FLITT Booking Request form Please fill out the form below. Item/Equipment Move Request FormCustomer Name First Last Customer Mobile NumberBusiness Name, if applicablteEmail Date Time Hours : Minutes AM PM AM/PM 2. Pick-Up DetailsPickup Address Street Address Suburb City State / Province / Region ZIP / Postal Code Contact Person at Pick-Up First Last Contact MobileProperty Type(Required) House Unit/Apartment Townhouse Office Warehouse Retail Store Other Please specify3. Pick-Up AccessPick-Up Access Ground Level Stairs Lift Access Loading Dock Driveway Access Street Parking only Tight access / difficult access Distance from parking area/loading area Less than 10m 10-25m 25-50m More than 50m Other Please specifyAre there any access restrictions?Example: height limits, narrow driveway, security gate, apartment complex, mine site, warehouse rules, inner city4. Delivery DetailsContact Person at Delivery First Last Contact MobileDelivery Address Street Address Suburb City State / Province / Region ZIP / Postal Code Delivery Access Ground Level Stairs Lift Access Loading Dock Driveway Access Street Parking only Tight access / difficult access Distance from parking area/loading area Less than 10m 10-25m 25-50m More than 50m Other Please specifyAre there any access restrictions?Example: height limits, narrow driveway, security gate, apartment complex, mine site, warehouse rules, inner city5. Details: Items/Equipment to be MovedItem / Equipment QuantityApprox DimensionsApprox Weight if knownEstimated replacement valuePhotos attached Yes No Upload PhotoMax. file size: 128 MB. Customer must provide clear photos of all items being moved. Additional photos may be requested showing access points, stairs, lifts, driveways and loading areas.6. Type of Move RequiredType of Move Required Single item move Furniture move Whitegoods Office Equipment Tools/Trade Equipment Commercial Equipment House Relocation Two-person lift required Full House Relocation Partial House Relocation Office Relocation Retail/Commercial Relocation Warehouse Relocation No. of bedroomsNo. of living areasGarage Included Yes No Outdoor Furniture Included Yes No Storage Shed Included Yes No PalletsMachinery or Heavy EquipmentCommercial/Industrial Equipment InformationForklift Available at Pickup Yes No Forklift Available at Delivery Yes No Pallet Quantity:Heaviest Item Weight:Loading Dock Available Yes No 7. Vehicle RequiredVehicle Required Ute Van Small Truck Truck with tail lift Trailer Prime mover Low loader Unsure - Flitt to assess 8. Handling RequirementsAdd any extra notesHandling Requirements Heavy lift Standard loading and unloading Two-person lift Trolley required Furniture blankets required Packing required Unpacking required Appliance Disconnect Required Appliance Reconnect Required Furniture Assembly Required Furniture Disassembly Required Fragile Handling Stairs Carry Assembly/Disassembly required Crane Forklift Other Please specify9. Special InstructionsPlease list anything the driver needs to know before arrival. Examples: parking, gates, contact person, fragile items, access issues, stairs, pets, time restrictions, commercial site rules. Notes10. Dangerous/Prohibited Goods DeclarationThe customer confirms the goods do not include prohibited, illegal, dangerous, hazardous, explosive, flammable, toxic, contaminated, or restricted goods unless specifically disclosed and accepted by FLITT in writing. FLITT may refuse to move any item considered unsafe, unlawful, incorrectly described, overweight, unstable, unsuitable for the vehicle, or not able to be safely loaded, restrained, transported, or unloaded. Are any goods hazardous or restricted? Yes - provide details No Please specify11. Customer DeclarationConsent I confirm that the information provided is accurate and complete. I understand that additional charges may apply if the move differs from the information provided, including extra items, difficult access, waiting time, stairs, additional labour, heavier items, or delays outside the driver’s control. Quotes are based on the information supplied by the customer and are valid for 14 days unless otherwise stated.Customer Name First Last Date SignatureYour NameYour NameYour NameYour Name