Moving service B+D Prague Bořivojova 55, 130 00 Prague 3 The Czech Republic Fax: +420/222 717 878 Fill in the form and send it by fax or by post.	Check off one from following eventuality:   Please give me a rate   Making a personal examination   I want to order
Details about moving
Moving from:	Moving to:
Street and number: ...................................................... Floor and lift: ........................................... City, post code: ..................................................... Country: ...................................................................	Street and number: ...................................................... Floor and lift: ........................................... City, post code: ..................................................... Country: ...................................................................
Description of moving equipment (e.g. asign size of apartment,number of offices, value,proportions or weight of freight,and like...)
Check off next required services Dissasembly Assembly Packing material Packing services Removal without transportation Customs clearances
Reputed date of moving.......................................
Here you can write any other informations or any your questions
Contact informations
Name and surname: ................................................. Name of a company: ................................................ Street and number .................................................... City ..........................................................................	Phone, fax .......................................................... E-mail: .............................................................. company ID: (for companies) ................................................. tax ID:(for companies) ..................................................
	...................................... Stamp, signature