Name/s:	*	Reference No.:	*
Removal From:	*	Option No. accepted:	*
		Estimated Cost:	*
Postcode:	*	If we sent you more than one estimated price please ensure that you quote the correct reference no, option number and amount above.
Contact Tel No:	*

House If Flat/apartment please advise Floor: Lift:

Parking:Restricted Meters Permits If any of these apply, please confirm you will obtain dispensation from the appropriate authority

Please arrange my/our removal for UK packing/collection on the following date/s:
Start date:		End date:		*

Please arrange my/our removal for UK packing/collection on the following date/s:
Start date:	N/A	End date:	N/A

Dates to be confirmed

I confirm my final destination is: Country * Delivery to *

Wood Casing Requirements: If we quoted for wood casing please confirm if you require this

Items to be wood cased:Items to be wood cased:

Service: Items to go Air Freight:

Service:

Vehicle for export: Vehicle make & model:

Registration No:

Engine No:

Chassis No:

Removal Emergency & Disruption Cover to cover disruption to your move due to Covid or serious illness:
£150 (sole use container) £75 (groupage / LCL container)

Please arrange Flexible Shipment Protection cover via the SIMPSONS SPECIAL OFFER with NO EXCESS or IPT (tick box )
Valuation Form: Enclosed (tick box ) / Will be forwarded at least 10 days prior to removal date (tick box )
UK storage required prior to shipment: * Period of storage required:
Extend Simpsons transit cover for storage period (tick box )
We require written instructions 7 days prior to storage expiry date to extend the storage period.

I understand that payment must be made prior to removal commencement (unless otherwise agreed in writing by Simpsons)
I wish to pay by Bank Transfer

Final invoice will be sent after removal date by email If you prefer it mailed to UK contact address below please tick

Invoice address (if different from removal address):

Tel: Fax: Email: *

Final invoice will be sent after
removal date by email If you prefer it mailed to UK contact address below please tick
I/We can be contacted at the following UK contact address until our departure date which is (date):
UK CONTACT ADDRESS:
*

Tel: * Fax: Email: *

Bank Transfer Please ensure you include your quote reference number in your remittance
NatWest Bank, Sort Code 51-50-03, Account No 75106167

DESTINATION CONTACT ADDRESS ie if none put the address of FRIEND / RELATIVE / WORK / ETC:
*

Tel: Fax: Email:

All business conducted is subject to the terms and conditions available on our website; these conditions detail your and our rights, obligations and responsibilities. Your attention is particularly drawn to Clauses 4, 7 and 9 to 11 of the contract terms, which set out our liability to you for loss of or damage to goods and property, the time limit for claims, and our policies regarding cancellations.

I/We confirm acceptance of this estimate and have read and understood the conditions of business printed overleaf. I/We agree to ensure full payment is received by Simpsons prior to commencement of removal from the UK address (unless other arrangements have been agreed in writing by Simpsons).

SIGNED: * DATE: *

By signing this form, you are accepting our estimate and agree to be bound by the companies terms and conditions of business.

Please check with our office as most countries require you to be in the destination country when goods arrive at destination, some countries also require a completed Customs Form, Copy of Passport & Copy of Visa.

REMOVAL ACCEPTANCE & BOOKING