Booking – Address Information

Pre Booking Reference Number *

This is the reference number displayed on your quote.

Move Consultant Name *

Does the shipment contain a self propelled vehicle(s)? *

YES

SHIPPER INFORMATION

Full Name of Shipper *

(as it appears on passport)

Origin Address is a.... *

Residence / Business

Storage Facility

Name of Storage Facility *

Origin Street Address *

Origin City *

Origin State *

Origin Zip Code *

Primary E-Mail Address *

(This email MUST be maintained throughout move until delivery of shipment)

Secondary E-Mail Address

(We highly recommend an alternate email address to insure constant communication is maintained)

Origin Phone Number *

(xxx-xxx-xxxx)

Alternate Phone Number

(xxx-xxx-xxxx)

Phone Number of Storage Facility *

(xxx-xxx-xxxx)

Will the above mentioned shipper be present during the pick up? *

Yes

Name of person to be present during pick up *

Phone Number of person to be present at Pick Up *

(xxx-xxx-xxxx)

DESTINATION INFORMATION

Destination Address *

Delivery

Contact (Freind, Relative, Business, etc.)

This option should be used if you do not have a permanent delivery address established at the time of booking or if your move is to port.

If this option is selected, the destination information on your Order for Service will reflect what is stated on your accepted quote.

If your final delivery address, once you have established one, is different from the quoted address, additional charges MAY apply to your move.

Full Name of Consignee

(Person receiving the shipment if different from the shipper)

Destination Street Address *

Destination City *

Destination State / Province

Destination Country *

Destination Phone Number (Include country code) *

We must have clear copies of the following document(s):

For ALL shipments - Passport of Shipper and Consignee (if different from shipper)

For ALL Shipments going to Brazil - Email clear copy of your CPF/CIC/CPNJ card

For ALL Shipments going to Argentina - Email clear copy of your CUIL/CUIT

Booking – Address Information

SHIPPER INFORMATION

DESTINATION INFORMATION

We must have clear copies of the following document(s):

Fax to 786-363-1452 or scan and email to ops@intlmove.com