FLITT Home & Office request form Please fill out the form below. Flitt Home & Office Request Form Everyday pickups, deliveries, clear-outs and moves Use this form for everyday jobs that need a ute, van, trailer or truck—from one item that will not fit in your car through to a complete home or office move. 1. Customer DetailsCustomer Type(Required) Individual Business Name or Company(Required)Contact Person(Required)Mobile(Required)Email(Required) 1. What can we hlelp you with?Choose one or more(Required) Store / retail pickup Furniture delivery Hardware / building supplies Donation drop-off Household clear-out Storage unit-move Partial home move Apartment move Packing / unpacking Marketplace TV or appliance delivery Boxes or personal belongings Tip / dump run Garden-waste run Single-room move Full home move Office move Furniture assembly Others Please specifyDate Time Hours : Minutes AM PM AM/PM Date Flexibility(Required) Fixed Flexible by ______ days Indicate how many daysPeople required(Required) 1 person 2 people Unsure 3. Pickup detailsAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Site contact / mobile(Required)Property type(Required) House Apartment Office Retail Storage Other Please specify:Level / FloorStairs(Required) None Yes - number of flights Number of flights:Lift(Required) Not required Available Booking required Parking to doorApprox. distance: ______ metresAccess restrictions(Required)Height limits, narrow driveway, gates, loading zone, building rules 4. Delivery / drop-off detailsAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Site contact / mobile(Required)Property type(Required) House Apartment Office Retail Storage Other Please specify:Level / FloorStairs(Required) None Yes - number of flights Number of flights:Lift(Required) Not required Available Booking required Parking to doorApprox. distance: ______ metresAccess restrictions(Required)Height limits, narrow driveway, gates, loading zone, building rules 5. Items and scopeList the main items or rooms. Attach an inventory for larger moves.Item/roomQtyApprox. sizeApprox. weightSpecial Notes Add RemoveChoose one Photos attached Floor plan attached Inventory attached More information to follow Describe the move, including anything that must be dismantled, packed, protected, assembled or positioned:6. Heavy, fragile or special itemsChoose from the below(Required) Piano Pool table Large fridge Artwork / antiques Fragile electronics Stone / marble item Aquarium Item over 100 kg None Other: OtherProvide dimensions, estimated weight and handling details for special items:7. Clear-out, tip or donation jobsComplete this section only for rubbish removal, clear-outs, garden waste or donation drop-offs. Chose from the options below(Required) General household items Whitegoods / appliances Green / garden waste Donation-quality items Furniture Cardboard / packaging Scrap metal Mixed load Other: Please specify:Approximate load to size(Required) A few items Ute load Trailer load Van load Multiple loads Unsure Approximate load to size(Required) Yes No - removal from property required Disposal preference(Required) No asbestos, chemicals, fuel, gas cylinders, medical waste or other hazardous material Disposal charges(Required) I understand tip, disposal or facility fees may be added where applicable Describe the material and anything especially heavy, sharp, dirty or difficult to access:8. Additional requirementsChoose from the options below Packing materials Unpacking service Reassembly Rubbish / packaging removal Packing service Dismantling Temporary storage After-hours service Other Please specify:Anything else the team needs to know before arrival?Customer declarationTick the box I agree to Flitt’s applicable service termsI confirm the declaration I confirm the information supplied is accurate and complete. I understand that the quote and service plan will be based on this information, and that additional charges or a revised service may apply if the goods, access, timing, labour, equipment or site requirements differ. I authorise Flitt to share relevant job information with suitable transport providers and service partners for quoting, planning and completing the service. For clear-out or disposal jobs, I confirm that I have identified the materials honestly and have not included asbestos, chemicals, fuel, gas cylinders, medical waste or other hazardous or prohibited material unless Flitt has expressly agreed in writing.Name(Required) First Last Date(Required) Signature(Required)Your NameYour NameYour NameYour Name
