SIZE) MOTOR CYCLE (Please specify MODEL&MAKER possible dimension) PIANO UP/RIGHT PIANO ELECTRONIC PIANO BABY GRAND PIANO GRAND PIANO CONCERT PIANO GARDEN ITEMS(Please specify items) BACKYARD ITEM(Please specify items) BICYCLE(How many?) OTHERS EXTRA FRAGILE ITEM Please advise Road condition QUESTIONS AND REQUESTS If you want to contact directly TEL : 81-45-212-1266/4839 or mail to : survey@ykij.com