Type of Move	:	Select Domestic moving Overseas moving
Date of Moving/Delivery	:	Date:　Month:　Year:
Date of Departure/Arrival (For overseas moving only):	:	Date:　Month:　Year:
Name	:
Current Address	:
Postal code	:
		The room is on thefloor. Elevator:（Yes, there is.　　No, there isn’t.）
Telephone number	:	where you would like to be contacted:
E-mail	:
Type of Current Housing	:	Detached house,　condominium,　corporate housing,　apartment Apartment built by the Japan Housing Corporation,　company condominium,　dormitory
Arrangement of the rooms	:	(2DK etc.)
Number of family members	:	Adult(s) 　　Child(ren)
New address	:
Postal code	:
		The room is on the floor Elevator:（Yes, there is.　　No, there isn’t.）
Your Furniture and Household Belongings	:	(Please state the sizes using large, medium, and small.)