First name

Last name

Phone*

E-mail

Postal Code of Pickup Address

Floor of Pickup Address (Ex: Basement / Ground Floor / 1st Floor..)

Postal Code of Drop Off Address

Floor of Pickup Address (Ex: Basement / Ground Floor / 1st Floor..)

Describe the Item(s) to pickup (Ex: 30" Fridge + 20 Boxes + Marble Table...)

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