Mind At Peace Moving – Service Order & Agreement

MIND AT PEACE MOVING SERVICE ORDER & AGREEMENT

Official form for scheduling and billing moving services, including customer contact details, addresses, labor rates, packing material usage, and payment authorization.

Customer Name *

First

Last

Customer Email *

Customer Phone *

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

New Address

Address Line 1

Address Line 2

City

State

Zip Code

Second Address (Destination)

Address Line 1

Address Line 2

City

State

Zip Code

MOVE LOGISTICS

Move Date & Time

Date

Time

Notes

RATES & LABOR

Hourly Rate *

Men and Truck # *

Minimum Hours

Minimum Box Quantity

PACKING MATERIALS

Small Box Quantity

Wardrobe Box Quantity

Box Count Starting #

Medium Box Quantity

Bubble Wrap Quantity

Box Count Ending #

DESCRIPTION OF CHARGES

Long Distance Fee

Arrival Fee

Total Balance Due

PAYMENT & AUTHORIZATION

Payment Method *

Cash
Check
Credit / Debit Card

Check #

AUTHORIZATION

Client Signature *

Clear Signature

Client Signature Date *